Pubdate: Wed, 01 Mar 2006
Source: Des Moines Register (IA)
Copyright: 2006 The Des Moines Register.
Contact:  http://desmoinesregister.com/index.html
Details: http://www.mapinc.org/media/123
Author: Tony Leys, Staff Writer
Bookmark: http://www.mapinc.org/find?232 (Chronic Pain)

PAIN PATIENT - MY DRUGS ARE MY BUSINESS

John Grim is tired of staying quiet about his pain and the medicine 
he takes to control it. He's fed up with the stigma surrounding the 
thousands of patients like him who use narcotics for legitimate 
reasons. And he's outraged that state regulators want to set up a 
computer database that would track every prescription he fills.

"I'm worried about scrutiny from people who have no business snooping 
into my medical issues," he says.

Grim is sitting at a cafe table near his home in Des Moines. He leans 
forward onto his forearms, grimacing as he shifts weight off his 
ruined back. "Do I look like a junkie to you?" he asks.

He looks like a typical Iowan. He is 47, and he used to be a 
corrections officer in the state prison system. He was placed on 
disability after rupturing a disc in his back while restraining an 
inmate nine years ago. He's undergone nine surgeries, and he expects 
more. He clutches a gray, plastic remote control for an electronic 
implant that helps block pain signals from traveling up his spinal cord.

Every four hours, he takes narcotic pain relievers. He is not an 
addict, he says. He gets no high off the pills. "I'm physically 
dependent on them - just like a diabetic is physically dependent on insulin."

Grim says he takes no pleasure in talking about these things 
publicly, but someone has to step out of the shadows and show how 
normal a pain patient can be.

He has been following closely a proposal to have the Iowa Board of 
Pharmacy Examiners set up a computerized system, which would 
automatically track every order pharmacists fill for addictive 
medications. The idea was approved last spring by the Iowa House, but 
it bogged down in the Senate amid privacy concerns raised by doctors' 
groups. Now the proposal is back before legislators after supporters 
altered it to address some of the complaints.

Under the revised plan, government officials could not perform random 
searches for patients who were buying unusually large amounts of 
drugs. Officials could look at the registry only if they could show 
"probable cause" to suspect that a specific person was doing 
something wrong. Supporters of the computer system say it mainly 
would be used by doctors and pharmacists, who could check it to see 
whether patients were duping multiple physicians into prescribing the 
same drugs.

Grim is not mollified by the changes in the proposal. "I have no 
faith," he says. "There's no way they can convince me that law 
enforcement isn't going to find a way to peruse these records."

His main concern is that the system would make doctors wary of 
prescribing narcotics, because they would fear being targeted by 
regulators and police. He recalls how his first surgeon refused to 
give him anything stronger than Tylenol 3 . "All he would do is pat 
me on the shoulder and say, 'God bless you. I'm sorry I can't carry 
your cross for you.' "

Grim agrees with registry supporters who say some drug addicts 
"doctor shop" to obtain excessive amounts of narcotics. But he doubts 
the problem is widespread, and he says if addicts couldn't get a fix 
that way, they would find another source. Meanwhile, he says, the 
registry could make life harder for law-abiding people like him.

He likens the proposed system to a computerized registry that would 
track how Iowans spend their money. Such a system could spot people 
who make foolish, unaffordable purchases, he says. But why would that 
be the government's business? "Who are they going to pick on next, 
that's what I want to know."
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MAP posted-by: Beth Wehrman