Drug Enforcement Agency's dilemma in long-term care: delays in treatment, delays in solutions.

摘要

The past year or two has felt for many in the long-term care world like a sea-change in how scheduled medications are ordered, provided, and administered in care facilities. Yet, it is interesting to note that there have been no new regulations or new legislation. All of this is driven by the Drug Enforcement Agency's (DEA's) change in interpretation and enforcement practices related to the Controlled Substances Act. Dr Elon et al provided a comprehensive summary of the historical context, regulatory environment, and process of care related to the administration of scheduled medications in the nursing home. Several key concepts in this article are critical to reiterate if there is to be a meaningful dialogue and eventual solution. First, the regulations to which nursing care centers must comply were written more than 20 years ago to address how community pharmacies would serve the needs of the individuals accessing services. Second, a related fundamental basis to our current dilemma is that the DEA is not a care provider or even an oversight body of care and service; it is a law enforcement agency. Although police are a vital component to our communities and our safety, it is evident that a law enforcement approach does not integrate very well into this important aspect of medical care for our loved ones and patients.