Regulatory and Legal Issues in the Use of Controlled Substances in the Treatment of Chronic Pain

  • Vernon L. KruegerEmail author


This chapter provides an overview of the regulatory and legal issues and environment in which physicians (practitioners) must function when prescribing controlled substances in the treatment of pain.

States (as well as the federal agencies and institutions) are increasingly playing a regulatory role when it comes to prescribing opioids and other controlled substances for chronic pain. Many states are now requiring that physicians justify or provide a rationale for daily opioid dosages above a specified amount. Most states are now using prescription drug monitoring programs to try and affect changes in prescription drug misuse, abuse and overdoses. Practitioners must be familiar with the federal and state prescribing rules and regulations.

Practitioners are encouraged to become familiar with and maintain an understanding of their state’s laws, regulations and policies.

Knowledge of the state medical board requirements as well as the medical negligence litigation process can assist the practitioner in dealing with a medical board complaint or a civil lawsuit. Legal issues involving treatment of chronic pain by prescribing controlled substances are common to four areas of law: administrative law proceedings, civil litigation, criminal law and constitutional law. This chapter primarily deals with administrative law proceedings and civil litigation.


Regulatory Legal issues Pain management Controlled substances Opioid prescribing Medicolegal 

Suggested Readings

  1. 1.
    Federation of State Medical Boards of the United States, Inc. Model guidelines for the use of controlled substances for the treatment of pain. Euless; 1998.Google Scholar
  2. 2.
    Good PM. The drug enforcement administration and proposed model guidelines for the use of controlled substances in pain management. Presentation at the Federation of State Medical Boards Symposium on Pain Management and State Regulatory Policy. Dallas; 1998.Google Scholar
  3. 3.
    Centers for Disease Control and Prevention; Office of State, Tribal, Local and Territorial Support “Prescription Drug Physical Examination Requirements”.
  4. 4.
    Federation of State Medical Boards Guidelines for the Chronic use of Opioid Analgesics, adopted April 2017; p.1.
  5. 5.
    Fishman S, editor. Responsible opioid prescribing: a Physician’s guide. Washington, DC: Waterford Life Sciences; 2007.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Krueger Law Group, LLPDallasUSA

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