The DEA's War on Pain Doctors

The DEA's War on Pain Doctors
Posted by CN Staff on November 04, 2003 at 11:01:59 PT
By Frank Owen
Source: Village Voice
Twenty-four years after Darlene broke her back in a swimming pool accident, crippling pain still rules every aspect of her life, from getting up in the morning (which she describes as akin to "climbing the highest mountain") to falling into a fitful sleep at night. After years of botched surgery that left her in even more agony, she knows there is no real cure for what ails her, but thanks to synthetic opioids (which include such regulated substances as Vicodin, Dilaudid, and the devil drug of the moment, OxyContin), she says that she can now lead a halfway normal life. Just folding sheets or washing dishes or sitting at the computer are daily miracles for Darlene, who claims she would otherwise be bedridden and suicidal without the chemical crutches that high doses of these powerful opium-like painkillers provide.
But in some ways worse than the pain, says Darlene (who doesn't want her last name revealed), are the shame and fear that come with it. Shame when she goes to have her special triplicate prescription—required for all scheduled drugs—filled at the drugstore and the pharmacist looks at her as if she were some addict abusing the drug to get high. Fear that her medications will soon be taken away by the Drug Enforcement Administration's ongoing crackdown on pain doctors. "You worry every day that the medicine won't be available for much longer, or your doctor won't be there tomorrow because he's been arrested by the DEA," she claims. All the bad publicity in the press about the abuse of OxyContin by celebrities such as Rush Limbaugh and Courtney Love doesn't help matters. But, says Darlene, the media scare stories shouldn't blind people to the fact that these drugs—when taken under medical supervision—have made life livable for hundreds of thousands of chronic pain patients, herself included. Some in the medical community call it "a war on pain doctors," others "a government jihad" or "state-sponsored terrorism." However you describe the current campaign, which according to pain-patient advocates began under Janet Reno, but which they say has increased in intensity under John Ashcroft, the DEA's hardball tactics—storming clinics in SWAT-style gear, ransacking offices, and hauling off doctors in handcuffs—have scared physicians nationwide to the extent that legitimate pain sufferers now find it increasingly difficult to get the medicine they need. Doctors' offices today display signs that say "Don't ask for OxyContin" or "No OxyContin prescribed here." And medical schools advise students not to choose pain management as a career because the field is too fraught with potential legal dangers. "The war on drugs has turned into a war on doctors and pain patients," says Dr. Ronald Myers, president of the American Pain Institute and a Baptist minister who operates a string of clinics for poor people in the Mississippi Delta. "Such is the climate of fear across the medical community that for every doctor who has his license yanked by the DEA, there are a hundred doctors scared to prescribe proper pain medication for fear of going to prison. The DEA is creating a situation where legitimate pain patients now have to go to the streets to get their medication. It's a health care catastrophe in the making." (Myers theorizes that Rush Limbaugh is probably "a neglected pain patient" and another victim of the crackdown: "Why else would someone with all his money have to go to the street to get enough medication, other than if he couldn't find a doctor to give him an adequate supply?") Advocates for pain doctors and their patients have had enough. Limbaugh's recent admission that he's addicted to OxyContin and other painkillers has brought the issue of pain management and the law to the fore in the media. But the September arrest of northern Virginia's Dr. William Hurwitz—a respected if controversial pioneer in high-dosage pain treatment—galvanized opposition among physicians and patients to the DEA's harsh approach. Hurwitz, a leading specialist in his field, was arrested on federal drug-trafficking charges, accused of prescribing excessive quantities of OxyContin to addicts who he knew were selling the drugs on the street. The 49-count indictment alleges that his prescribing practices led to the death of three patients and bodily harm to two others. Federal prosecutors have depicted Hurwitz, a contentious figure who has had his license suspended three times by medical boards, as no better than "a street-corner crack dealer . . . who dispensed misery and death." After initially being threatened with the death penalty, Hurwitz now faces life in prison. But others defend the doctor. "Dr. Hurwitz saved my husband's life," says Siobhan Reynolds, founder of the Pain Relief Network, a New York City-based grassroots organization defending pain doctors and their patients. For over a decade, Reynolds's husband has suffered terrible head pain caused by a connective-tissue disorder. "Other doctors treated my husband like a leper. If it weren't for Dr. Hurwitz, he would have killed himself. Dr. Hurwitz is responsible for every day that my son has a father." After the arrest, the Association of American Physicians and Surgeons condemned the prosecution at a news conference held at the National Press Club in Washington, D.C., saying that doctors who treat pain patients are heroes, not felons. A major protest on the National Mall is being organized by the National Pain Patients Coalition for next April to bring attention to what some experts regard as the No. 1 health issue in America: the under-treatment of chronic pain. And a push is on in various states to get politicians to pass bills guaranteeing patients' right to opioids to alleviate their suffering, if a doctor deems it necessary. Many doctors used to think that extreme pain was something that their patients just had to live with. The pain-management movement that has sprung up over the past few years takes a radically different tack, believing that long-term chronic pain can be managed with large amounts of synthetic opium, a treatment that remains controversial both within and outside the medical community. The extremely high doses often prescribed—sometimes dozens of pills a day—can seem dangerous and excessive to both laymen and other physicians. A number of doctors insist that these drugs are so powerful that no one should be prescribed them except end-stage cancer patients. But pain-management advocates argue that despite the scare stories, drugs such as OxyContin are actually safer than the alternatives and are much more effective. The DEA denies there's been an increase in investigations and prosecutions of physicians and refutes the notion that it's engaged in a crackdown on pain doctors in general. The agency insists that it's after only rogue practitioners who overprescribe the medicines and who know—or should know—that their patients are selling the drugs on the black market. So far this year, says the DEA, the agency has launched 557 investigations, pursued actions against 441 doctors, and arrested 34, a small fraction of the nearly 1 million physicians licensed to dispense controlled drugs. "DEA statistics," the agency proclaimed on October 30, "show that the vast majority of practitioners registered with the DEA comply with the requirements of the Controlled Substances Act and prescribe controlled substances in a responsible manner." The agency added, "Doctors operating within the bounds of accepted medical practice have nothing to fear from the DEA." But some doctors believe that the DEA, having conspicuously failed to stem the tide of illegal drug use in this country, is coming after physicians to ratchet up the agency's prosecution count. (This year alone, two federal reviews lambasted the DEA for its poor performance in fighting illegal drug use, one report giving the agency a zero on a scale of one to 100.) "They're unable to take down the real drug lords, so they're coming after doctors using the same tactics," one pain physician tells the Voice. For an agency keen to justify its massive budget, doctors provide an easy target. Consider some other recent cases: In Roanoke, Virginia, pain specialist Dr. Cecil Knox and two of his associates were accused of operating what federal prosecutors call "a pill mill." Prosecutors alleged that Knox overprescribed OxyContin and methadone to increase the profits of his financially struggling operation and that this contributed to the deaths of eight patients. Armed agents in flak jackets raided Knox's office. "They all came in with guns drawn," a clinic employee who was present during the raid reported to the Pain Relief Network. "I thought I was going to die. My husband was helping out that day, and a DEA agent came in and pointed a gun at his head and said, 'Get off the phone now.' " (As this story went to press, news came that the feds failed to win a single conviction in the case; the jury cleared Knox of 30 of the 69 charges, deadlocking on the remaining counts.) In another case of DEA strong-arm tactics, more than 20 