Treating Doctors as Drug Dealers
Treating Doctors as Drug Dealers; The DEA's War on Prescription Painkillers, by Ronald T. Libby
This article by Ronald T. Libby comes via the Cato Institute, and describes a topic related to Gonzales v. Raich. It further illustrates the cruelty of our government and the lengths it will go to justify the War on Drugs. In the United States today, the government is pointing a gun at the back of the head of every doctor treating patients for pain. If doctors prescribe pain medicines at levels the DEA deems inappropriate, the DEA will prosecute them and the doctors could face significant jail time. Who is more likely to know what pain medicines are appropriate, doctors treating patients face to face, or the bureaucrats running the DEA?
To understand the implications of the DEA’s policies, consider why most patients breakdown and go to the doctor. Very few people like going to the doctor, so they only go when they are in pain and/or discomfort and seeking relief. However, the DEA scares doctors from providing relief. The DEA only cares about justifying its existence and budget, so it allows patients to suffer.
I am posting the article's Executive Summary and Conclusion.
Executive Summary
The medical field of treating chronic pain is still in its infancy. It was only in the late 1980s that leading physicians trained in treating the chronic pain of terminally ill cancer patients began to recommend that the "opioid therapy"(treatment involving narcotics related to opium) used on their patients also be used for patients suffering from non terminal conditions. The new therapies proved successful, and prescription pain medications saw a huge leap in sales throughout the 1990s. But opioid therapy has always been controversial. The habit-forming nature of some prescription pain medications made many physicians, medical boards, and law enforcement officials wary of their use in treating acute pain in non terminal patients. Consequently, many physicians and pain specialists have shied away from opioid treatment, causing millions of Americans to suffer from chronic pain even as therapies were available to treat it.
The problem was exacerbated when the media began reporting that the popular narcotic pain medication OxyContin was finding its way to the black market for illicit drugs, resulting in an outbreak of related crime, overdoses, and deaths. Though many of those reports proved to be exaggerated or unfounded, critics in Congress and the Department of Justice scolded the U.S.Drug Enforcement Administration for the alleged pervasiveness of OxyContin abuse.
The DEA responded with an aggressive plan to eradicate the illegal use or "diversion" of OxyContin. The plan uses familiar law enforcement methods from the War on Drugs, such as aggressive undercover investigation, asset forfeiture, and informers. The DEA's painkiller campaign has cast a chill over the doctor-patient candor necessary for successful treatment. It has resulted in the pursuit and prosecution of well-meaning doctors. It has also scared many doctors out of pain management altogether, and likely persuaded others not to enter it, thus worsening the already widespread problem of underrated untreated chronic pain.
Conclusion
The government is waging an aggressive, intemperate, unjustified war on pain doctors. This war bears a remarkable resemblance to the campaign against doctors under the Harrison Act of 1914, which made it a criminal felony for physicians to prescribe narcotics to addicts. In the early 20th century, the prosecutions of doctors were highly publicized by the media and turned public opinion against physicians, painting them not as healers of the sick but as suppliers of narcotics to degenerate addicts and threats to the health and security of the nation.
Since 2001, the federal government has similarly accelerated its pursuit of physicians it says are contributing to the alleged rising tide of prescription drug addiction. By demonizing physicians as drug dealers and exaggerating the health risks of pain management, the federal government has made physicians scapegoats for the failed drug war. In that they are generally legitimate, well-meaning professionals who keep accurate records, pain physicians also present a better target than underground, blackmarket drug dealers for a DEA that has been subject to increasing criticism from Congress and the Department of Justice for its inability to measurably reduce the domestic drug supply. Even worse, the DEA’s renewed war on pain doctors has frightened many physicians out of pain management altogether, exacerbating an already serious health crisis—the widespread undertreatment of intractable pain. Despite the DEA’s insistence that it’s not pursuing “good” doctors, it isn’t hard to see how rhetoric from law enforcement officials and prosecutors would make doctors think otherwise. Hurwitz’s prosecutor, for example, promised to root out bad doctors “like the Taliban.”159 Another assistant U.S. attorney said, upon the sentencing of one doctor to eight years in prison for having worked for 57 days at a pain clinic: “I believe and I hope that this case has sent a clear message to the medical community that they need to be sure the controlled substances they prescribe are medically necessary. If doctors have a doubt about whether they could get in trouble, this case should answer that”—a statement that implores doctors to err on the side of undertreatment.160
It isn’t hard to see how all of this would make it more difficult for pain patients to find treatment. “You worry every day that the medicine won’t be available for much longer,” one patient told the Village Voice, “or your doctor won’t be there tomorrow because he’s been arrested by the DEA.”161 One doctor flatly told the Wall Street Journal, “I will not treat pain patients ever again.”162 Still another told Time magazine, “I tend to underprescribe instead of using stronger drugs that could really help my patients. I can’t afford to lose my ability to support my family.” The Voice also reports that many medical schools now “advise students not to choose pain management as a career because the field is too fraught with potential legal dangers.”163
The most obvious (though least likely) course of action to address these problems would be for Congress to end the costly, regrettable War on Drugs. Barring that, the best way for law enforcement officials to battle the problem of diversion would be to combat the theft of the drugs from warehouses, manufacturing facilities, and en route to pharmacies. More importantly, the DEA, DOJ, Congress, and state and local authorities should end the senseless persecution of doctors and allow them to pursue whatever treatment options they feel are in the best interests of their patients, free from the watchful eye of law enforcement.
