DOCTORS PROCLAIM DRUG WAR BASED ON "MYTHOLOGY"

(Audio Track) Intro and Poppygate - Glenn Greenway: Bush administration
officials have indicated that Afghanistan's opium production in 2004 will
be nearly double that of 2003 and will double again by 2005. Time magazine
reports in this week's edition that conservative estimates indicate that
al-Qaeda and the Taliban are earning tens of millions of dollars from
Afghan opium. PBS reported last week that seven million Afghanis now rely
on Poppy farming for their livelihoods. Last Sunday the New York Times
reported that Twenty-one U.S. troops have died from ambushes, land mines
and other hostile fire in Afghanistan so far this year, compared with 12
combat deaths in all of 2003. Wrapping up today's Poppygate update: Afghan
Opium production and US combat deaths in Afghanistan will double this year.
Seven million Afghanis now rely on Poppy farming and al-Qaeda is making
millions from the Opium trade. This is Glenn Greenway reporting for the
Drug Truth Network.

Dean: Well I feel privileged that the caliber of the guests willing to come
on this show just keeps on keeping on. I started three years ago,
broadcasting from the gulag city, that this drug war is a sham. Our guests
range form judges to scientists, from warden to prisoner, all proclaiming
the drug war a failure, a hopeless failure. Powerful words spoken by U.S.
congressmen, Canadian senators, Nobel Prize winners and members of the
European parliament in support of this host and the Drug Truth Network have
helped tremendously in the growth of our little network of broadcast
affiliates. Yet, feigned ignorance still thrives in certain offices of
government and superstition lives on in the populace, but the truth is
evident, and the failure of the drug war grows more obvious with each
passing day. Most of all, the progress comes from you, my dear listeners.
Through your support and involvement in working to end the harms of the
drug war, the Drug Truth Network keeps on keeping on as well. Starting this
week, we're proud to say welcome to our 13th and 14th stations: in
Brattleboro, Vermont, station RFB and we'll get some AM play from CKLN,
Toronto, Canada. So, having patted us all on the back, let's get down to
business. I'm proud to have as our guests tonight on Cultural Baggage, two
gentlemen, leaders in the effort to provide adequate medication to those in
severe, intractable pain. We have with us Dr. Joel Hochman, the founder and
executive director of the National Foundation for the Treatment of Pain and
Dr. Stratton Hill, professor emeritus of medicine, who pioneered new pain
treatment strategies at world renown M.D. Anderson hospital. Gentleman,
thank you and welcome to Cultural Baggage.

Dr. Hochman: Thank you.

Dr. Hill: Thank you.

Dean: If you would, please tell me.first tell my audience a little more
about yourselves and the work you do and let's start with you first, Dr. Hill.

Dr. Hill: Well, of course I'm still seeing some patients out at M.D.
Anderson, but I don't take any new patients. I've been working currently
with trying to change the medical practice act which comes up for sunset
this year, well actually in 2005, the next legislature is going to have to
deal with that, to try to clean up some of the onerous and ponderous and
burdensome barriers that doctors have to face in prescribing opioids
adequately for the persons in pain and we're hopeful that this is going to
bear fruit in this coming session.

Dean: Thank you, sir. And Dr. Hochman, please.

Dr. Hochman: Well, I'm, as you mentioned, the executive director of the
National Foundation for the Treatment of Pain, that's at www.paincare.org .
That site gets 15,000 hits a day. We have 3,000 dues-paying members across
every state in the union and 13 foreign nations. The objective of the
Foundation is to guarantee to legitimate intractable pain patients that
none of them will go without proper medical care, even if they have to fly
to Houston to get it. I have a very busy practice, medical practice, taking
care of intractable pain patients and also I've been very politically
involved in various associations and working to try to, as Dr. Hill is
trying to, to inject rationality and evidence based medicine into the arena
of pain management. There are 17 million, at least, intractable pain
patients in the United States. If you go to that web site you will read and
see from what they have to say what the status is of pain management in the
United States, and it is beyond disgraceful. It is an outrage.

