Question 9: Do you think media sensationalism is going to help or harm patients? physicians? law enforcement efforts?

Raymond Sinatra, MD: Do you think all of this sensationalized media coverage is really going to hep the problem or hurt it in the long run? The way I'm seeing it is you're tempting more people to try it and then you're getting physicians very, very reluctant to prescribe what they know is a good drug because they're sort of worried. How can they prevent diversion if they think that they're prescribing it to a patient who appears to be have ... suffering the symptoms of pain and that patient later goes on to divert some of that drug. And the physician is then found to be ... is the physician to be blamed for that? So these are issues that are coming up, I wonder if you could comment on that.

David Joranson, MSSW: Well, I certainly agree with the way you positioned the question Dr. Sinatra. I think that the sensationalized media coverage is by definition an unbalanced approach because it doesn't give due recognition to the important medical uses of these drugs. And it gives undo attention to their misuse and abuse and ends up I believe increasing all of the barriers that we've been studying and trying to erase for the last decade. I think that the media have in large part turned a potentially positive pain story into a very negative crime story. We've seen increases in patient fears and decrease in their confidence in the use of these drugs. It appears that some physicians concerned are leading to changes in the wrong direction in their prescribing practices. We hear about pharmacist concerns about not wanting to stock the drug anymore. And I believe in one state, Massachusetts, the state actually directed them to continue to stock the drugs. All in all, it's going to increase the barriers and interrupt more pain relief and plus it's not very effective, sensationalized media coverage is not very effective against diversion.

I know Commander Burke and others here on the panel have lots of good ideas for what physicians can do to deal with diversion. Was that one of your questions as well Dr. Sinatra?