agents burst into a Dallas pain clinic in June. The agents kicked down doors, ransacked the office of Dr. Daniel Maynard, and handcuffed patients, including an elderly woman with a stroller and an oxygen tank. In South Carolina, physician Deborah Bordeaux was convicted earlier this year under a federal drug-kingpin statute and is currently awaiting sentencing. She faces up to 100 years in prison as a major drug dealer for dispensing opiates to patients suffering from chronic pain at a Myrtle Beach clinic, where she had worked for only two months. Dr. Benjamin Moore, who worked at the same clinic, committed suicide in July 2002 rather than testify against his co-workers. In Arkansas, Dr. Randeep Mann claims that a patient approached him in 2002 and told him that a federal agent had offered her $250 to say that Mann had prescribed her painkillers in exchange for sex. Mann also charges that another female patient told him that local authorities had offered to forgive her cocaine arrest if she told the same lie in court. "They destroyed my practice and they've managed to run away a lot of my patients, and I can no longer prescribe opioids, but I still have my license," Mann tells the Voice. In New Orleans, Dr. David Jarrott, who specializes in pain management, claims that an undercover DEA agent posing as a truck driver tried to entrap him by giving him fake X-rays to secure a supply of Vicodin for a supposed bad back. Jarrott also says the same agent tried to bribe him for amphetamine-based diet pills claiming he needed to stay awake while driving his truck. In early October, the doctor had his license suspended for three years after two of his patients died, one of whom, unbeknownst to Jarrott, was mixing street drugs with his legitimate medication. In Arizona, Dr. Jeri Hassman, who runs Tucson's biggest pain practice, was indicted in March after a sting involving two undercover agents and a three-time-convicted felon. She is being threatened with a 28-year prison term because some of her patients abused prescriptions she wrote. It's not just on the federal level that harsh punishment is being meted out. Dr. Robert Weitzel from Utah was convicted of negligent homicide and sentenced to 15 years in prison. He gave morphine to a 91-year-old patient, who soon after died of heart disease. Weitzel won a retrial (and acquittal) in November 2002 after it was learned that a local prosecutor had concealed exculpatory evidence. In Florida in the same year, Dr. James Graves was not so lucky, becoming the first U.S. physician to be convicted of manslaughter related to an OxyContin prescription, after local authorities charged that four of his patients fatally overdosed on OxyContin, some of them after combining it with illegal street drugs. Graves contended that his patients would not have died if they had taken the drugs as directed. He is currently serving 63 years. Federal officials claim that nearly 500 people died from overdosing on OxyContin in 2002, but a recent article in The Journal of Analytical Toxicology could find only 12 cases in which OxyContin was the sole cause of death; all the others fell victim to poly-drug abuse—mixing OxyContin with cocaine, alcohol, Valium, or various other substances. "Opioids when taken under clinical supervision are not that dangerous," says the American Pain Institute's Myers. "The data tells us that only 3 percent of people who take opioids become addicts. The latest research conclusively shows that the best medicines for the treatment of chronic pain are narcotics. They have less side effects and more benefits than any other type of drug." More dangerous, contends Myers, are the everyday drugs that pain sufferers turn to when they can't get narcotics. He talks about something called "suicide by Tylenol": "When chronic pain patients can't get opioids, they go out and use tremendous amounts of drugs like Tylenol and Motrin, which can cause serious liver and kidney damage. Pain patients are dying from kidney and liver disease because of this." Many pain patients are also dying by their own hand, according to the Pain Relief Network's Reynolds. "All over America, pain patients are committing suicide because of the DEA's campaign," she claims. "I know of at least 17 recent cases in Arkansas alone. It's really astonishing the amount of human carnage that this campaign has already caused." Fumes Myers: "What's going on here is morally reprehensible and medically incomprehensible and it has to stop. Doctors who treat pain patients are not criminals." Source: Village Voice (NY)Author: Frank OwenPublished: November 5 - 11, 2003Copyright: 2003 VV Publishing CorporationContact: editor villagevoice.comWebsite: DEA Archives