Dean: Thank you, gentlemen, both. Now, we've come at this from different
directions. I think we've perhaps arrived at much the same conclusion,
though. That I've thousands of patients, maybe some of your.you know your
patients along the way. People that have suffered in many ways from pain or
even from just the interactions of life, leading them down a road of misery
of one type or another and how this drug war steps in the way of progress
in many ways, from many different directions.

Dr. Hochman: Well, the drug war has, from a physician's point of view; the
drug war has become a war on doctors who dare to competently and adequately
treat pain. The data now is that probably, at the wildest estimate, there
may 30 to 40 thousand doctors out of the million doctors in the United
States who hold a narcotics license, there may be 30 or 40 thousand who are
willing to effectively treat pain management.provide pain management. And
in 2002 about 600 of them were prosecuted by the DEA which gives you a
ratio of about one out every 80 practicing, full-time pain management
doctors became a victim of the war on doctors and since the rate of
incidence is cumulative, if you add another 600 in 2003, that's about 1,000
to 1,200 doctors have gone through a career shattering experiences out of
perhaps 40,000, so that's one out every 40 practicing pain management
doctors has gone through this. So it's an outrageous situation and it's no
wonder that very few doctors are willing to treat patients in pain, which
is particularly ironic since, as I've written, "Ask not for whom the bell
tolls, it tolls for thee." Whom among us gets through life their experience
of intractable pain? Intractable pain is an inevitable consequence of any
chronic illness and we all suffer inevitably chronic illnesses, be it
arthritis or.(unint.).or migraine or cancer. 75% of patients, terminal
cancer patients, based on a survey last year, 75% of them die in
inexcusable agony from inadequate treatment of their pain. It's all because
of the mythology of the addiction from opioids, that if you take opioid
medication you're inevitably going to become addicted, which is complete
mythology. I've even had patients tell me that doctors have told them, "You
can't take these medicines because it will destroy your brain, it will
destroy your liver." When the truth of this matter is that these medicines
are among the safest medicines prescribed in medicine today and in
contrast.well, for example, there's not one documented case of a patient
dying from
an overdose of oxycotin when they took the medicine as prescribed by their
physician. In contrast, 17,000 people died from Tylenol toxicity the last
year they have data. So, I mean the reality is, if you look at it
rationally, Tylenol is a very dangerous drug; it's un-regulated,
over-the-counter. Opioids, which are extremely safe medications when taken
as prescribed, and very effective, life-saving for an intractable pain
patient, these are the focus of a campaign to absolutely discourage
physicians from prescribing them. Meanwhile, illicit opium products are
more available than ever. The street traffic is growing. The poppy
production is growing. It's a $500 billion international narco-conspiracy.
Where's the money going, folks? It's certainly not going in any legitimate
direction. 38% of the Gross National Product of Mexico is derived from
illicit drugs. Where's the money going? One philosopher once said, "If you
really want to understand any human phenomenon, look for the money." I'd
suggest we do the same in this area of drug mythologies. Who is served by
these mythologies?

Dean: Very well put, sir. Thank you. Dr Hill, you've been involved in
this.looked at it over decades, seen some of the changes that were brought
about in Texas. Tell us about that history and perhaps where we're headed now.

