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Moline M, Asakura S, Beuckman C, Landry I, Setnik B, Ashworth J, Henningfield JE. The abuse potential of lemborexant, a dual orexin receptor antagonist, according to the 8 factors of the Controlled Substances Act. Psychopharmacology (Berl) 2023; 240:699-711. [PMID: 36749354 PMCID: PMC10006052 DOI: 10.1007/s00213-023-06320-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 01/17/2023] [Indexed: 02/08/2023]
Abstract
RATIONALE Lemborexant (LEM) is a dual orexin receptor antagonist (DORA) approved in multiple countries including the USA, Japan, Canada, Australia, and several Asian countries for the treatment of insomnia in adults. As a compound with central nervous system activity, it is important to understand the abuse potential of LEM with respect to public health. OBJECTIVES This review discusses data for LEM relevant to each of the 8 factors of the United States Controlled Substances Act. RESULTS LEM did not demonstrate abuse potential in nonclinical testing and was associated with a low incidence of abuse-related adverse events in clinical study participants with insomnia disorder. Similar to other DORAs that have been evaluated (eg., almorexant, suvorexant (SUV), and daridorexant), LEM and the positive controls (zolpidem and SUV) also showed drug liking in a phase 1 abuse potential study that enrolled subjects who used sedatives recreationally. However, internet surveillance of SUV and the FDA Adverse Events Reporting System suggests that drugs in the DORA class display very low abuse-related risks in the community. Additionally, as described in FDA-approved labeling, it does not carry physical dependence and withdrawal risks. CONCLUSIONS LEM, similar to most other prescription insomnia medications, was placed into Schedule IV. However, LEM and other drugs in the DORA class may have a lower potential for abuse as suggested by real-world postmarketing data from federal surveys and internet surveillance, and thus may have lower risks to public health than Schedule IV benzodiazepines and nonbenzodiazepine hypnotics that potentiate GABA signaling.
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Affiliation(s)
- Margaret Moline
- Eisai Inc., 200 Metro Boulevard, Nutley, Jersey, NJ, 07110, USA.
| | | | | | | | - Beatrice Setnik
- Altasciences, Laval, Quebec, Canada and the Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | | | - Jack E Henningfield
- Pinney Associates, Inc., Bethesda, MD, USA.,The Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Rothstein MA, Dyche ME, Irzyk J. Doctors and Pain Patients Avoid "Ruan" in the Supreme Court. J Law Med Ethics 2022; 50:841-847. [PMID: 36883411 DOI: 10.1017/jme.2023.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Physicians' fear of criminal prosecution for prescribing opioid analgesics is a major reason why many chronic pain patients are having an increasingly difficult time obtaining medically appropriate pain relief. In Ruan v. United States, 142 S. Ct. 2370 (2022), the Supreme Court unanimously vacated two federal convictions under the Controlled Substances Act. The Court held that the government must prove that the defendant knowingly or intentionally acted in an unauthorized manner.
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Affiliation(s)
- Mark A Rothstein
- LOUIS D. BRANDEIS SCHOOL OF LAW, THE UNIVERSITY OF LOUISVILLE, LOUISVILLE, KY, USA
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Weedn VW, Elizabeth Zaney M, McCord B, Lurie I, Baker A. Fentanyl-related substance scheduling as an effective drug control strategy. J Forensic Sci 2021; 66:1186-1200. [PMID: 33951192 PMCID: PMC8360110 DOI: 10.1111/1556-4029.14712] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/04/2021] [Accepted: 03/08/2021] [Indexed: 11/27/2022]
Abstract
Fentanyl is now the primary driver of the current opioid crisis. Fentanyl and its analogues are subject to the Controlled Substances Act of 1970, the Controlled Substances Analogue Enforcement Act of 1986 (Federal Analogue Act), state laws, international treaties, and the laws of foreign countries. The appearance of novel psychoactive substances led to further legislative developments in scheduling. New fentanyl analogues proliferated in a manner previously unseen since about 2016. Overdose deaths of these fentanyl analogues prompted the Drug Enforcement Administration to reactively emergency schedule each new fentanyl analogue as it appeared. The international community also acted. Finally, on February 6, 2018, a proactive temporary (emergency) class-wide scheduling of fentanyl-related substances was implemented based upon the fentanyl core structure to save lives. This action spurred a similar action in China. Fentanyl analogues fell dramatically in the marketplace, despite further increases in fentanyl itself. Congress temporarily extended this scheduling, but it will soon expire. Opposition to permanent class-wide was lodged due to concerns over law enforcement overreach, inadequate Health and Human Services input, and hindrance of research. This paper reaffirms the importance of a class-based scheduling strategy while also arguing for increased research of schedule I controlled substances.
