Washington, DC—Today, the American Association of Neurological Surgeons (AANS) and Congress of Neurological Surgeons (CNS), and seven other leading medical organizations sent a joint letter to Senate Judiciary Committee Chairman Chuck Grassley (R-Iowa) and Ranking Member Dick Durbin (D-Ill.) ahead of the Committee’s hearing titled, The Poisoning of America: Fentanyl, its Analogues, and the Need for Permanent Class Scheduling, scheduled for February 4, 2025. The hearing aims to examine the public health and safety threats posed by illicit fentanyl and its analogues and to evaluate the need for permanent class-wide scheduling of these substances under the Controlled Substances Act (CSA).
“The fentanyl crisis has devastated families and communities across the country. We thank Chairman Grassley and Ranking Member Durbin for the opportunity to provide our clinical perspective on this critical issue and urge Congress to advance a solution before the current authority expires next month,” said Alexander A. Khalessi, MD, MBA, chair of the AANS/CNS Washington Committee. “As physicians and DEA registrants, we are committed to the responsible stewardship of controlled substances, ensuring patients have access to evidence-based pain management. While supporting efforts to combat this public health crisis, we urge Congress to address regulatory barriers that limit access to certain FDA-approved opioid therapies—often the last line of relief for patients with advanced cancer, complex surgical needs, and neurological disorders.”
The letter outlines key clinical considerations related to the permanent scheduling of fentanyl-related substances, focusing on physician compliance with the CSA and the importance of maintaining patient access to necessary treatments. Additionally, the organizations highlighted an unintended consequence of the SUPPORT Act, which has been misinterpreted to prevent pharmacies from dispensing controlled substances for use in intrathecal pain pumps—a critical therapy for patients with severe, chronic pain conditions such as advanced cancer, spinal cord injuries, and neurological disorders. This misinterpretation has created significant logistical barriers, forcing patients and physicians to rely on complex and burdensome workarounds that jeopardize patient safety, disrupt continuity of care, and increase the risk of medication errors and diversion. The letter urges Congress to enact a targeted legislative correction to restore clear, consistent access to these therapies while maintaining appropriate oversight of controlled substances.
In addition to AANS and CNS, the letter was signed by:
- American Academy of Pain Medicine (AAPM)
- American Academy of Physical Medicine & Rehabilitation (AAPM&R)
- American Society of Anesthesiologists (ASA)
- American Society of Neuroradiology (ASNR)
- American Society of Regional Anesthesia and Pain Medicine (ASRA Pain Medicine)
- North American Neuromodulation Society (NANS)
- North American Spine Society (NASS)
To read the letter, click here.
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The American Association of Neurological Surgeons (AANS), founded in 1931, and the Congress of Neurological Surgeons (CNS), founded in 1951, are the two largest scientific and educational associations for neurosurgical professionals in the world. These groups represent over 10,000 neurosurgeons worldwide. Neurological surgery is the medical specialty concerned with the prevention, diagnosis, treatment, and rehabilitation of disorders that affect the entire nervous system, including the spinal column, spinal cord, brain, and peripheral nerves. For more information, please visit www.aans.org, www.cns.org, and www.neurosurgery.org.