Dr. Hill: Well, at first we saw problems with regulatory agencies, and we
now see that these.not only do we see regulatory agencies involved, we see
that the criminal justice system is getting involved. So, doctors are not
only being sanctioned by their licensing boards and disciplinary boards,
but they are being charged with crimes, and a lot of doctors are going to
jail. We started in 1989 and Texas was the first state to pass an
intractable pain treatment act which we thought was going to help the
doctors, to give them some assurances that they could practice in a safe
pain practice, but that really didn't do very good.do very well. So we then
had the board of medical examiners to adopt some rules that are guidelines
to implement this intractable pain treatment act. But we found that the
board simply ignores those rules and that we're seeing that more and more,
that the regulatory agencies are influenced by this mythology that Dr.
Hochman has talked about because it's so ingrained in our culture that I
think some patients and the society in general feels like that if there's a
change we are sort of betraying our whole society. Law enforcement people
have gotten into the act because they basically are dictating medical
practice because they're saying that you can only give so much medication.
They are saying that physicians should have known that this person was an
abuser of drugs, should have known that they may be involved in some
criminal activities. They accuse physicians of conspiracy and distributing
these medications. So, what I think is happening is not a overt conspiracy,
it's a silent, unspoken conspiracy among health care providers, doctors and
so forth, to give sub-optimum treatment to patients so they do not raise a
red flag to cause any notice to their practice by the licensing boards and
certainly the law enforcement agencies. So, it's really changed from
strictly a regulatory thing to regulatory and law enforcement. So, one
could conclude that the war is getting more severe.

Dean: In some ways, you're right. I think that's so true. I want to talk
about last month's issue.this month's issue of Reason magazine. There was a
story in there, a "Dr. Feelscared" (
http://www.reason.com/0408/fe.ms.dr.shtml ), which talks about many of
these same problems, same situations y'all had brought forward and Steve,
let's go ahead and take that one minute break, and we'll be right back.

(Audio Track) Musical interlude - MPP plug - "Name That Drug!"

Dean: Ok, did anybody name that drug? That was a repeat. You should have
gotten it. Many of these clinics that the DEA sees too many drugs being
prescribed by the clinic, calls it a conspiracy and arrests everybody
including the receptionist. There's some terrible stories in that regard.
Y'all want to talk about that?

Dr. Hochman: Well, last year, no, year before last there were, according to
DEA statistics, there were 88 instances in which physicians were arrested
in their offices, often at gunpoint, often by SWAT teams. And there were
instances in which the staff were placed on the floor with guns to their
head. Typically what happens is they're charged with kingpin drug
conspiracy laws so all their assets are confiscated. They can't afford to
retain counsel to defend themselves. They're coerced, therefore, into
accepting plea bargains, accepting guilt on poor legal advice. It basically
ends up that their entire career is destroyed. It's over for them,
professionally. That was 88 times last year and the excuse always is,
"Look, the streets are awash with these drugs." "There's a crisis in
Kentucky with Oxycotin and it's the doctor's fault. They're just nothing
but dealers in white coats and, of course, the whole thing is based on no
logic, no rationality and no facts. It's all hysteria. It's all propaganda.
And it's all mythology. My concern is that, my goodness, what is happening
to our society? Where's the value of intelligence, of intellectual decision
making, of rational and critical thinking? It's all in a. tossed in a
hand-basket while sound bytes and tabloid mentality prevails. In fact I
think it's basically the issue in the upcoming election. Does it make a
difference. do you have to wear a turban to be a Taliban - to be an extreme
radical thinking person - that you have a set of beliefs and anyone who
disagrees with you is some kind of a communist or a subversive or a
criminal or should be destroyed? I mean, we have that kind of thinking in
every quarter now. It's not just something we have to fight in Afghanistan.
I think it's a world wide issue.

Dr. Hill: Well, the bottom line in all of this is that the people that
suffer the most, I mean doctors. it's terrible what they do, but - I mean
what they have to go through - but - what they do to doctors - but the
patient, in the long-run, is the one that suffers here. Because when the y
make these raids and some of them are very dramatic, as Joel has said. One
time, I think it was in Indiana, they landed in a Helicopter on a busy city
street, stopped all the traffic, went inside in all this gear, arrested the
doctor, and about a year later, the newspaper reported something that said,
"With no more fanfare than a stamp in an office," they dropped all the
charges against that doctor. What did they do? They confiscated all the
doctor's records, so when they do that, the doctor then tries to place
these patients with other doctors. It's very difficult, almost impossible
to get another doctor to take a patient like this. But then the first thing
that a physician wants to see, when the take a patient like that from
another physician, is say, "Let me see what's going on in the past." "How
can I give.

