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.