PATIENTS FEEL PAIN WHEN DEA TARGETS DOCTORS

Not long ago, chronic pain patients trusted their doctors to prescribe the
medicines they needed to live a normal, pain-free life.

Attorneys general from 29 states, the District of Columbia and Puerto Rico
- -- but not Virginia -- say those days are now gone; that to protect
themselves from federal agents, America's physicians are shortchanging
their patients. In a letter sent to Washington earlier this year and signed
by all 31 attorneys general, a solid case was laid out against the federal
Drug Enforcement Administration.

The letter described how the drug warrior tactics used by DEA to catch a
few bad doctors is tearing apart the traditional patient-doctor
relationship -- especially for end-of-life patients. These law officials of
course want to stop those who divert Oxycontin and other opioid-based
prescription medicines onto the black market. But they do not accept
federal methods that condemn American citizens to needlessly live in pain.

The case against the DEA, according to the 31 attorneys general, looks like
this.

"In our consumer protection role, working to remove barriers to quality
care for citizens of our states at the end of life," the attorneys general
wrote, "we have learned that adequate pain management is often difficult to
obtain. ... Many physicians fear investigations and enforcement actions if
they prescribe adequate levels of opioids or have many patients with
prescriptions for pain medications."

The DEA puts patients at risk by giving doctors mixed signals, and not
drawing a clear legal line to define where medical practice crosses into
what the DEA considers illegal, drug-dealing territory.

By reserving for itself the complete discretion to decide when a crime has
been committed by a doctor, the DEA keeps physicians in a legal fog.

The DEA's crime indicators make little sense to a doctor. For example, the
number of patients in a practice who receive pain killers, the number of
tablets prescribed for each patient and the duration of therapy with these
drugs, according to the DEA, are factors that may indicate drug diversion
by a physician.

The letter writers disagree: "Because good practice may involve precisely
the factors that DEA believes might be indicative of diversion, DEA is
creating a climate that puts legitimate medical practitioners in danger of
investigation and discourages good practice."

The letter adds, "As law enforcement agents, we should concentrate on drugs
that are illegally on the streets and work back to see how they got there.
An undue focus [by DEA] on potentially misleading factors like the number
of prescriptions written or number of patients seen in a practice serves
neither the goals of law enforcement nor the needs of suffering patients."

In other words, the DEA should get out of the doctor's office and spend
more time out on the street.

State officials are also concerned that current DEA policies give the
agency a blank check to harass physicians.

The DEA contends: "It is a longstanding legal principle that the [federal]
government can investigate merely on suspicion that a law is being violated
or even just because it wants assurances that it is not."

Why, the state lawmen want to know, does the DEA feel it necessary to
broadcast that any physician can be investigated at any time for any reason?

"This type of uncertainty alone," they wrote, "is detrimental to the
practice of medicine because physicians tend to practice conservatively to
avoid even the possibility of legal involvement. Such practice is not
primarily concerned with the best interests of patients, but is instead
concerned with protecting physicians from liability. Physicians should not
be put in the position of having to choose between protecting themselves
and providing the best possible care for the patients who need their services."

And who pays the price when doctors cover their legal backsides by
undertreating people in pain, by withholding medicines that might raise a
red flag in Washington? Why, the patients do.

The states have called upon the DEA to take a close look at the collateral
damage being caused by its drug war culture and tactics and to "focus on
factors that distinguish the criminal trafficking and diversion of pain
medicines from the legitimate and responsible practice of medicine."

Many millions of Americans in chronic pain, including those in Virginia,
are now waiting to see if the DEA got the message.