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Affiliation(s)
- Victor W Weedn
- Department of Forensic Sciences, George Washington University, Washington, DC, USA
| | | | - Bruce McCord
- Department of Chemistry and Biochemistry, Florida International University, Miami, FL, USA
| | - Ira Lurie
- Department of Forensic Sciences, George Washington University, Washington, DC, USA
| | - Andrew Baker
- Hennepin County Medical Examiner's Office, Minneapolis, MN, USA
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Del Pozo B, Beletsky L. No "back to normal" after COVID-19 for our failed drug policies. Int J Drug Policy 2020; 83:102901. [PMID: 32807624 DOI: 10.1016/j.drugpo.2020.102901] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/25/2020] [Accepted: 07/31/2020] [Indexed: 01/03/2023]
Abstract
Before COVID-19 pandemic, advocates had long urged drug policy reforms based on health, security, civil rights, racial justice, fiscal stewardship, and other considerations. In the United States, such calls went largely unanswered. In response to COVID-19, public health and occupational safety concerns have rapidly transformed some drug policies, along with their enforcement. Almost contemporaneously, nationwide protests against violence and racism by militarized police have highlighted the enduring legacy of the Drug War in fueling carceral systems. Disruption from these historical events provides a once-in-a-century opportunity to reconsider the legal architecture of drug policy and policing–both in the U.S. and elsewhere. Rather than returning to a fundamentally broken and inequitable status quo, we urge envisioning a new drug policy in service to life, liberty, and the pursuit of happiness.
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Johnson MW, Griffiths RR, Hendricks PS, Henningfield JE. The abuse potential of medical psilocybin according to the 8 factors of the Controlled Substances Act. Neuropharmacology 2018; 142:143-166. [PMID: 29753748 PMCID: PMC6791528 DOI: 10.1016/j.neuropharm.2018.05.012] [Citation(s) in RCA: 151] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 04/22/2018] [Accepted: 05/09/2018] [Indexed: 01/09/2023]
Abstract
This review assesses the abuse potential of medically-administered psilocybin, following the structure of the 8 factors of the US Controlled Substances Act (CSA). Research suggests the potential safety and efficacy of psilocybin in treating cancer-related psychiatric distress and substance use disorders, setting the occasion for this review. A more extensive assessment of abuse potential according to an 8-factor analysis would eventually be required to guide appropriate schedule placement. Psilocybin, like other 5-HT2A agonist classic psychedelics, has limited reinforcing effects, supporting marginal, transient non-human self-administration. Nonetheless, mushrooms with variable psilocybin content are used illicitly, with a few lifetime use occasions being normative among users. Potential harms include dangerous behavior in unprepared, unsupervised users, and exacerbation of mental illness in those with or predisposed to psychotic disorders. However, scope of use and associated harms are low compared to prototypical abused drugs, and the medical model addresses these concerns with dose control, patient screening, preparation and follow-up, and session supervision in a medical facility. CONCLUSIONS: (1) psilocybin has an abuse potential appropriate for CSA scheduling if approved as medicine; (2) psilocybin can provide therapeutic benefits that may support the development of an approvable New Drug Application (NDA) but further studies are required which this review describes; (3) adverse effects of medical psilocybin are manageable when administered according to risk management approaches; and (4) although further study is required, this review suggests that placement in Schedule IV may be appropriate if a psilocybin-containing medicine is approved. This article is part of the Special Issue entitled 'Psychedelics: New Doors, Altered Perceptions'.
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Affiliation(s)
- Matthew W Johnson
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Roland R Griffiths
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Neuroscience, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Peter S Hendricks
- Department of Health Behavior, School of Public Health, University of Alabama, Birmingham, AL, USA.
| | - Jack E Henningfield
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Pinney Associates, Bethesda, MD 20814, USA.
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Henningfield JE, Fant RV, Wang DW. The abuse potential of kratom according the 8 factors of the controlled substances act: implications for regulation and research. Psychopharmacology (Berl) 2018; 235:573-89. [PMID: 29273821 DOI: 10.1007/s00213-017-4813-4] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 12/06/2017] [Indexed: 02/08/2023]
Abstract
RATIONALE Consideration by the US Drug Enforcement Administration and Food and Drug Administration of placing kratom into Schedule I of the Controlled Substances Act (CSA) requires its evaluation of abuse potential in the context of public health. OBJECTIVE The objective of the study is to provide a review of kratom abuse potential and its evaluation according to the 8 factors of the CSA. RESULTS Kratom leaves and extracts have been used for centuries in Southeast Asia and elsewhere to manage pain and other disorders and, by mid-twentieth century, to manage opioid withdrawal. Kratom has some opioid effects but low respiratory depression and abuse potential compared to opioids of abuse. This appears due to its non-opioid-derived and resembling molecular structure recently referred to as biased agonists. By the early 2000s, kratom was increasingly used in the US as a natural remedy to improve mood and quality of life and as substitutes for prescription and illicit opioids for managing pain and opioid withdrawal by people seeking abstinence from opioids. There has been no documented threat to public health that would appear to warrant emergency scheduling of the products and placement in Schedule I of the CSA carries risks of creating serious public health problems. CONCLUSIONS Although kratom appears to have pharmacological properties that support some level of scheduling, if it was an approved drug, placing it into Schedule I, thus banning it, risks creating public health problems that do not presently exist. Furthermore, appropriate regulation by FDA is vital to ensure appropriate and safe use.
