Hydromorphone: Legal consequences

Last modified: Sunday, 31. May 2009 - 4:23 pm

Legal consequences of Hydromorphone

Researchers long ago found an association between narcotics addiction and increased levels of crime. Significant numbers of prisoners incarcerated in the United States have been imprisoned because of crimes involving drugs and drug abuse. A report by a conference at the National Institutes of Health found that more than one-fourth of all prisoners at all state and federal prisons were convicted of drug-related crimes.
Researchers have found strong associations between opiate addiction and theft. Opiate addicts steal to obtain greater amounts and quality of drug. The goal of many researchers and drug treatment programs is to not only to treat the opiate addiction problem of the individual but also to reduce the amount of theft and other crimes associated with this problem.

Legal history

Until 1914, it was legal to put opiates into patent medicines, for example, that were sold over-the-counter. A 1914 law was the first to regulate the sale and distribution of controlled substances. At the time, this law was not enacted to benefit public health, but rather to generate tax revenue.

Federal guidelines, regulations, and penalties

Hydromorphone is classified as a Schedule II controlled substance under the Controlled Substances Act (CSA) of 1970. This act of the United States Congress placed enforcement of the CSA on the shoulders of the Drug Enforcement Administration (DEA). The CSA was created as a means to regulate the distribution and use of prescription drugs that are highly addictive, such as codeine, oxycodone, morphine, and hydromorphone. The CSA was not enacted to limit or disrupt the practice of medicine and the legitimate use of narcotic analgesics in patients with significant pain.
Under the CSA, a Schedule II drug is one that has a high potential for abuse and whose use may lead to significant psychological or physical dependence. Prescriptions for these drugs must be typewritten or written in ink and signed by the practitioner, or verbal prescriptions must be confirmed in writing within 72 hours and may be given only in a genuine emergency. No renewals are allowed without a new prescription.
Despite the significant power bestowed by Congress on the DEA to enforce the CSA, the actual power of the DEA to regulate and control physician practice is not unlimited. This provision allows physicians some leeway when treating terminal cancer patients with intractable pain, for instance. Such patients often receive significant amounts of opioids, and this could raise the eyebrows of the DEA. All physicians who prescribe drugs classified under the CSA are registered with the DEA for monitoring reasons. Likewise, other components of the health care system, such as hospitals and pharmacies, must also register with the DEA. All of the individuals and entities that dispense drugs covered under the CSA receive a number issued by the DEA. This number can be tracked every time one of these controlled substances is prescribed. All of these entities must also keep very accurate records that document all of the information associated with the prescription.
The primary aim of the CSA and the DEA’s implementation of the law is to find those physicians who are prescribing opioids and other controlled substances for nonmedical purposes. All of the entities included in the chain of the production and distribution of the controlled substance are carefully watched by the DEA for signs of irregularities. Violators of the CSA can be charged with a felony and are subject to fines and imprisonment.
In addition to federal laws enforced by the DEA, many states have supplemental laws that cover controlled substances. These state laws have even more detailed guidelines on dosage limits and the total number of pills that can be prescribed. One of the oddities present in the CSA and the DEA guidelines is that there are no limitations on the amount of drug prescribed at one time or on the length of treatment for the patient. This is surprising because the guidelines for dispensing Schedule II drugs are so precise in some areas, such as the inability to renew prescriptions. The laws generated by some states attempt to eliminate some of the loopholes created by the CSA and the DEA guidelines.

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