THE DEA'S CAMPAIGN AGAINST ILLICIT OXYCONTIN IS KEEPING PAIN RELIEF
FROM MILLIONS

Thousands of people in Virginia depend on OxyContin and other
prescription painkillers - drugs that are also popular on the black
market. Trouble is, the government's actions to keep OxyContin out of
illegal channels are making it more and more difficult for 48 million
Americans who suffer from chronic pain to get relief.

From a doctor's viewpoint, Dr. Joel Hochman, director of the National
Foundation for the Treatment of Pain, says Washington is engaged "in a
fruitless and bizarre effort to curtail the abuse of drugs, and has
begun to eat its citizens and its physicians."

Of the 4,383 pain management doctors listed on the DoctorsForPain.com
registry, 153 are in Virginia. That averages out to about one chronic
pain doctor per county, meaning the loss of a single physician can cut
off hundreds of Virginians from access to pain care. To the Drug
Enforcement Agency, this fragile network of caregivers is a tempting
law enforcement target.

In the 1990s, DEA began targeting doctors who treat patients with high
doses of OxyContin. To DEA, these doctors look like potential drug
traffickers and a pipeline to the black market.

Since OxyContin is seldom addictive, pain doctors prescribe
increasingly high doses until the patient's pain abates, or side
effects set in. Because this treatment is still controversial among
some physicians, pain practitioners are vulnerable at trial.

In 1993, to bankroll DEA's war on doctors, Congress set up a diversion
control fund. Each year, a million doctors buy a license to prescribe
FDA-approved drugs. In 2003, this fee was doubled. DEA now rakes in
about $130 million per year from these fees, money used to hire
investigators to target physicians.

The agency also gets funding each year - $54 million in 2002 - from an
asset-forfeiture fund, including assets that once belonged to
physicians prosecuted by the DEA. These two pots of money afford DEA
both the financial incentives and the freedom from congressional
oversight to vigorously prosecute pain doctors.

The DEA monitors the prescription-writing habits of all doctors, and
those prescribing high doses of OxyContin raise a red flag.
Investigators go to work. Plea bargains win testimony from former patients.

Indictments are filed. Trial juries hear from DEA-hired doctors who
say the use of high levels of OxyContin are outside the normal
practice of medicine. Doctors for the defense give contrary testimony.

Faced with conflicting expert testimony, lay juries tend to
convict.

In the past three years, according to Hochman, DEA investigated about
1,800 doctors nationwide, 1,200 of whom lost their prescription
license. He says, "When doctors are investigated by the DEA, their
usual response is to cease treating pain patients." Assuming each
doctor serves 300 patients, Hochman estimates as many as 180,000 pain
patients lose their care providers each year.

Each publicized DEA investigation and conviction spreads fear. Other
doctors voluntarily get out of, or decide not to go into, the practice
of pain management. To catch the few bad doctors, DEA is driving many
more good ones out of business. Some patients who lose their support
systems turn to the black market or even suicide for relief.

Dr. Jane Orient of the Association of American Physicians and
Surgeons, says DEA uses dirty tricks to convict doctors. "Throughout
the U.S.," she says, "physicians are being threatened, impoverished,
delicensed and imprisoned for prescribing in good faith with the
intention of relieving pain. Law enforcement agents are using
deceitful tactics to snare doctors, and prosecutors manipulate the
legal system to frighten doctors who might be willing to testify on
behalf of the wrongly accused doctors."

In March 2004, DEA administrator Karen Tandy told Congress that her
drug warriors have been "successful in addressing OxyContin diversion
as evidenced by a reduction in the rate of increase of OxyContin
prescriptions being written and a leveling-off of OxyContin sales."

For DEA, the fewer pain-relief prescriptions written, the better. This
cockeyed measure of success makes no sense, since respected experts
estimate the pain experienced by 40 percent of cancer, AIDS and
terminally ill patients already goes undertreated.

Thanks to DEA, Orient predicts, "If you have an operation or an acute
injury, chances are your doctor will order adequate pain medication.
But if you are one of the millions with chronic, intractable,
so-called benign pain, you may be told to learn to live with it."

Bottom line: The loss of one Virginia pain physician will not create a
ripple in the black market. But 300 honest citizens in pain may curse
the DEA's tactics when they are told, "Learn to live with it."

Ron Fraser of Burke, VA writes on public policy issues for the
Washington-based DKT Liberty Project.