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Comment #9 posted by jose melendez on November 05, 2003 at 06:56:44 PT
Attention drug "warriors"
Reschedule or Retire
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Comment #8 posted by kaptinemo on November 05, 2003 at 05:24:30 PT:
For all the DrugWarriors reading this
The probability approaches 100% that someone in the Fed government and their cat's-paws in the state governments are reading this website daily.Maybe they are even laughing at the articles and commentaries being written here.Perhaps they'd like to laugh at this:From the link:*Once patients get their drugs, they are frequently limited to a maximum of one month's supply. That means they run out faster, and then, because pharmacies can no longer carry large supplies, they struggle to find a pharmacy to refill their prescriptions. A further limitation, which is another direct result of the painkiller crackdown, is that many patients are being forced by their doctors to sign contracts in which they promise never to visit another doctor or pharmacy for prescriptions. So, if the pharmacy specified in the agreement doesn't have what the patient needs, the patient has to decide what is worse: to violate a contract by going to another pharmacy? Or to forgo medication that makes life livable? Sara Patterson was forced to make such a choice just last month. Her daughter Holly, who is 7, suffers from damaged nerves and a degenerative spinal disorder. Essentially, says Patterson, "her body doesn't regulate the pressure of her spinal fluid, and the fluid puts pressure on her damaged nerves, which causes the pain." Holly's form of excruciating agony comes and goes. She can spend three or four months in unrelenting, paralyzing pain, and then enjoy a month of relative comfort, only to have the pain strike suddenly once again. Last month, when the pain hit, Patterson called her daughter's pain clinic -- a two-hour drive from her Central Florida home -- to get a prescription for Holly. The doctors didn't answer. In a panic, Patterson went to Holly's local pediatrician, who immediately offered to prescribe medication. "But I said no, you can't do that," Patterson says. "I told her I had signed a contract that prohibited me from buying medication from another doctor. I was afraid of getting in trouble." Instead, Holly endured another day without relief before getting the right medication from the "legal" source. Meanwhile, Patterson says she fears that Holly will commit suicide. "Every birthday, she blows out her candles and wishes for the pain to go away," Patterson says, her voice quivering. "She constantly says that she doesn't want to live. She just asked me 15 minutes ago if she could go ahead and kill herself. Right now she doesn't understand what it means to terminate her life. But what happens when she gets older? She might actually succeed. Our time is running out." *This is what the Fed swine are doing: torturing little children to make a point. Causing oldsters to live out their lives in agony. As the old saying goes, "Misery loves company."A little girl, innocent of any harm against being tortured. TORTURED, DrugWarriors. By the laws that keep you in a paycheck.Compassionate conservatism in action. A government so disposed towards its' people that it feels it has a right to torture them to 'save' them is one doomed to fall, someday. Just ask any survivor of Communism.
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Comment #7 posted by FoM on November 04, 2003 at 20:18:44 PT
ekim here's a link and portion of the transcripts
COOPER: All right, we are getting a lot of e-mail pouring in. Probably a predictable question just got asked. It is an e-mail from a viewer: "Which of you are ready to admit to having used marijuana in the past?" And they want us to go around and ask each of you. Governor Dean? DEAN: We'll all keep our hands down on this one. (LAUGHTER) COOPER: John--Senator Kerry? Yes or no? KERRY: Yes. (APPLAUSE) COOPER: Congressman Kucinich, yes or no? (APPLAUSE) KUCINICH: No, but I think it ought to be decriminalized. (APPLAUSE) COOPER: Reverend Sharpton? SHARPTON: I grew up in the church. We didn't believe in that. COOPER: OK. Senator Edwards? EDWARDS: Yes. (APPLAUSE) COOPER: Senator Lieberman? (APPLAUSE) LIEBERMAN: Well, you know, I have a reputation for giving unpopular answers in Democratic debates. I never used marijuana, sorry. COOPER: General Clark? CLARK: Never used it. COOPER: Ambassador