Pubdate: Thu, 24 Feb 2011
Source: Portland Press Herald (ME)
Copyright: 2011 MaineToday Media, Inc.
Author: Lawrence Goodglass


Although I commend U.S. Attorney Thomas Delahanty's willingness to 
involve limited federal resources to the frightening prescription 
drug problem in Maine ("Agencies team up to fight prescription drug 
problem," Jan. 25), I feel that federal law enforcement is only a 
small part of the solution.

I have two perspectives regarding the problem of prescription opiates 
in this state.

One comes from representing insurance companies in workers' 
compensation cases where opiate addition is an issue; the second from 
being a court-appointed counsel in many criminal matters that involve 
opiate addiction.

As an insurance attorney, I have cross-examined many physicians who 
prescribe powerful opiates such as oxycontin and hydrocodone to 
patients for extended periods. Some of these patients have little in 
the way of objective diagnoses and are diagnosed with generic 
problems such as "chronic pain syndrome."

My sense is that some providers do not appreciate the side effects 
that these opiates have on certain patients. The simple fact is that 
opiates make some patients feel euphoric, and they easily become addicted.

As a criminal attorney, I see clients whose entire world revolves 
around the next dose of an opiate, whether it be a tab of oxycontin 
they buy off the street, a dose of methodone that they get at the 
local clinic or a heroin fix. They will do anything to get it.

The suggestion that a longer prison sentence or a less comfortable 
prison environment will act as a deterrent to an opiate addict is one 
that I have difficulty accepting.

One suggestion to address opiate addiction is for the FDA to publish 
strict mandatory guidelines for health providers restricting when 
certain opiates can be prescribed, and for how long.

Another suggestion would be the promulgation of strict monitoring for 
methadone clinics to make sure that patients are being tapered and 
that their treatment is not indefinite. My observations leads me to 
believe that such monitoring may not be in place.

Lawrence Goodglass

Cape Elizabeth
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