This article by Ronald T. Libby comes via the Cato Institute, and describes a topic related to Gonzales v. Raich. It further illustrates the cruelty of our government and the lengths it will go to justify the War on Drugs. In the United States today, the government is pointing a gun at the back of the head of every doctor treating patients for pain. If doctors prescribe pain medicines at levels the DEA deems inappropriate, the DEA will prosecute them and the doctors could face significant jail time. Who is more likely to know what pain medicines are appropriate, doctors treating patients face to face, or the bureaucrats running the DEA?
To understand the implications of the DEA’s policies, consider why most patients breakdown and go to the doctor. Very few people like going to the doctor, so they only go when they are in pain and/or discomfort and seeking relief. However, the DEA scares doctors from providing relief. The DEA only cares about justifying its existence and budget, so it allows patients to suffer.
I am posting the article's Executive Summary and Conclusion.
Executive Summary
The medical field of treating chronic pain is still in its infancy. It was only in the late 1980s that leading physicians trained in treating the chronic pain of terminally ill cancer patients began to recommend that the "opioid therapy"(treatment involving narcotics related to opium) used on their patients also be used for patients suffering from non terminal conditions. The new therapies proved successful, and prescription pain medications saw a huge leap in sales throughout the 1990s. But opioid therapy has always been controversial. The habit-forming nature of some prescription pain medications made many physicians, medical boards, and law enforcement officials wary of their use in treating acute pain in non terminal patients. Consequently, many physicians and pain specialists have shied away from opioid treatment, causing millions of Americans to suffer from chronic pain even as therapies were available to treat it.
The problem was exacerbated when the media began reporting that the popular narcotic pain medication OxyContin was finding its way to the black market for illicit drugs, resulting in an outbreak of related crime, overdoses, and deaths. Though many of those reports proved to be exaggerated or unfounded, critics in Congress and the Department of Justice scolded the U.S.Drug Enforcement Administration for the alleged pervasiveness of OxyContin abuse.
The DEA responded with an aggressive plan to eradicate the illegal use or "diversion" of OxyContin. The plan uses familiar law enforcement methods from the War on Drugs, such as aggressive undercover investigation, asset forfeiture, and informers. The DEA's painkiller campaign has cast a chill over the doctor-patient candor necessary for successful treatment. It has resulted in the pursuit and prosecution of well-meaning doctors. It has also scared many doctors out of pain management altogether, and likely persuaded others not to enter it, thus worsening the already widespread problem of underrated untreated chronic pain.
Conclusion
The government is waging an aggressive, intemperate, unjustified war on pain doctors. This war bears a remarkable resemblance to the campaign against doctors under the Harrison Act of 1914, which made it a criminal felony for physicians to prescribe narcotics to addicts. In the early 20th century, the prosecutions of doctors were highly publicized by the media and turned public opinion against physicians, painting them not as healers of the sick but as suppliers of narcotics to degenerate addicts and threats to the health and security of the nation.
Since 2001, the federal government has similarly accelerated its pursuit of physicians it says are contributing to the alleged rising tide of prescription drug addiction. By demonizing physicians as drug dealers and exaggerating the health risks of pain management, the federal government has made physicians scapegoats for the failed drug war. In that they are generally legitimate, well-meaning professionals who keep accurate records, pain physicians also present a better target than underground, blackmarket drug dealers for a DEA that has been subject to increasing criticism from Congress and the Department of Justice for its inability to measurably reduce the domestic drug supply. Even worse, the DEA’s renewed war on pain doctors has frightened many physicians out of pain management altogether, exacerbating an already serious health crisis—the widespread undertreatment of intractable pain. Despite the DEA’s insistence that it’s not pursuing “good” doctors, it isn’t hard to see how rhetoric from law enforcement officials and prosecutors would make doctors think otherwise. Hurwitz’s prosecutor, for example, promised to root out bad doctors “like the Taliban.”159 Another assistant U.S. attorney said, upon the sentencing of one doctor to eight years in prison for having worked for 57 days at a pain clinic: “I believe and I hope that this case has sent a clear message to the medical community that they need to be sure the controlled substances they prescribe are medically necessary. If doctors have a doubt about whether they could get in trouble, this case should answer that”—a statement that implores doctors to err on the side of undertreatment.160
It isn’t hard to see how all of this would make it more difficult for pain patients to find treatment. “You worry every day that the medicine won’t be available for much longer,” one patient told the Village Voice, “or your doctor won’t be there tomorrow because he’s been arrested by the DEA.”161 One doctor flatly told the Wall Street Journal, “I will not treat pain patients ever again.”162 Still another told Time magazine, “I tend to underprescribe instead of using stronger drugs that could really help my patients. I can’t afford to lose my ability to support my family.” The Voice also reports that many medical schools now “advise students not to choose pain management as a career because the field is too fraught with potential legal dangers.”163
The most obvious (though least likely) course of action to address these problems would be for Congress to end the costly, regrettable War on Drugs. Barring that, the best way for law enforcement officials to battle the problem of diversion would be to combat the theft of the drugs from warehouses, manufacturing facilities, and en route to pharmacies. More importantly, the DEA, DOJ, Congress, and state and local authorities should end the senseless persecution of doctors and allow them to pursue whatever treatment options they feel are in the best interests of their patients, free from the watchful eye of law enforcement.
Grace, Love & Peace August Ecklund at 12:13 AM
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