TREATING PAIN SHOULD NOT BE A CRIME

Siobhan Reynolds - Reynolds is founding executive director of Pain Relief
Network, a national not-for-profit organization dedicated to restoring the
autonomy of medical practice and the civil rights of Americans in pain.

The real "Oxycontin story" is finally getting told. Patients in pain are
being scrutinized by nervous doctors who vainly attempt to divine whether
the patients are truthful about the extent and severity of their pain. As a
result of the federal criminal prosecution of Dr. Cecil Knox and office
manager Beverly Boone - in addition to at least 100 more physician
prosecutions across America - the inevitable costs of law enforcement's
encroachment on the practice of medicine is slowly being reckoned.

A Roanoke Times news story, "Doctors cautious with pain prescriptions" (May
23), noted that 90 percent of Knox's patients were the 1 to 2 percent of
patients other doctors don't know what to do with. Roanoke's Dr. Marc
Swanson described them as "devastated": patients with numerous back
operations, degenerative disk disease, gunshot wounds to the spine and other
catastrophic ailments and injuries.

The reason the doctors "don't know what to do with them" is that the doctors
are not safe to do what they know perfectly well they ought to do with them;
i.e., treat their pain. What happens to these most vulnerable members of our
society as a result of the doctors' fear is unthinkable: These ill American
citizens are made to go begging for the medicines they need to survive.

Joseph Sutphin, a bilateral amputee, recently wrote a letter to the editor
in which he said that he is being judged and humiliated by doctors who fear
prosecution. I defy the Drug Enforcement Agency, the Food and Drug
Administration, Attorney General John Ashcroft or any member of Congress to
explain how the federal government's effort to keep pain medications away
from addicts (who, by the way, will get them anyway) could ever possibly
justify the systematic humiliation of even one disabled man, let alone
what's been going on lately, such that all people with high-dose
requirements are being routinely humiliated and abused. Sometimes the
doctors are apologetic as they turn the sick person away.

Most often, they will simply and coldly refuse them help.

Perhaps worst of all is what happens when a doctor takes such a patient on,
only to find, as he begins prescribing pain medicines, that his fears have
gotten the better of him. Rather than confront the fact that he cannot both
treat his patient in an ethical manner and protect his own life and liberty,
the doctor will start to see "red flags" in everything the patient does. Any
lost prescription or increased need for medications will be used as an
absolute and unappealable justification for terminating the patient's care.

These are, indeed, devastated people. These are the people Knox is being
prosecuted for treating humanely. The case against him and the nationwide
witch hunt for doctors who treat pain must be brought to an immediate end.
Law enforcement will have to be prevented from attacking medical care, and
the state medical boards will have to be put back in charge of regulating
medicine.

The costs of doing otherwise, as has been amply demonstrated in Roanoke, are
simply too high.