Pain Mangement Journals
JLME Volume 33:4, 2005
JLME Volume 31:1, 2003
JLME Volume 29:1, 2001
JLME Volume 26:4, 1998
JLME Volume 24:4, 1996
JLME Volume 31: 1, 2003
Read the full articles of this issue here
in Acrobat (.pdf) format 
Symposium Articles
Introduction
Providing Relief to Those in Pain: A Retrospective
on the Scholarship and Impact of the Mayday Project 
Sandra H. Johnson
Since the inception of the Mayday Project at the American Society of Law, Medicine & Ethics
in 1995, there has been a significant change in the legal environment for the
prescription of controlled substances for pain management. This positive change
is evidenced in the passage of pain relief acts by several states, the development
of standards for state medical boards, and a change in attitudes among those
boards. The Mayday Project, particularly through the scholarship published
in the Journal of Law, Medicine & Ethics, played a significant role in
the development of this improvement in public policy.
Achieving the Right Balance in Oversight of Physician
Opioid Prescribing for Pain: The Role of State Medical Boards
Diane E. Hoffmann and Anita J. Tarzian
To better understand how state medical boards are evaluating and balancing
the need for adequate pain treatment with concerns about drug diversion and
inappropriate prescribing, the authors undertook a survey of state medical
boards across the country. This article, after briefly describing the evaluation
of medical knowledge regarding the treatment of pain, the history of efforts
to regulate controlled substances used to treat pain, and the literature regarding
physician concerns about legal repercussions for prescribing opioids, reports
on the survey results.
Maximizing the Value of Electronic Prescription
Monitoring Programs
David B. Brushwood
Electronic prescription monitoring programs have been established in approximately
seventeen states, and legislation has been introduced into Congress that would
create a national program. The goal of these programs is to reduce controlled
substance diversion, without adversely affecting the appropriate use of controlled
substances for pain and other medical conditions. This article questions whether
this goal is being achieved and offers five key factors that can maximize the
value of electronic prescription monitoring programs: comprehensiveness, expert
analysis, timely and meaningful feedback, clear standards, and periodic program
review.
Challenges in the Federal Regulation of Pain Management
Technologies
Lars Noah
This article considers the roles played by the Food and Drug Administration
(an agency focused on medical and scientific questions) and the Drug Enforcement
Administration (an agency preoccupied with law enforcement matters) in regulating
a variety of different pain management technologies, especially narcotic analgesics
such as OxyContin.
Pain Relief, Prescription Drugs, and Prosecution:
A Four-State Survey of
Chief Prosecutors
Stephen J. Ziegler and Nicholas P. Lovrich, Jr.
Physicians often undermedicate their patients out of fear that their aggressive
treatment of pain with opioid analgesics will increase the likelihood of investigation
or prosecution. Is this fear based in reality, and if so, what factors contribute
to and predict its likelihood? This study surveys chief prosecutors in the
states of Connecticut, Maryland, Oregon, and Washington in an effort to empirically
assess the likelihood of investigation or prosecution in the context of pain
relief.
Monitoring and Investigating Certified Registered
Nurse Practitioners in Pain Management
Jean B. Lazarus and Belinda (Wendy)
Downing
This article reports on the results of a survey of nurse practitioners certified
for practice in Alabama, where nurse practitioners in collaborative practice
have legal restrictions on prescribing medications, particularly controlled
substances used for treatment of pain. Survey participants were asked to comment
on barriers to pain management, their preparedness for prescriptive practice,
and the need for monitoring and investigating nurse practitioners’ compliance
with collaborative practice protocols. Investigators from the Alabama Board
of Nursing and the Board of Medical Examiners and other state boards of nursing
were also surveyed.
