Note: this resolution was defeated by one vote in the Arizona Medical Association House of Delegates. A substitute, weaker resolution was passed by ArMA and also by the AMA
RESOLUTION CONCERNING PAIN MANAGEMENT WHEREAS: Arizona physicians are facing intensified investigations and prosecutions for prescribing controlled substances for the management of chronic, nonmalignant pain, despite official reassurances that such prescriptions are lawful, that the evaluation of pain is subjective, and that the dosage prescribed must be a matter of professional judgment; and
WHEREAS: the process of a criminal investigation and indictment is itself destructive of a physician's practice, financial stability, and personal life; even if the physician is ultimately vindicated; and
WHEREAS: fear of such investigation or indictment deters physicians from prescribing appropriately and thus jeopardizes patients' access to treatments that could restore them to productive life, without which they are condemned to intense, needless suffering; and
WHEREAS: the perception that such investigations may be arbitrary and abusive undermines respect for the law; and
WHEREAS: drugs that may be substituted for opioids, such as nonsteroidal anti-inflammatories, have a much higher incidence of mortality and serious morbidity than opioids used as directed; and
WHEREAS: physicians have neither the authority nor the training to serve as law-enforcement agents; and
WHEREAS: the expectation that a physician treat every pain patient as a potential criminal suspect destroys the trust required for a patient-physician relationship; and
WHEREAS: appropriate dosage depends on the patient's metabolism and pathology, and the proportion of a physician's prescriptions that are for controlled substances depends on the nature of the physician's practice, so that there are no valid statistical tests to show that a physician is prescribing "too much,"
THEREFORE BE IT RESOLVED THAT: The Arizona Medical Association declare that:
AND BE IT FURTHER RESOLVED THAT: The Arizona Medical Association work for the urgent enactment of legislation that would:
AND BE IT FURTHER RESOLVED THAT: the Arizona Medical Association urge the American Medical Association to work for similar reforms on the federal level to curb prosecutorial abuse.