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CANHR urges U.S. Senate to Maintain Protections Against Controlled Substances in Nursing Homes


On March 24, 2010, the U.S. Senate Special Committee on Aging held a hearing with the inflammatory title, "The War on Drugs Meets the War on Pain: Nursing Home Residents Caught in the Crossfire." At issue is the Drug Enforcement Administration's recent enforcement of long-standing rules under the Controlled Substances Act, which require that physicians initiate prescriptions of controlled substances for nursing home residents. The nursing home and long-term care pharmacy industries are seeking exemptions from these requirements, claiming that residents are being denied timely access to pain medications.

The Center for Medicare Advocacy and CANHR submitted a statement to the Committee opposing this proposal, pointing out that it would further diminish the role of physicians in nursing home care. Rather than allowing physicians to rubber-stamp orders for narcotic pain medications by phone, Congress should push for enforcement of the current requirement that nursing homes have physicians available 24 hours per day to provide emergency care for residents.

The real medication issue that the Committee and Congress should be addressing is the epidemic misuse of antipsychotic drugs by nursing homes to chemically restrain residents. Almost five years ago, the Food and Drug Administration issued its first "black box" warning against the use of antipsychotic drugs for persons who have dementia, cautioning that the drugs substantially increase their risk of death. Yet the federal government reports that more than 350,000 nursing home residents, most of whom have dementia, are receiving antipsychotic drugs. An FDA official testified in 2007 that 15,000 nursing home residents a year die from the off-label use of antipsychotic drugs.


Statement by the Center for Medicare Advocacy and CANHR to the Senate Special Committee on Aging.