Amid growing reports of patient deaths and complications caused by problems with legally prescribed pain medication, the Food and Drug Administration (FDA) is discussing the possibility of requiring doctors to receive specialized training before prescribing narcotics, the New York Times reported Aug. 16.

The imposition of license requirements such as continuing education on physicians is generally the responsibility of state medical boards, but the FDA is looking into this area because state boards have done little to require training in prescribing pain medication. The federal agency is expected by early next year to release some recommendations, which also may include requiring drug makers to engage in more monitoring of how their products are prescribed.

Federal officials have been frustrated that advisories they have sent to physicians about prescribing dangers associated with the drugs methadone and fentanyl do not appear to be lowering the number of adverse incidents resulting from improper prescribing.

"We are putting out communications," said Gerald Dal Pan, M.D., director of the FDA's office of surveillance and epidemiology. "We don't know why they are failing."

Physicians generally are required only to demonstrate proof of their license in order to receive federal authorization to prescribe narcotics. Some pain management experts fear that if these requirements were made significantly more stringent, some physicians would stop prescribing altogether and consumers would have fewer options for pain management treatment.