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May 27, 1974

Misprescribing Analgesics

Author Affiliations

Dr. Lewis is Senior Scientist, AMA Department of Drugs.

JAMA. 1974;228(9):1155-1156. doi:10.1001/jama.1974.03230340057039

THE abuse of drugs and associated problems are of great concern to physicians, as well as to the public today. Analgesics, including heroin, are the most commonly abused drugs. This commentary is limited to a discussion of the misuse and abuse of analgesic drugs used medically, omitting the larger problem of "street" abuse.

Two types of misuse of certain analgesics, overprescribing and underprescribing, have been observed. Overprescribing has resulted in some cases of drug dependence; underprescribing, based on a fear of causing dependence, has led to the inadequate treatment of patients who are in pain. Both types of misuse apparently result from misconceptions or misunderstanding of certain properties of the drugs involved, particularly dependence liability. Therefore, it would be advisable for physicians to reexamine their prescribing practices for analgesics.

Overprescribing  Two analgesics, pentazocine (Talwin) and propoxyphene (Darvon), are not listed under the Controlled Substances Act. Because of this and the