Under-treatment of Pain
It's Not Just Marijuana. DEA is at War With Other Medicines Too.
Posted in Chronicle Blog by Scott Morgan on Thu, 10/29/2009 - 12:09amThe Washington Post has a disturbing piece that ought to broaden recent discussion of the conflict between the drug war and legitimate medical treatments. The DEA is taking legal medicines away from elderly people who need them:
Heightened efforts by the Drug Enforcement Administration to crack down on narcotics abuse are producing a troubling side effect by denying some hospice and elderly patients needed pain medication, according to two Senate Democrats and a coalition of pharmacists and geriatric experts.
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Terence McCormally, a doctor who cares for patients in nursing homes in Northern Virginia, said the tug of war reflects "the tension between the war on drugs and the war on pain.""For the doctor and the nurse, it's a nuisance," he said, "but for the patient it is needless suffering."
Our efforts to control the lives of people who take drugs for fun have led us to destroy the lives of people who take drugs for serious medical conditions. The harsh reality here is that the best medicines often become popular with people they weren't intended for. That's going to happen no matter what you do. But if every effective pain reliever is overly restricted, then the medicine's primary purpose of relieving pain can never be achieved.
The drug war has gone blind even to the most basic functions that drugs are supposed to serve in our society. As efforts to prevent diversion and recreational use continue their inevitable failure, we face a very real threat that desperate drug war bureaucrats will legislate many of our best medicines out of existence.
Pain Activist Facing Fines in Free Speech Case
Posted in Chronicle Blog by David Borden on Mon, 09/07/2009 - 8:08pmThe government's war against pain doctors hit a new low last spring, when federal prosecutor Tanya Treadway, busy prosecuting Kansans Steve and Linda Schneider, subpoenaed pain control advocate Siobhan Reynolds for information on the Pain Relief Network's (PRN) public advocacy in support of the Schneiders.
Despite ACLU efforts to quash the subpoena as an attempt to shut down free speech, judge US District Judge Julie Robinson allowed it. Friday, according an update from Jacob Sullum on Reason, Robinson imposed a $200/day civil contempt fine on both Reynolds and PRN, to begin in 10 days if she does not comply with the subpoena. An appeal is planned -- stay tuned.
Earlier in the week, Boston-based civil liberties attorney Harvey Silverglate criticized Treadway in a column in Forbes magazine. We reprint a few paragraphs, also via Sullum:
When Reynolds wrote op-eds in local newspapers and granted interviews to other media outlets, Assistant U.S. Attorney Tanya Treadway attempted to impose a gag order on her public advocacy. The district judge correctly denied this extraordinary request.
Undeterred, Treadway filed on March 27 a subpoena demanding a broad range of documents and records, obviously hoping to deter the peripatetic pain relief advocate, or even target her for a criminal trial of her own. Just what was Reynolds' suspected criminal activity?
"Obstruction of justice" is the subpoena's listed offense being investigated, but some of the requested records could, in no possible way, prove such a crime. The prosecutor has demanded copies of an ominous-sounding "movie," which, in reality, is a PRN-produced documentary showing the plight of pain physicians. Also requested were records relating to a billboard Reynolds paid to have erected over a busy Wichita highway. It read: "Dr. Schneider never killed anyone." Suddenly, a rather ordinary exercise in free speech and political activism became evidence of an obstruction of justice.
Medical Marijuana: Veterans Administration Says Positive Marijuana Drug Screening Will Not Void Pain Contracts for Vets with Doctors' Recommendations
The Veterans Affairs watchdog group VA Watchdog reported last week that the VA will not remove veterans with me
Free Speech: ACLU Backs Pain Activist's Effort to Quash Subpoena Issued in Kansas Case
The American Civil Liberties Union (ACLU) has joined pain activist Siobhan Reynolds and the
Free Speech: Grand Jury Subpoenas Prominent Pain Relief Advocate Who Has Criticized the Prosecution of a Kansas Physician
Siobhan Reynolds, head of the pain patient and doctor advocacy group the Pain Relief Network, has been targeted for a grand jury invest
Pain Management: FDA to Tighten Regulation of Extended-Release and Patch Opioid Meds
The Food & Drug Administration (FDA) is beginning a "massive new program" to reduce overdoses, diversion, and inappropriate use of powerful opioid pain relievers, especially targeting extended-
Pain Relief: FDA Panel Urges Ban on Darvon, Related Drugs
Acting on a petition from the public interest group Public Citizen, a Food & Drug Administration (FDA) advisory panel last Friday voted narrowly to recommend that a widely used opioid pain medi
The Drug War's Dangerous Distortion of Medical Standards
Posted in Chronicle Blog by David Borden on Sun, 02/01/2009 - 3:48pmWe haven't reported lately on the issue of under-treatment of pain, so this weekend day seemed like a good time to link to a couple of the sites whose people labor in trenches of the pain struggle every day.
First, the war on pain doctors continues, with the latest major battle being that of Wichita-area Dr. Stephen Schneider and his wife Linda Schneider. The Schneiders were charged with the deaths of 56 patients by over-prescribing pain medications, but the judge has now limited the case to just four. My guess is that most of these patients passed due to the medical issues that led them to seek treatment, just as one would expect to happen in any medical practice that takes on seriously ill patients; and that a few might have needed the drugs for pain but misused them (as one would also expect to happen sometimes). I haven't examined the case closely enough for that to be more than a guess, but it's an educated guess, as that is usually what is going on in these pain doctor trials. Visit the Pain Relief Network news update page for info.
