Is criminal and Medical Board prosecution of pain medicine prescribers overstated?

Barry Meier reports in the New York Times that, between 1998 and 2006, the rate of prosecution of physicians (criminal and administrative, i.e. Medical Board) for inappropriate prescription of pain medication was roughly .1%. Although this number may sound low, based on the media attention and the climate of fear among physicians related to this issue, the statistic is of dubious comfort to California physicians, given that this remains a relative priority on the Medical Board’s enforcement agenda. Moreover, the study appears to ignore a significant, countervailing development in recent years: DEA enforcement. Using enhanced data-mining capacity to track unusual patterns (e.g. specialties not ordinarily treating pain) and high volume prescribers, the DEA has become increasingly aggressive in enforcing DEA regulations concerning recordkeeping, storage, prescription, and dispensation of narcotic pain medications. (California has distinct pain medication regulatory requirements as well, albeit ones that are subject to lower levels of enforcement.) With civil monetary penalties set at $10,000 per violation, physicians who prescribe pain medication cannot afford to take legal compliance lightly when it comes to pain medication.