Dr. Hochman: "I have to review the medical records."

Dr. Hill: give this patient the right treatment.

Dr. Hochman: Right.

Dr. Hill: You know, I don't repeat, I don't have to do all this stuff."
There's no records. And so a doctor is doubly reluctant to take a patient
under those circumstances. So these raids that they do are just very
destructive for patients and I think, basically, the reason why it's
prevalent with physicians, it sure is easier to go after physicians than it
is the Medline cartel. (laughter) The cartel shoots back.

Dean: That's right.

Dr. Hill: Doctors don't.

Dr. Hochman: And they have money for lawyers. (laughter)

Dean: I wanted to make a point in support of what Dr. Hochman has said, and
I think it was last week, perhaps the week before, the HHS, the health and
Human Services, put out a memorandum to their staff that they were no
longer to attend World Health Organization meetings without approval of
someone at the, you know, the top of the command chain. It just seems that
we're shrinking science. We are going back to a bit of a medieval way of.

Dr. Hochman: Stem cell, so, I mean there it is, right there.

Dean: Yes, sir.

Dr. Hill: Well, I think actually, we did better in medieval times.
(laughter) Let me tell you.

Dean: The leeches actually worked in some cases, yes.

Dr. Hochman: Let me give you a single example of how this works. Richard
Weiner was the founder of the American Academy of Pain Management (
http://www.aapainmanage.org ). About 3 or 4 years ago, Richard developed
pancreatic cancer, which is one of the most painful conditions known to
medicine. Dr. Weiner could not find anyone in the entire city in which he
lived willing to write opioid prescriptions for him in his agony, in his
terminal agony. The president of the American Academy of Pain Management at
that time, Dr. Barry Cole, had to fly from Hawaii to California to write
prescriptions for his colleague, Dr. Weiner, and that man was the founder
of the American Academy of Pain Management. So, if someone of that stature
can't get his pain recognized as legitimate and get a physician courageous
enough to prescribe for him, what chance does the ordinary person in agony
have of getting legitimate care.

Dr. Hill: Oh, Joel, you must have a hundred letters and a hundred e-mails
on your website with that story over and over again.

Dr. Hochman: Over and over and over again and patients going, legitimate
patients, patients with (uint.), bleeding out of the rectum, going to, if
the can find a physician to write the order, the prescription, going to a
pharmacy and being literally, physically thrown out of the pharmacy by some
brobdingnagian pharmacist accusing them of being a drug seeker and a seeker
and "get out of their pharmacy" and "don't you ever come back here again"
in front of a crowd of others. It's just outrageous.

Dr. Hill: Well, I had a doctor in California who asked me to help her,
which I was unable to do because they finally took her license away from
her, but they came into her office and made her give a urine sample right
there on the spot and her - she didn't have to give the urine specimen in
front the patients that were in the waiting room. They took her in there
and said, "You're going to give us a urine specimen" right then and, you
know, she - they accused her of being, of using these drugs.

Dr. Hochman: Well, the whole notion of probable cause, of due process, it's
all thrown out the window and the excuse being the eminent danger to the
public of drug addiction.

Dr. Hill: Well, you see, I think that if.

Dr. Hochman: If pain patients don't get addicted.

Dr. Hill: But in the law, in Texas, it says that if a physician should have
known - now if they apply - I mean, that this person was going to abuse
some drugs or something like that. Well, that takes a pretty good
clairvoyant physician to know that. So, if you apply that to Ken Lay, he
should have known about what happened in Enron. He's a dead duck.

Dr. Hochman: And the President should have known that the intelligence
about weapons of mass destruction was unreliable. I mean, it's the same
notion and the gun shop owner should have known that the gun he sold seven
years ago was going to get in the hands of somebody who's a criminal. It's
just - the whole situation is just irrational, insane, hysterical. And as
I've said a thousand times now, look folks out there, there are no drug
problems. I've been saying this for 30 years now. There are only human
problems and one of those problems is some humans try to medicate their
problems with drugs. Treat the people, not the drugs. The supply-side
approach is bankrupt.