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Marcoux RM, Larrat EP, Vogenberg FR. Medical marijuana and related legal aspects. P T 2013; 38:612-619. [PMID: 24391380 PMCID: PMC3875249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
State policies vary regarding the legal use of marijuana for medicinal purposes. Pharmacists, physicians, and P&T committee members must become familiar with the laws in their states before assuming that this controlled substance can be legally prescribed or dispensed to patients.
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Baron CH. Not DEA'd yet: Gonzales v. Oregon. Hastings Cent Rep 2006; 36:8. [PMID: 16604888 DOI: 10.1353/hcr.2006.0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Affiliation(s)
- George J Annas
- Department of Health Law, Bioethics, and Human Rights, Boston University School of Public Health, Boston, USA
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Lindsay RA. Gonzales v. Oregon and the politics of medicine. Kennedy Inst Ethics J 2006; 16:99-104. [PMID: 16770893 DOI: 10.1353/ken.2006.0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
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The assisted-suicide decision. N Y Times Web 2006;:A22. [PMID: 16429626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
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Greenhouse L. Justices reject U.S. bid to block assisted suicide; Court, 6-3, says attorney general was wrong in Oregon case. N Y Times Web 2006:A1, A16. [PMID: 16432926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
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Greenhouse L. Justices explore U.S. authority over states in assisted suicide. N Y Times Web 2005:A1, A32. [PMID: 16231463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
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Krisberg K. Court decision on medical marijuana use worries patient advocates. Nations Health 2005; 35:1,14. [PMID: 16130240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
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Schneider CE. A government of limited powers. Hastings Cent Rep 2005; 35:11-2. [PMID: 16225297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
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Terri Schiavo and beyond. Bull Med Ethics 2005;:5-6. [PMID: 16830427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
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Vandenbroucke A. Case brief: physician assisted suicide. DePaul J Health Care Law 2005; 9:893-904. [PMID: 17061387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
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Hilliard B. Evaluating the dissent in state of Oregon v. Ashcroft: implications for the patient-physician relationship and the democratic process. J Law Med Ethics 2005; 33:142-53. [PMID: 15934671 DOI: 10.1111/j.1748-720x.2005.tb00216.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Over the past decade or so, no issue in medical ethics or bioethics law has raised more concerns about federal intervention in the practice of medicine, about judicial attempts to craft health policy, or about the wisdom of public mandates directing specific health care initiatives than the issue of physician-assisted suicide. State voter referenda, lower and federal court cases (including two U.S. Supreme Court decisions), proposed legislation in both houses of Congress, and orders and determinations from agencies within the executive branch of two administrations are representative of the kinds of actions taken in the last ten years implicating medical care at the end of life. Whether the intent was to codify into law physician-assisted suicide, to deny a constitutional right of assisted suicide, or to make “easier” physicians' efforts to alleviate intractable suffering at the risk of hastening death, or to prohibit physician aid in dying altogether, the impact on the patient-doctor relationship and on our understanding of what constitutes dignified and humane care at the end of life is undeniable.
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Abstract
OBJECTIVE Late in 2001, the State of Oregon filed suit against Attorney General John Ashcroft, seeking to halt his recent directive that physicians who comply with the Oregon Death with Dignity Act by writing a lethal prescription for a controlled substance should be prosecuted for violating the federal Controlled Substances Act (CSA). This special article reviews the history of the series of challenges to the Oregon Act since its initial adoption in 1994, with particular consideration of the arguments on both sides of Oregon v. Ashcroft and the disposition of the case by the district court. DESIGN The article utilizes an historical review of the Oregon Act, including legal and political challenges to it, as well as discussion of the 3 years of data on the experience with legalized physician-assisted suicide in Oregon, and analysis of the legal issues in the current litigation. CONCLUSIONS The federal district court concluded that the Attorney General's interpretation of certain provisions of the CSA so as to preclude the writing of a lethal prescription where otherwise permitted by state law as a legitimate medical practice was inconsistent with the CSA and, therefore, beyond the scope of his authority. The Oregon Act will continue in force while the Attorney General's appeal of the district court ruling is considered by the Ninth Circuit Court of Appeals.
