Thread by @national_pain

1/ Today, @national_pain filed an amicus brief in consolidated cases before the U.S. Supreme Court, Ruan v. US & Kahn v. US. The cases concern when a doctor who prescribes controlled medications can be found liable under the Controlled Substances Act (CSA). #SCOTUSbrief

2/You can find our brief at supremecourt.gov/DocketPDF/20/2… #SCOTUSbrief

3/ An amicus curiae, or “friend of the court,” is someone with a strong interest in the outcome of the case who is not a party to the case.

4/ @national_pain has a strong interest as it works to advance the health and rights of people with pain. These interests are undercut by incorrect & inconsistent interpretations of the CSA that have resulted in significant & even life-threatening negative effects on patients.

5/ The CSA prohibits “intentional” and “knowing” distribution of controlled substances, but creates an exception for a medical provider who prescribes for a legitimate medical purpose in the usual course of his or her professional practice.

6/ Some courts have upheld convictions of physicians – without looking at their intent, i.e.., whether they acted knowingly or intentionally. Intent is a central concept running through American law that separates criminal from civil culpability.

7/@national_pain argues that the government’s interest in preventing diversion of controlled medication must strike a balance that allows providers to practice good medicine – a result supported by the plain language of the statute, regulation, & Supreme Court precedent.

8/ Pain is a widespread, costly, and consequential condition, and that providing relief from suffering is a central goal of medicine.

9/ While the decision to prescribe a controlled substance requires balancing risks and benefits, the legitimate use of controlled medications is a mainstay of modern medicine.

10/ We argue that an interpretation of the CSA that overly deters providers predictably chills care, when honest doctors fear being mistaken for bad actors.

11/ Overdeterrence creates perverse incentives that encourage medical providers to act from self-protection and may result in under-management of pain, practices that increase risks to patient safety, and abandonment of patients from care.

12/ In our brief, we show—in study after study—how each of these predictable outcomes is happening in pain care today. Oral argument in these cases is scheduled for March 1.