How have things come to this? Big topic, but Dr. Alex DeLuca has a post last week on his "War on Doctors / Pain Crisis" blog, "The Distortion of Medicine and Confusion of Standards," that goes into some of it. A key part of the problem is that while modern pain management textbooks recommend "titration to effect" -- e.g. "gradually increasing the opioid dose until the pain is relieved or until untreatable side effects prevent further dosage increase" -- most doctors just don't do that. And so patients in ongoing, serious pain go without adequate treatment.
This makes the typical standard of pain care below medical standards. But it also means that doctors who wrongly believe they shouldn't be relieving a patient's pain are available to testify in trials for the prosecution -- hence the Schneider trial and many others. Even when the defense brings in experts to testify as to what the expert view really is, it creates confusion that can lead to false convictions. This is in fact what happened in the famous William Hurwitz case. DeLuca goes into this in more detail in an interview filmed by the Competitive Enterprise Institute, linked to in his post, so check it out.
Another physician victim of the pain wars, Dr. William Mangino, recently submitted a Reply Brief in the appeal of his case. He is imprisoned in Pennsylvania, and he wrote the brief himself. It paints a pretty terrible picture of the what the government is doing in these cases. Dr. Mangino sent us a copy, via one of his friends, and we've posted it here.
Pain Treatment: Millions Suffer Unnecessarily From Lack Of Medications, Human Rights Watch Says, Drug Control Part of the Problem
Millions of people worldwide are suffering unnecessarily from treatable pain, Human Rights Watch said in a report
My First Year Of Freedom: Richard Paey Speaks Out
Open to the public; sponsored by Floridians for Criminal Justice Reform, Families Against Mandatory Minimums (FAMM), November Coalition and Pain Relief Network.
Medical Marijuana: PTSD Victim Sues West Virginia Pain Management Center for Dismissing Him Because He Smokes Marijuana for Relief
Medical marijuana patients are routinely discriminated against in medical settings.
Feature: Prescription Drug "Fatal Medical Errors" Rising Dramatically -- What Does It Mean?
A study released this week charted a startling increase in deaths from "fatal medical errors," particularly those associated with people mixing street drugs and alcohol with prescription medication
Pain Medicine: Pain Relief Network Sues State of Washington Over Narcotic Prescribing Guidelines
The Pain Relief Network (PRN), a nonprofit organization waging a lonely battle to protect the rights of doctors who prescribe opioid pa
Pain Relief Network Sues State of WA
Posted in In the Trenches by David Guard on Tue, 07/01/2008 - 3:51pmAs always, we ask that you help PRN fight to protect the rights of patients and the doctors who treat them. Please click the link below.
Pain Treatment Advocacy Group Sues State of WA
Jun 25, 2008
By: Donna Gordon Blankinship
The Associated Press SEATTLE - A pain treatment advocacy group filed suit Wednesday in federal court to challenge the restrictions Washington state officials have put on prescription pain medication.
The nonprofit Pain Relief Network says the guidelines for prescribing narcotics, written by the Washington state Department of Health and published in March 2007, have influenced pain treatment across the country and have made doctors afraid to give opiate prescriptions[...]
Complaint for Declaratory and Injunctive Relief, Damages a class action lawsuit by Laura Cooper (lead attorney) et al., Filed: 2008-06-24
Exhibit 1: The WA state Opioid Dosing "Guidelines" by Agency Medical Directors Group (AMDG); Mar. 2007; Filed 2008-06-24
Exhibit 2: Findings of Fact Laura Cooper, Esq.; Filed 2008-06-24 www.painreliefnetwork.org
Pain Medicine: Kansas Doctor Fights Back, Attacks Federal Prosecution and Controlled Substances Act as Unconstitutional
Lawyers for a Haysville, Kansas, physician facing a 34-count federal indictment alleging he acted as a drug dealer in prescribing pain medications fought back last Friday, filing in federal court <
The Pain Relief Network: Update 5-19-08 -- Schneider Defense Calls DOJ Prosecution Unconstitutional
Posted in In the Trenches by David Guard on Thu, 05/22/2008 - 12:44pmSchneider Defense Calls DOJ Prosecution Unconstitutional: Read the Briefs
As always, we ask that you help PRN fight to protect the rights of patients and the doctors who treat them. Please click the link below.
Schneider defense calls DOJ prosecution Unconstitutional
This case is an effort by the federal government to define and regulate the practice of medicine masquarading as a criminal prosecution. This case should not be about whether Dr. Schneider fell short of the standard of care for certain patients, but whether he engaged in the legitimate practice of medicine [...]
Memorandum of points and authorities in support of the defendants' joint motion for absention
The federal government has usurped the authority of the State of Kansas to regulate medicine within the State by bringing a halt to its regulatory process, and assuming that authority, impermissibly, through the federal criminal process. If any part of the Indictment is not dismissed as unconstitutional or otherwise defective, this Court should abstain, allowing the State process to run its course [...]
Competetive Enterprise Institute Joins Pain Relief Network in the battle against untreated pain
May 16, 2008
Cei.orgToday, millions of Americans live in chronic pain, without adequate access to prescription pain medications, because their doctors are too afraid of being harassed or even arrested by the Drug Enforcement Administration to prescribe sufficient doses. Everyone agrees that doctors should not be using their positions to supply addicts with narcotics or feed the illicit drug market. Many doctors, however, have been arrested or threatened with loss of their medical licenses simply for prescribing opiate-based pain medications in doses that federal drug authorities believe are too high [...]
Pain Treatment: Prosecutors in Case Seek to Shut Up Doctor, Critics
Federal prosecutors in the case of Haysville, Kansas, physician Dr.