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Affiliation(s)
- Ben A Rich
- University of California, Sacramento, California 95817, USA.
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Boyd AJ. Medical marijuana and personal autonomy. John Marshall Law Rev 2004; 37:1253-88. [PMID: 16506343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Affiliation(s)
- Andrew J Boyd
- Honorable Judge Charles R. Norgle, United States District Court for the Northern District of Illinois, USA
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Boyle B. The Oregon Death with Dignity Act: a successful model or a legal anomaly vulnerable to attack? Houst Law Rev 2004; 40:1387-421. [PMID: 16189902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
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United States. Court of Appeals, Ninth Circuit. Oregon v. Ashcroft. Wests Fed Rep 2004; 368:1118-49. [PMID: 16477722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
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Abstract
When one considers the protracted and continuing struggle of the
citizens of Oregon to include physician-assisted suicide (also known as
“physician aid in dying”) among the panoply of measures
available to dying patients and the physicians who care for them, the
depth and breadth of the issue becomes inescapable. The potential
intractability of the dispute is illustrated by the very fact, noted in
the preceding parenthetical phrase, that consensus eludes us on even
the most basic of semantic points—how we are to most aptly
characterize the conduct in question? The case featured in this
issue's The Caduceus in Court must be examined as the latest
battle in a long war of attrition waged by opponents of physician-assisted
suicide against the Oregon Death with Dignity Act (“the
Oregon Act”). After briefly reviewing that history, I will then
consider the details of Oregon v. Ashcroft and the implications
of the litigation not only for the care of dying patients but also for
the regulation of medical practice in the United States and, more broadly
still, the search for resolution of serious medical disputes in a democratic
society.
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Affiliation(s)
- Ben A Rich
- Bioethics Program, University of California, Davis Medical Center, Sacramento, USA
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Stark SE. Bio-ethics and physician liability: the liability effects of developing pain management standards. St Thomas Law Rev 2003; 14:601-40. [PMID: 12741384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
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Meisel A. Thwarting assisted suicide threatens palliative care. Med Ethics (Burlingt Mass) 2003; 10:4, 8. [PMID: 16175723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
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McStay R. Terminal sedation: palliative care for intractable pain, post Glucksberg and Quill. Am J Law Med 2003; 29:45-76. [PMID: 12953318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
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Gast S. Who defines "legitimate medical practice?" Lessons learned from the Controlled Substances Act, physician-assisted suicide, and Oregon v. Ashcroft. Va J Soc Policy Law 2002; 10:261-91. [PMID: 16493846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Affiliation(s)
- Scott Gast
- United States Court of Appeals for the Seventh Circuit, US
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Wiley LF. Assisted suicide: court strikes down Ashcroft directive. J Law Med Ethics 2002; 30:459-460. [PMID: 12497708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
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Brumbaugh RJ. The Oregon Death with Dignity Act: reversal of the Department of Justice's position on physician assisted suicide and the ensuing court battle. St Louis Univ Public Law Rev 2002; 21:377-94. [PMID: 15212019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
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Buzzee SEM. The Pain Relief Promotion Act: Congress's misguided intervention into end-of-life care. Univ Cincinnati Law Rev 2001; 70:217-49. [PMID: 16389683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
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Yoo K. Self-prescribing medication: regulating prescription drug sales on the Internet. John Marshall J Comput Inf Law 2001; 20:57-89. [PMID: 16331879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Affiliation(s)
- K Yoo
- The John Marshall Law School, USA
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Egan T. Threat from Washington has chilling effect on Oregon law allowing assisted suicide. N Y Times Web 1997:A18. [PMID: 11647283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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Wilford BB, Finch J, Czechowicz DJ, Warren D. An overview of prescription drug misuse and abuse: defining the problem and seeking solutions. J Law Med Ethics 1994; 22:197-203. [PMID: 7749473 DOI: 10.1111/j.1748-720x.1994.tb01295.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Each year, millions of individuals in the United States are treated for a variety of serious medical conditions with prescription drugs whose therapeutic benefits are well known. The vast majority of these medications are used to treat medical and psychiatric illnesses. Generally, they are used as prescribed, and contribute to a better quality of life for persons suffering from debilitating or life-threatening disorders.The fact that a small portion of these medications is diverted by those who seek their psychoactive effects raises the important policy issue: how to make drugs easily available for medical use while limiting access for purposes of abuse.Such a responsibility poses challenges very different from those of the so-called “war” on illicit drugs, because this control must be achieved without impeding patients’ access to medical care. A rational public policy would attempt to achieve a balance between the need to minimize abuse and the need to provide relief.
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