February 5, 2003

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February 5, 2003
PULLMAN, WASH. – Two Washington State University Researchers are shedding new light on the connection between patients in pain and their doctor’s fear of prescribing medication.

“Today, millions of Americans suffer from intractable pain that is inadequately medicated,” said Washington State University researcher, Nicholas Lovrich, director of WSU’s Division of Governmental Studies and Services. “Although most American physicians freely admit that their pain management practices are lacking, they nonetheless fear that dispensing significant amounts of opioid analgesics for both terminally ill and chronic pain patients could result in a criminal investigation by local prosecutors.”

You are likely to hear much more about this research in a matter of weeks. In late April, Ziegler and Lovrich will be at the National Press Club in Washington, D.C., for an all-day press conference.

The research examining the political and institutional barriers to the timely and effective relief of pain started last fall when Lovrich and Ph.D. candidate Stephen Ziegler (J.D.- Political Science) received a $10,000 research grant from the Mayday Fund of New York and the American Society of Law, Medicine and Ethics of Boston.

The Ziegler and Lovrich study surveyed prosecutors from Connecticut, Maryland, Oregon and Washington in an effort to assess empirically whether this fear of investigation and/or prosecution is justified. The study entailed the use of plausible scenarios derived from court cases and hearings before state medical licensing boards and the U.S. Congress, and was extremely well received — achieving an uncommonly high rate of response (76 percent) for this otherwise difficult to study group. The study found that while the risk of investigation or prosecution was generally far lower than doctors tend to believe, in some limited circumstances the fear of increased regulatory scrutiny may be warranted.

With regard to the increasingly high rate of participation achieved among prosecutors in this study, Lovrich said, “we owe a great deal to Tom McBride from the Washington Association of Prosecuting Attorneys. He was able to get Washington prosecutors to participate and as a member of a similar, national group, he put us in touch with his counterparts in other states.”

The original idea for the study came from Ziegler’s prior research in pain relief and end-of-life care, and will serve as the basis for his doctoral dissertation. An excerpt from his dissertation has already been accepted for publication in the “Journal of Law, Medicine & Ethics,” one of the leading peer-reviewed journals in the field. The article will appear in a special edition of the journal.

Ziegler was one of the first graduate students to receive the Graduate Scholar Award, a two-year scholarship intended to recruit outstanding graduate students to Washington State University’s Pullman campus. Ziegler has delivered the first draft of his dissertation and anticipates defending his thesis this spring. Ziegler is also a graduate fellow at the Thomas S. Foley Institute for Public Policy and Public Service, and in 2002 received the Charles H. Sheldon Graduate Fellowship.

Because of their success with surveying prosecutors in this study, Ziegler and Lovrich are working on an article for Justice System Journal that will detail promising methods for conducting this kind of research.
Patients in Pain/Doctors in Fear WSU Research Sheds New Light

PULLMAN, WASH. – Two Washington State University Researchers are shedding new light on the connection between patients in pain and their doctor’s fear of prescribing medication.

“Today, millions of Americans suffer from intractable pain that is inadequately medicated,” said Washington State University researcher, Nicholas Lovrich, director of WSU’s Division of Governmental Studies and Services. “Although most American physicians freely admit that their pain management practices are lacking, they nonetheless fear that dispensing significant amounts of opioid analgesics for both terminally ill and chronic pain patients could result in a criminal investigation by local prosecutors.”

You are likely to hear much more about this research in a matter of weeks. In late April, Ziegler and Lovrich will be at the National Press Club in Washington, D.C., for an all-day press conference.

The research examining the political and institutional barriers to the timely and effective relief of pain started last fall when Lovrich and Ph.D. candidate Stephen Ziegler (J.D.- Political Science) received a $10,000 research grant from the Mayday Fund of New York and the American Society of Law, Medicine and Ethics of Boston.

The Ziegler and Lovrich study surveyed prosecutors from Connecticut, Maryland, Oregon and Washington in an effort to assess empirically whether this fear of investigation and/or prosecution is justified. The study entailed the use of plausible scenarios derived from court cases and hearings before state medical licensing boards and the U.S. Congress, and was extremely well received — achieving an uncommonly high rate of response (76 percent) for this otherwise difficult to study group. The study found that while the risk of investigation or prosecution was generally far lower than doctors tend to believe, in some limited circumstances the fear of increased regulatory scrutiny may be warranted.

With regard to the increasingly high rate of participation achieved among prosecutors in this study, Lovrich said, “we owe a great deal to Tom McBride from the Washington Association of Prosecuting Attorneys. He was able to get Washington prosecutors to participate and as a member of a similar, national group, he put us in touch with his counterparts in other states.”

The original idea for the study came from Ziegler’s prior research in pain relief and end-of-life care, and will serve as the basis for his doctoral dissertation. An excerpt from his dissertation has already been accepted for publication in the “Journal of Law, Medicine & Ethics,” one of the leading peer-reviewed journals in the field. The article will appear in a special edition of the journal.

Ziegler was one of the first graduate students to receive the Graduate Scholar Award, a two-year scholarship intended to recruit outstanding graduate students to Washington State University’s Pullman campus. Ziegler has delivered the first draft of his dissertation and anticipates defending his thesis this spring. Ziegler is also a graduate fellow at the Thomas S. Foley Institute for Public Policy and Public Service, and in 2002 received the Charles H. Sheldon Graduate Fellowship.

Because of their success with surveying prosecutors in this study, Ziegler and Lovrich are working on an article for Justice System Journal that will detail promising methods for conducting this kind of research.