Narcotic lollipops that first hit the market in 1998 were approved by the Food and Drug Administration (FDA) to treat chronic pain in cancer patients, but use of the narcotic lollipop Actiq has expanded to include legal but controversial "off-label" prescribing for migraine headaches and other conditions, Newsweek reported in its May 7 issue.

The fentanyl-based lollipops are "safe and effective" for a variety of conditions, said Russ Portenoy of Beth Israel Medical Center in New York, a national expert on pain medicine. But concern about the drug has risen as the population of non-cancer patients using Actiq has grown to an estimated 80 percent of all users.

Cephalon, the company that makes Actiq, has come under legal and law-enforcement scrutiny for allegedly encouraging off-label prescribing. David Brennan, a former Cephalon auditor, sued the company, saying he was fired because he reported that high numbers of Actiq patients were getting off-label prescriptions and that the company failed to discourage the practice among doctors and others.

Connecticut attorney general Richard Blumental said he has evidence that Cephalon paid doctors to promote off-label use of the drug.