DIAGNOSIS: TYRANNY

If you suffer from chronic pain, you'd better get used to it; the drug
warriors are about to make life more difficult for you and your doctor.

In an attempt to quell illegal sales and use of OxyContin, a popular
prescription opiate, patients in Pulaski, Va., will be forced to submit to
fingerprinting at local pharmacies to get their pain reliever. The July 11
Washington Post called the new hoop through which chronic pain sufferers
must jump "part of a novel law enforcement effort to curb widespread abuse
of the prescription painkiller."

How widespread? "It has been linked to at least 43 deaths in southwest
Virginia since 1997. " Forty-three people in four years is not a big
number. How many people want to bet that bee stings or bathroom accidents
claimed more lives in that stretch than illegally procured OxyContin?

Also, as Post scribe Josh White explained, the drug "has been blamed for
significant rises in crime -- from fraud and theft to violence and murder
- -- throughout the region." Never mind that it is the illegality of the drug
itself that spurs the crime.

The economics of any black-market substance produces incentives and
conditions that are ripe for criminal exploitation. Prohibition
artificially inflates the price of an illegal object because suppliers of
the product have to assume greater risks; chancing severe penalties if
caught, risk adds to the cost of doing business. With prices too high,
sometimes users are forced to garner the extra money by less than legal
means -- hence the hike theft.

Likewise, violent people with little or no compunction are often drawn into
the trade simply because they have an advantage over nonviolent, straight
dealers. Honesty is not a common thing in an illegal business; it's a
liability. Amoral people thrive in illegal markets because oftentimes
violence and dishonesty are vital facets of the business plan.

Ignoring these economic factors, Pulaski police think they can Barney Fife
the problem and nip this dope trade in the bud -- in this case, the pharmacy.

Under the plan, patients taking OxyContin will leave their fingerprints on
script papers at the dispensing counter. Police hope to use the ID'd forms
to track down lawbreakers. "Anything that will stop the flow onto the
streets we'll be happy with," said Detective Marshall Dowdy of the Pulaski
police. "This is a seemingly never-ending battle."

The reason it's a never-ending battle, Dowdy and other drug warriors fail
to realize, is the fact that it is a battle in the first place. By
prohibiting drugs like opiates, officials have created market incentives
ensuring that dealers of drugs will always be either on the streets or in
the wings and the DEA and other drug-fighting agencies will always have
more work than they can handle.

Prohibition, coupled with humanity's history-long desire for minor
psychoactive refreshment (caffeine, alcohol, nicotine) or extreme twists on
reality (cocaine, opiates, hallucinogens), is a no-win situation. It means
the police are forever trying to keep willing buyers and sellers from doing
business with each other, an interference which only drives market
participants underground, keeping the dealings as "private" as possible.

Once the trade is done on the sly, the police are forced to proactively
root out any offenders, necessitating greater erosion of individual
privacy. Two immediate victims of this have been the Fourth Amendment and
the doctor-patient relationship.

The triplicate form for prescribed narcotics was bad enough -- doctors
forced to keep authorities in the know about when they write script for
heavy dope. Now, local police are nosing in further, by keeping track of
patients who need these painkillers to cope with chronic afflictions.

The result of the triplicate form has been doctors writing less script for
opiates and other heavy drugs not wanting to be hassled by
over-the-shoulder scrutiny about how they run their practices, knowing that
federal reprisal for "overprescribing" is more that just a possibility.
Patients suffer as a result, because they don't get the pain medication
they need, and the doctor-patient relationship suffers because patients
lose faith in physicians who cannot heal or treat them.

Now pharmacists are being dragged into the drug war.

Dowdy is right: "This is a seemingly never-ending battle." And he shares
the fault along with all his fellow drug warriors.

If the drugs sought after by "chemical recreants" were legal, the ongoing
drug-war-spawned destruction of our constitutional rights would be stopped,
drug users' excesses could be managed medically, socially and legally the
same way alcohol is at present (far preferable to the management of
Prohibition), and sufferers of chronic pain could get the painkillers they
need without being treated like criminal suspects.