Dr. Hill: Yeah they - aberrant behavior is not, does not reside in the drug.

Dr. Hochman: Right.

Dean: Right. It's in the lifestyle that grows up around the prohibition
those drugs that many of these problems begin to occur.

Dr. Hochman: Well, if we just simply apply intelligence and rationality to
any problem, that's the first step toward solution and the data has been in
for two decades now. You want to treat an abuse problem or an addiction
problem? You provide treatment not incarceration. Nobody ever got well in jail.

Dr. Hill: You're talking about these cases, here. Joel and I are involved
in a case of Dr. Bill Horowitz in Washington. He has been harassed by the
authorities and this time it's a criminal case. He has been.

Dr. Hochman: Life sentence.

Dr. Hill: He will never get out of prison and he's treated patients that
can't get treated anywhere else. He's had patients - because I've examined
his records - come to him from Washington, from Winter Park, Florida.

Dean: Alright.

Dr. Hill: He's had them from Greeley, Colorado because they can't get
treated. And one of the patients from Winter Park, Florida drove non-stop
because she had a antique shop and couldn't afford to have somebody watch
it more than a day or two. She would drive non-stop from Winter Park to
Washington D.C so she could see him because the authorities required that
she come every so often and she had eight of the hundred microgram per hour
patches of Fetinel and was able to drive up there and back on numerous
occasions. So there's something different about people who have pain.

Dean: And to have that much commitment to it, and etcetera shows irrelevance.

Dr. Hill: They're trying to put him in jail.

Dean: We got about two minutes left and I wanted to address this one
thought within this "Dr. Feelscared" from Reason magazine. There was talk
of some of these clinicians having been thrown to the floor, shackled and
so forth and lose basically all hope. Being forced to either testify
against their fellow clinicians or go to prison. That they actually hung
themselves or committed suicide in other ways.

Dr. Hochman: Dr. Benjamin Moore.

Dr. Hill: Yeah.

Dean: Yes, sir. What an outrage that is.

Dr. Hochman: Well, another physician in Louisville, Kentucky, about a month
ago, did the same thing. He committed suicide - and his lawyers said, "I
thought we had this case almost where they were going to dismiss it." But
he was so fed up; it took so long that, and then the feds were coming in
and he had to face up to criminal charges so he just killed himself.

Dean: Well, gentlemen, I want to give you about 20 seconds each to just
talk to my audience. You want to give them a website or whatever? Dr. Hill,
you first. I mean, Dr. Hochman first.

Dr. Hochman: Well, again www.paincare.org and we have a million dues paying
members. We will do something in the Congress, I promise you. And, you
know, join with us. Every additional membership gives us more power.

Dr. Hill: Well, the only thing I can say - I don't have a website - but
what we're trying to do is to work within the system to change it right now
so that doctors will feel more secure in dealing with what they have to do
right this minute.

Dean: Well, Dr. Stratton Hill, Dr. Joel Hochman, gentlemen, I thank you so
much for joining us tonight on Cultural Baggage a couple of program notes:
next week the network will receive a half-hour show on the Drug Czar
himself, his visit to Houston. I want to thank Philip Guffy for doing our
transcriptions. We're going to be doing that on regular basis. I urge you
all to make use of these programs and this one tonight included. Make
quotes available. Send them in letters to your editor and use them and, you
know - the main thing, my friends, is we, working together, can make a
difference. This drug war is a hopeless fraud. No one from the other side
dares to come on the battlefield. The Drug Czar even runs from me. And, so
therefore, I ask you to just do something. Write that letter, call you
Congressman. But remember, because of drug prohibition, you don't know
what's in that bag. I urge you to please, be careful.

(Audio Track) ending.