Pubdate: Thu, 16 Jun 2005 Source: Billings Gazette, The (MT) Copyright: 2005 The Billings Gazette Contact: http://www.billingsgazette.com/ Details: http://www.mapinc.org/media/515 Author: Diane Cochran, Gazette Staff Bookmark: http://www.mapinc.org/find?232 (Chronic Pain) Bookmark: http://www.mapinc.org/motd.htm (Pain Relief Network) DEA ACCUSED OF TARGETING PAIN DOCTORS The Drug Enforcement Administration unfairly targets doctors who prescribe narcotic painkillers - including a Billings neurologist - as a means to justify its existence to the federal government, said a national chronic pain management advocate during a visit to Billings on Wednesday. "What the DEA does is sell drug prosecutions to Congress to say, 'Look what we're doing about the drug problem,' " said Siobhan Reynolds, president of the Pain Relief Network. It is a "desperate effort by an endangered federal agency," she said. Instead of addressing the nation's drug problem, the DEA prevents physicians from adequately treating patients who suffer from chronic pain, Reynolds said. The New York City-based advocate traveled to Billings this week to meet with Dr. Richard A. Nelson, a local neurologist whose office was raided by the DEA in April. Bill Weinman, a DEA spokesman in Denver, referred to an agency mission statement when asked to respond to Reynolds' allegations. The mission statement tasks DEA investigators with "preventing, detecting and investigating the diversion of pharmaceutically controlled substances and listed chemicals from legitimate channels while ensuring an adequate and uninterrupted supply of (them) to meet legitimate medical, commercial and scientific needs," Weinman said. In an interview on Wednesday, Nelson said DEA agents told him that his practice had been selected for an administrative review. They took 72 patient files, which were returned 10 days later, and have not contacted him again. "We haven't heard anything," Nelson said. "It has been as much a surprise to me as to anyone that we were selected to be evaluated." Nelson treated several dozen patients suffering from chronic pain with opioids, the medical term for narcotic painkillers. The DEA temporarily revoked his privilege to write prescriptions for those drugs, forcing his patients to seek prescriptions elsewhere, but he remains in good standing with the Montana Board of Medical Examiners. The board first licensed him in 1970. Trained as a general practitioner, Nelson specialized in neurology because he was interested in how the body works. He began treating patients with chronic pain only a couple of years ago. "I wasn't taking it on with the idea that I was doing anything special," he said. Many doctors refuse to treat chronic-pain patients. Some physicians are uncomfortable treating pain because it is not easily defined, while others fear being investigated by DEA. "The DEA has invested a great deal of energy in working against doctors in terms of policing what the doctors are doing instead of what people are doing on the street," Nelson said. Physicians who do accept pain patients often will not prescribe narcotics. Nelson said he prescribed them while counseling his patients against them. "Taking medications and tablets is not going to change the underlying anatomy, but it will block the pain," he said. "You can take these medications for two, three, four years, but you are, No. 1, not changing the anatomy, and, No. 2, building tolerances." Nelson said he encouraged his patients to seek other treatments, including surgery. "We try to move them along" away from opioids, he said. But convincing a patient who has had a failed surgery - as many of his patients have - to submit to another one is difficult, he said. No formal allegations or charges have been made against Nelson, but his case is getting national attention. A reporter from Time magazine interviewed the doctor and several of his patients in Billings on Wednesday, as did a documentary filmmaker. And Reynolds is spending several days in Billings talking with Nelson, his patients and politicians. "My hope is to engage the state of Montana in an effort to reclaim Montana's sovereignty over the regulation of Montana physicians," Reynolds said. "Politicians at the top of the state of Montana need to wake up and see their turf is being trampled on and their police power trumped." Reynolds thinks Montanans are more likely than other Americans to stand up to what she calls an abuse of power by the DEA. The state's residents are independent spirited and tend to frown upon federal intervention, she said. Mike Bledsoe, a patient of Nelson's who suffers chronic pain from a work-related injury, said he hopes drawing attention to the DEA investigation will educate doctors and the public about pain. "I would like to see a change in the medical community's attitude toward treating people with chronic pain with opioids," Bledsoe said. "I hope somebody's going to hear us and look into this." Nelson also hopes to effect change. He said Billings needs a chronic pain management center. The center would be "much like an emergency room but it would be for pain … where a person with chronic pain can go day or night," he said. "It could avoid the many problems our patients have had where suddenly their doctor is not available to give them medications." Find out more Siobhan Reynolds founded the Pain Relief Network in 2002 after watching her husband experience chronic pain as a symptom of Ehlers/Danlos Syndrome, a congenital connective tissue disorder. Her 13-year-old son also has the disorder. The Internet-based organization claims a total 2,200 members from all 50 states, including pain sufferers and their family members, physicians and lawyers. The Web site is http://www.painreliefnetwork.org.