Comment About the Three Commentaries

Abstract

We wish to thank Drs. Passik, Kirsh, Fishman, and Attorney Bolen for their thoughtful Commentaries. We agree with many of their observations and concerns. Each of these Commentaries, in one way or another, expresses the idea that fear of prescribing opioids is caused by a variety of perceptions of risks involved with prescribing opioids. We think a prerequisite to addressing this fear is to learn whether the perceptions are in accord with the reality. We acquired the data in our article to determine whether the reality of the risk of U.S. Drug Enforcement Administration (DEA) criminal action was congruent with the perception. We interpreted our results to indicate that a physician using standard-of-care management of a bona fide patient in pain and with a medical record documenting this care had little to fear from a DEA criminal action. None of these four authors rejected that conclusion. All went on to describe a number of other factors that were contributing to this fear. Physicians' fear of an action by government is only one of many barriers to better treatment of patients in pain. Many people known to the readers of Pain Medicine have contributed to trying to overcome these barriers. Our own work in this area has addressed several barriers [1–5]. At this time, we think that fear of governmental action is a major barrier to better pain care. In order to address fear of government …