THE DEA'S DISASTROUS WAR AGAINST PAIN-TREATING DRUGS

The very same federal agency that has repeatedly failed to slow the flow of
illegal cocaine from abroad, is now waging an alarmingly successful war
against legal prescription drugs here at home. Problem is, the Drug
Enforcement Agency's efforts to keep legal drugs off the black market has a
nasty side-effect: Terrified of DEA, many hometown physicians no longer
give 15 million Americans struggling with chronic pain the medicines they need.

In 2002, according to Dr. Joel Hochman, director of the National Foundation
for the Treatment of Pain, the DEA investigated 622 physicians, brought
charges against 586, and in 426 cases medical licenses were revoked "for
cause."

He warns, "If the DEA continues as at present, there won't be any doctors
writing opioid prescriptions in two more years."

Opioids, like OxyContin, are highly effective painkillers made from either
opium or synthetics with the properties of opiate narcotics. Roanoke
physician Cecil Knox, whose trial ended last week for prescribing OxyContin
"outside the scope of legitimate medical practice," is, according to the
DEA, a prescription-abusing doctor and a pipeline to drug abusers. But
some, including other physicians, claim Knox did not violate medical
standards. Instead, he simply cared for the difficult patients many doctors
prefer to avoid.

The DEA justifies its actions against Virginia doctors this way: "Virginia
is one of the half-dozen or so states commonly cited by law enforcement and
medical practitioners when discussing the national OxyContin abuse
epidemic." Still, Virginia was ranked only 32nd in the nation for the
number of OxyContin prescriptions written per capita in 2000.

It is true that some pain patients do sell their pills on the black market.
Others sometimes overdose by mixing prescription medicines with other drugs
and die as a result. And perhaps some profiteering physicians knowingly
take part in these illegal schemes.

But most doctors under attack, says Hochman, are not deliberately abusing
their professional responsibilities. They simply need better pain-control
training and office management skills.

His solution is for the DEA, state regulatory agencies and state medical
boards to work with, rather than against, the nation's 5,000 doctors
practicing chronic opioid therapy.

"To be a competent physician," says Hochman, "every doctor in the United
States needs to be adequately trained - and most are not - in the
management of intractable pain. Law enforcement and physicians must work
together to separate the sheep from the wolves and to identify and
prosecute the small number of prescription abusers. Targeting the physician
only drives legitimate pain patients into deeper despair, terminal
hopelessness and into the black market for relief - as in the case of Rush
Limbaugh."

The DEA's heavy-handed approach is a three-part recipe for disaster:

. Abandoned patients.

As doctors lose their licenses, the number of abandoned patients goes up
and all pain sufferers will have a harder time finding the care they need.

Where will abandoned pain patients find relief when other doctors in town
are "narcophobic?" Many will turn to illegal channels, meaning the DEA will
actually create new customers for the same black market in drugs it claims
to be dismantling.

. Fearful doctors.

To avoid trouble with the DEA, fewer physicians are likely to start new
pain care practices. Signs already appearing in doctors' offices read, "Do
not ask me to refill pain medications" and "Don't ask for opioids," as
doctors adopt a cover-my-rear medical ethic that ignores their patients'
welfare.

Even nursing home care is being harmed. Until outside pain consultants step
in, terminally ill nursing home patients are not getting the pain control
medicines they need. Staff physicians are too afraid of the drug warriors
to do their job.

. Government intrusion.

Despite surveys showing that seven of ten Americans want their doctors, not
the government, to decide what medical treatment they will receive, an
aggressive DEA is bullying the medical community to undertreat Americans
with severe pain. How? Dr. Jane Orient, director of the Association of
American Physicians and Surgeons, sums up DEA this way:

"Throughout the U.S., 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."

This year American taxpayers will give DEA about $120 million to target
doctors who aggressively use legal drugs to ease pain. I wonder if the
millions of these taxpayers suffering from chronic pain, including many in
Virginia, think this is money well spent?