ABSTRACT
The American physician is currently faced with a practice paradox (Parran, 1997), demanding a new balance in the prescribing of controlled medications for the treatment of pain. This newly developed clinical dilemma comprises underprescribing narcotic analgesics to a majority of pain patients, while, on the other hand, overprescribing to a minority of patients. To stay the course of quality clinical practice requires physicians to understand both the medical and legal strategies undergirding the forces forging a new paradigm of medical care. Several thematic key issues are considered in this structure.
