NO PAIN-KILLER EPIDEMIC

I applaud your support for a more rational drug policy (editorial, "Pro
Bono," Nov. 22). However, I must take issue with your assertion that there
is an epidemic of prescription drug addiction, specifically addiction to
anti- anxiety agents like Valium, and to pain-killers like Percodan.

The widespread belief that chronic medical use of these medications often
leads to addiction is incorrect, and is based in many of the same
assumptions as the drug war. True reform of drug policy must involve a more
balanced approach to the use of prescribed, as well as illegal, drugs.

Multiple studies over the past 20 years have failed to document abuse of
sedatives or anti-anxiety medications, with the exception of a small
percentage of patients with a past history of drug abuse.

Most people taking medications like Valium, Ativan or Xanax are middle-aged
and have anxiety and medical problems. The vast majority take less than
prescribed.

Pain continues to be scandalously undertreated in the United States, in
large part due to an irrational fear of addiction. Physicians must
constantly worry about sanctions applied by state medical boards for
"malprescription" of pain medications.

Thousands of people die every year in agonizing pain because physicians are
afraid to prescribe adequate doses of pain-killers for fear they will be
charged with murder.

Although it is true that tolerance and physical dependence may develop,
this does not constitute addiction. Addiction involves pathological use
that leads to deterioration in function.

Many people rely on these medications in order to perform everyday
activities such as cooking, shopping, parenting and working. Properly used,
they do not impair function, but improve it.
Mark Willenbring, M.D. Associate professor of psychiatry University of
Minnesota Minneapolis

Checked-by: derek rea