Pubdate: Fri, 19 Aug 2005
Source: Orange County Register, The (CA)
Copyright: 2005 The Orange County Register
Contact:  http://www.ocregister.com/
Details: http://www.mapinc.org/media/321
Author: Michael Arnold Glueck, M.D. and Robert J. Cihak, M.D.
Cited: Drug Enforcement Administration ( www.dea.gov )
Bookmark: http://www.mapinc.org/find?232 (Chronic Pain)

INFLICTING PAIN

The Misguided War On Drugs Keeps Patients From Needed Medication

Millions of Americans are living in chronic pain. But a federal offensive 
against pain management is driving some doctors out of practice, keeping 
others from treating patients, and forcing many to undertreat patients.

In 1914, five years before America embarked on that greatest of all failed 
prohibitions, Prohibition, Congress passed the Harrison Act. This law, one 
of the final products of the Progressive regulatory binge, outlawed the 
non-medical use of opium, morphine and cocaine. As with Prohibition, the 
Harrison Act created a new criminal class, this time about 250,000 patients 
and their doctors.

The struggle against addiction has evolved into a war against effective 
treatment of chronic pain.

In 1970, the Harrison Narcotics Act was replaced by the Drug Abuse 
Prevention and Control Act, which initiated the War on Drugs. In 1975, the 
Supreme Court ruled that Drug Enforcement Administration licensed doctors 
"can be prosecuted when their activities fall outside the usual course of 
professional practice" as if every patient and medical situation could be 
pigeonholed as "usual" and no different from any others.

Until the 1990s, the DEA mostly focused on illegal black market drugs, such 
as cocaine, crack and marijuana. But in 2001, fomented by erroneous media 
and legislative scares, the DEA created a new mission for itself, combating 
the illegal diversion of a legal prescription drug, OxyContin.

Ironically, these scares were shouted from the housetops during the same 
time that the medical profession learned that properly managed opiate 
pain-control drugs could be used safely and effectively to break the pain 
cycle caused by failure of the body's internal pain- control systems when 
overloaded with chronic pain.

We also learned that, properly managed, almost every patient taking these 
medicines for chronic pain relief easily stops taking these drugs when the 
pain-causing condition is resolved. These patients become "physically 
dependent" on the drugs for pain relief but do not suffer addiction, that 
is, do not suffer cravings for the substance and compulsively use the 
substance and continue to use it in spite of harm it might be causing them.

It's even a bit much for other prosecutors. Thirty state attorneys general 
expressed concern about the DEA's quicksand-solid position this January. 
They signed a letter to the DEA complaining, saying that "we have learned 
that adequate pain management is often difficult to obtain because many 
physicians fear investigations and enforcement actions if they prescribe 
adequate levels of opioids or have many patients with prescriptions for 
pain medications."

People suffering chronic pain are suffering because DEA agents are telling 
doctors how to do their jobs. The war on drugs is causing suffering or 
taking the lives of too many innocent patients and the livelihoods of 
innocent doctors.

It's time to prohibit this prohibition against treating pain. The real 
problem is dealing with those who believe that regulation and prosecution 
can solve all our problems.
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MAP posted-by: Jay Bergstrom