Braun? MOSELEY BRAUN: I'm not going to answer. (LAUGHTER) (APPLAUSE) COOPER: And Governor Dean? DEAN: Yes. COOPER: Yes, all right. (APPLAUSE) A question over here. QUESTION: Going along with this less serious note, but still this is a question of a lot of importance to me, I think. QUESTION: You guys seem to get to know each other fairly well. I'd be curious to find out, if you could pick one of your fellow candidates to party with, which you would choose. But keeping in mind, partying isn't just, you know, who do you think can shake their groove thing. (LAUGHTER) I mean, we're talking, who's going to be loyal to you? Who is going to stand by your side? If you get sick, who's going to hold your hair back? (LAUGHTER) 
Rock The Vote Democratic Presidential Candidate Forum 
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Comment #6 posted by John Tyler on November 04, 2003 at 20:01:15 PT
DEA out of control
It is a very strange world where cops untrained in medicine get to oversee the doctors in their medical practices.There was a case in Virginia recently, where the DEA charged a doctor and everyone on his office staff with drug distribution. Thank goodness a jury with an ounce of common sense aquitted them all, but the DEA put them all through hell in the mean time. When yo get charged with a crime, win or loose, you loose. That is the whole point. Jerk the people around. Instill fear in them. People's lives get ruined, but it is just another day at the office for the DEA guys. 
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Comment #5 posted by ekim on November 04, 2003 at 15:48:10 PT
Rock the Vote CNN 7pm est
if anyone is interested. Dem pres debate with younger voters. 
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Comment #4 posted by FoM on November 04, 2003 at 13:55:14 PT
Thanks Paul
I'm sure that Rush Limbaugh will see the world differently after he is clean for a year or so but I doubt that he will be drug free because they will probably give him something else to take. It seems to be a common occurance that people get moved from one addictive drug to another as a form of treatment. That's only what I think and I could be wrong.
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Comment #3 posted by paulpeterson on November 04, 2003 at 13:26:14 PT
That Oxy-C drug taken so copiously by the Oxy-moron is just a fine-falutin OPIATE. Addiction town. They say the big 4 aspects of addiction are TOLERANCE, CRAVING, WITHDRAWAL, RELAPSE. Those Opiates trigger the Mu receptor site, found in the breathing/heart control mechanisms (that is why people OD and shut down breathing and die). Opiates tolerance up really quickly. Pot chemicals don't, you just can't get stoned if your CB-1's are already filled to capacity from that last high a few hours ago (hypothically, that is). Once a person goes up that tolerance curve as fast and as far as Rush, the Oxymoron, did, the severe WITHDRAWAL symptoms would keep that goon paying out just to keep from having severe body jerks and gyrations.Let's just hope someone updates The Christmas Carol with this goon scripted as old McScrooge Duck in time for Christmas. Hope it hits the stores before this guy hits the airwaves again. He's probably going about through the "Ghost of Christmas Future" right about now (after passing thought the severe sweats/groans #1 & the initial post-withdrawal identity changes #2). That future guy is doing TALK THERAPY with him right now and real live hippies are already trying to ELEVATE his consciousness just in time for the Harmonic Convergence (11/5-11, peaking 11/8 at 8 pm or so).Let's all pray that Rush just went through his "Saul conversion to Paul" on the Road to Damascus thing, so he can become just as strong of a supporter as he has always been as a detracter of these agendas.And, of course, in keeping with the truisms RUSH = DRUG ABUSE. Let's call his new identity BUZZ = STONER. Stay tuned for BUZZ LIMBO, syndicated talk show host for the new mellinium. (Sort of like a modern day MAX HEADROOM!). 
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Comment #2 posted by FoM on November 04, 2003 at 12:30:13 PT
A Question
I have no first hand knowledge of OxyContin and wondered why Rush Limbaugh required so many pills. You would think that many pills could kill an elephant. How rapidly does the tolerance rise with Oxycontin? Does anyone know?
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Comment #1 posted by Virgil on November 04, 2003 at 12:07:11 PT
This is your government on drugs
Any questions?
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