BMJ  2007;334:811-812 (21 April), doi:10.1136/bmj.39175.458275.BE

Editorials

Regulation of opioid prescribing

Over-regulation compromises doctors' ability to treat pain

The first 150 words of the full text of this article appear below.

Long before the discovery of endogenous opioid systems, opium was used to produce insensibility and relieve pain. Societies began regulating opiates when the availability and use of opiate drugs reached a level that made opiate addiction a problem to society. In the United Kingdom and the United States this was at the beginning of the 20th century, with the Drug Enforcement Act in the UK (1920) and the Harrison Act in the US (1918). Before regulations, opiates were widely available in chemist shops, doctors' surgeries, and opium dens, and the choice of use was entirely up to the individual, with the risk of addiction being understood. None the less, a stigma was attached to the use of opiates, even therapeutically, but nothing like that seen after regulations made the use of opiates, other than by prescription, a criminal offence. Once these regulations were introduced, a hugely profitable illicit trade in . . . [Full text of this article]

Jane C Ballantyne, chief, division of pain medicine

Pain Center, Massachusetts General Hospital, MA 02114, USA

jballantyne@partners.org


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