Pubdate: Mon, 14 Feb 2005
Source: Baltimore Chronicle (MD)
Copyright: 2005 The Baltimore Chronicle and the Sentinel
Contact:  http://baltimorechronicle.com/
Details: http://www.mapinc.org/media/975
Author: Sheldon Richman
Note: Sheldon Richman is senior fellow at The Future of Freedom Foundation 
(fff.org) in Fairfax, Va., author of Tethered Citizens: Time to Repeal the 
Welfare State, and editor of The Freeman magazine.
Bookmark: http://www.mapinc.org/find?232 (Chronic Pain)

THE WAR ON PAIN SUFFERERS

Our all-wise and all-benevolent government has brought about a situation in 
which people with long-term pain have little choice but to suffer because 
their doctors live under a reign of terror. A good deal of air is exhaled 
over the state of medical care in America. Open state worshipers want a 
complete government takeover, while a more subtle band of state worshipers, 
the kind that like to call themselves advocates of limited government, 
propose instead to use "market incentives" to accomplish their aims. What 
neither party wants is to let free individuals choose their own aims, 
applying their own means (incomes) to accomplishing them.

The pseudo-debate is useful to the pseudo-debaters because it keeps 
people's minds off the real government-induced medical scandals, of which 
there are many.

For example, if you look carefully, you will learn that people who suffer 
chronic pain are routinely undertreated because their doctors fear that the 
US Drug Enforcement Administration (DEA) will accuse them of being drug 
pushers, destroy their practices, wipe them out financially, and throw them 
in jail for good measure. This is no exaggeration. Doctors have even been 
charged with murder when a patient dies an apparently drug-related death.

The most recent case involved Dr. William Hurwitz of Virginia, who was 
convicted in December of 50 drug and conspiracy charges. Possible sentence: 
life in prison. What did he do? He treated many chronic-pain sufferers with 
opioids. The government claimed that a small percentage of them were faking 
and didn't "need" the drugs. Some might have sold them in the black market. 
The prosecutors did not argue, much less prove, that Hurwitz actively 
conspired with anyone. Rather, they relied on a tacit-conspiracy theory, 
counting on the drug-hysterical jury to convict. They were not let down.

But this was only the latest travesty. Of course, the convictions are 
noticed by other doctors, who either stop treating chronic pain altogether 
or undertreat it in order to avoid the government's talons. The war on drug 
users and doctors is the product of a totalitarian mentality.

Let's pause to reflect: our all-wise and all-benevolent government has 
brought about a situation in which people with long-term pain have little 
choice but to suffer because their doctors live under a reign of terror.

When was the last time you heard your compassionate president, senator, or 
representative mention that?

The answer is never. In fact, what you hear are new commitments to redouble 
the so-called War on Drugs, which is really a war on drug 
consumers--including chronic-pain sufferers.

It was inevitable that drug prohibition would seriously affect the practice 
of medicine, all assurances to the contrary notwithstanding. And you 
thought prohibition would merely deprive junkies of their fixes. So goes 
the Law of Unintended Consequences.

The head of the DEA says there is no reason that good doctors should be 
hampered by its efforts. Karen Tandy pledges that her "goal is to ensure 
that patients with legitimate need have access to pain medications that 
relieve suffering and improve quality of life.... Doctors acting in good 
faith and in accordance with established medical norms should remain 
confident in their ability to prescribe appropriate pain medications."

But as Reason magazine's Jacob Sullum points out, that is no assurance at 
all. The DEA decides "after the fact" what "legitimate need" means, whether 
"established medical norms" are followed, and whether the prescriptions are 
"appropriate." When you go to the doctor, a prohibition agent is looking 
over his shoulder.

What could possibly be worth this cost? The prohibitionists will say that 
opioids are addictive. But Dr. Jane Orient, executive director of the 
Association of American Physicians and Surgeons, writes, "Today, there is 
considerable evidence that patients rarely, if ever, become junkies because 
of using opioids for pain relief--even though they are as dependent on the 
drugs as heart patients may be on their heart medicine.... The drugs have 
been literally lifesaving in countless patients who might otherwise have 
administered a gunshot wound to their head or suffered a fatal one-car 
accident."

The war on drug users and doctors is the product of a totalitarian 
mentality. People should be able to buy whatever drugs they want, subject 
only to the principles of self-responsibility and liability. Doctors should 
be able to give their best advice to patients without fear of being 
second-guessed by prohibition agents. Until then, the government is 
indistinguishable from our enemy.
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MAP posted-by: Beth