Federal health officials said misuse of prescription drugs has created a national drug crisis. According to the Drug Enforcement Administration (DEA), more people are addicted to painkillers and antidepressants than to cocaine. In addition, deaths related to prescription drugs have increased significantly.

"While we are making progress in dealing with heroin and cocaine, prescription-drug abuse is an area that has gone the wrong way," said Rogene Waite, a DEA spokeswoman.

Since the 1990s, doctors have prescribed ever-stronger painkillers to relieve chronic pain. While the potent painkillers have proved beneficial for many people, a growing number have become addicted to the drugs.

As a result, the government has announced tighter controls on some prescription painkillers. But several groups that support liberal use of pain medications argue that the new restrictions make doctors less likely to prescribe medications to patients who need them to ease debilitating pain.

"What you are seeing is the clash of the war on drugs conflicting with the war on pain," said Dr. Scott Fishman, chief of the division of pain medicine at the University of California Davis. "It has a chilling effect for healthcare in the future."

While both sides are concerned about addiction and illegal diversion, pain-control advocates said the problems can be solved through better education for doctors and patients.

"No one wants addicted citizens, but there are people suffering mind-bending pain, and they have no way to live their lives in a normal way," said Kathryn Padgett, executive director of the American Academy of Pain Management, a nonprofit patients'-rights group.

Under the DEA's plan, hydrocodone, the nation's most misused prescription drug, would be reclassified from a Schedule III to a Schedule II drug. The category includes oxycodone-based drugs and morphine.

If the reclassification takes place, pharmacies would require patients to come in person to have prescriptions filled. In addition, refills would be prohibited, which would require patients to get a new prescription from their doctor each time more medication is needed.

"The war on drugs has turned into a war on doctors and the legal drugs they prescribe and the suffering patients who need the drugs to attempt anything approaching a normal life," said Kathryn Serkes, public-affairs counsel for the Association of American Physicians and Surgeons. "Physicians are being threatened, de-licensed, and imprisoned for prescribing in good faith with the intention of relieving pain. Their patients have become collateral damage in this trumped-up war."

To address the concerns of pain specialists, the DEA is working to develop guidelines that would help doctors understand their responsibility to ensure that their patients aren't misusing prescription medications.

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