FORCE THE NURSING HOME REFORM LAW INSTEAD OF WEAKENING THE CONTROLLED SUBSTANCES ACT
March 24, 2010
For Immediate Release
Contact: Toby S. Edelman
(202) 293-5760, ext.104
The Center for Medicare Advocacy is troubled by the Senate Special Committee on Aging's March 24 hearing, "The War on Drugs Meets the War on Pain: Nursing Home Residents Caught in the Crossfire." The Center’s Senior Policy Attorney Toby S. Edelman, who submitted a statement for the record on behalf of the Center for Medicare Advocacy and California Advocates for Nursing Home Reform, said "The hearing is focused on the wrong question and the Committee has prejudged the issue, without seeking out the views of nursing home residents and their advocates."
A Better Protection for Residents is Compliance with the Nursing Home Reform Law
At issue in the hearing is the Drug Enforcement Administration's recent enforcement of long-standing rules under the Controlled Substances Act, which require that physicians initiate prescriptions of controlled substances for nursing home residents. Contrary to the law, nursing homes treat controlled drugs like other drugs, using so-called "chart orders." Ms. Edelman points out that, for nearly 20 years, the federal Nursing Home Reform Law has required nursing homes to have physicians available 24 hours per day to provide emergency care for residents. "If facilities complied with the Reform Law, they would also be able to comply easily with the Controlled Substances Act," said Ms. Edelman. "The issue before the Committee, which has been raised by the nursing home and long-term care pharmacy industries, is a false one. The question is not whether residents should receive pain medication. The answer is an obvious yes. The question is whether residents' medical care will be properly overseen by physicians. What we are seeing today is a solution that reverses current law and ignores patient safety."
The Real Issue is the Inappropriate Off-Label Use of Antipsychotic Drugs
Regardless, the real medication issue that the Committee and Congress should be addressing is the inappropriate off-label use of antipsychotic medications with nursing home residents. "Almost five years ago, the Food and Drug Administration issued its first 'black box' warnings against the use of antipsychotic drugs for patients who have dementia, cautioning that the drugs increased dementia patients' mortality. Yet in the fourth quarter of 2009, the federal government reports that more than 350,000 nursing home residents received conventional and atypical antipsychotic drugs and studies document that most of the antipsychotic drug use is off-label. An FDA official testified in 2007 that 15,000 nursing home residents a year die from the off-label use of antipsychotic medications. This is the real drug issue in nursing homes that needs urgent attention," said Ms. Edelman.
Ms. Edelman is available for comment. The Center's full statement is available at http://www.medicareadvocacy.orgInfoByTopicSkilledNursingFacility10_03.24.StatementToSenateAgingOnSNFsAndDrugs.pdf