Bill to Ease Access to Drugs for Pain Gains

A bill that would make highly restricted narcotics more available to patients with severe and intractable pain appeared headed toward approval Tuesday in the Assembly.

Supporters of the bill (SB 402) said it offered help and comfort to patients who in some cases have given up hope and considered suicide.

The bill, approved earlier by the Senate, received a unanimous vote on a preliminary roll call of the Assembly Health Committee, but a final vote was delayed so more members could be recorded.

Forest Tennant, a West Covina physician, said enactment of the bill amid the current national “right-to-die” debate would show that California would rather “take care of the sick, the suffering and the dying than go the suicide route.”

The bill, sponsored by Tennant and backed by the California Medical Assn., would require doctors to advise patients who suffer from “severe, chronic [and] intractable” pain that powerful narcotics are legally available that could grant them relief.

Before the hearing, Tennant and Sen. Leroy Greene (D-Carmichael), the bill’s author, told a news conference that many physicians refuse to prescribe these legal medications for patients who suffer from seemingly untreatable pain. Included are such potent painkillers as Percodan, Demerol and Dilaudid, whose use is closely monitored by the state Medical Board and the Bureau of Narcotics Enforcement.

Doctors may refuse to prescribe these drugs in the large quantities needed for severe pain relief because they fear prosecution from state authorities for overprescribing a controlled substance, Greene said. Additionally, many doctors are philosophically opposed to narcotics because they can create dependency, Tennant said.

Tennant and Harvey Rose, a Sacramento physician, said physicians also fear being sued for medical malpractice by patients who misuse the drugs.

But Greene said a law mandating that physicians inform their patients that such painkillers are available as an option would break down the doctors’ resistance. The bill provides that while a patient’s physician would not be required to approve the drug treatment, the patient could seek out a doctor who would.

Under the proposed “Pain Patient’s Bill of Rights,” unlimited quantities of the narcotic medications could be prescribed within the discretionary bounds of “good medicine.”

Although no witness spoke in opposition to the bill Tuesday, critics have argued that options to expanded access to narcotics are available. These include surgery, implantation in the body of devices such as morphine pumps, and nonsurgical procedures.

They also have argued that expanded access to the use of narcotics will make patients dependent on these medications and create new drug addicts.

But Greene asserted that some forms of dependency are good for everybody--such as relying on wristwatches for time or eyeglasses for vision.

“Dependency is a matter to be desired if you are in endless pain,” Greene said. Making narcotics more accessible would enable people immobilized by pain to achieve a higher quality of life and return to their jobs, he said.