Under-treatment of Pain

RSS Feed for this category

Pain Treatment: INCB Calls for Greater Access to Opioid Medicines in Developing World

As part of its 2007 Annual Report, released Wednesday, the International Narcotics Control Board (INCB) issued a press release saying that "ensuring access to pain treatment medicines is vital and possible." Millions of people around the world are suffering chronic and acute pain because narcotic pain medications are not being sufficiently used, the group said.

The INCB is a 23-member independent commission that works with the UN Office on Drugs and Crime (UNODC), its Commission on Narcotic Drugs (CND) and other international organizations to monitor implementation of the series of international treaties that form the legal backbone of the global prohibition regime. While its remit includes ensuring adequate supplies of drugs are available for medical and scientific uses, it spends most of its resources trying to prevent any deviations from the global prohibitionist drug policy status quo. (See related story here.)

According to the INCB, while global consumption of opioid pain relievers has more than doubled in the past decade, the vast majority of that growth has occurred in Europe and North America, which together accounted for 89% of global morphine consumption in 2006. By contrast, the 80% of the global population that lives in developing countries consumed only 6% of the morphine supply. In some countries, access to morphine is "extremely low and almost non-existent for most of the population," the group said.

The situation is similar for some other opioids such as fentanyl and oxycodone. In 2006, Europe and North America accounted for 96% of global fentanyl consumption and 97% of oxycodone, the group reported.

The lack of sufficient access to these powerful pain medications is "due to diverse interrelated factors such as inadequate medical education of health professionals and lack of knowledge and skills in pain treatment, public attitude, regulatory impediments or economic constraints," the INCB said. In a slap at proposals to deal with Afghan opium production by licensing it and diverting it into the legal medicinal market, as the Senlis Council has suggested, the INCB said global supply was at high levels and not the problem.

"Suggestions to further increase the supply of raw materials by using opium from the illicit production in Afghanistan do not address the cause of the problem. Governments should focus on measures to increase demand for pain-relief medication in line with the recommendations of INCB and WHO," said INCB President Philip Emafo.

The INCB said it urged governments to identify obstacles to adequate access to narcotic pain medications and to take steps to improve their availability. It also announced that, in consultation with the World Health Organization (WHO), it had created the Access to Controlled Medications Program to address identified impediments. The group urged all governmental and concerned international organizations to cooperate with the WHO, and called on governments to pony up some cash to pay for it.

Pain Wars in the Heartland: With Their Doctor Behind Bars, Kansas Patients Wonder Where To Turn

In a drama that has been played out all too many times across the country in recent years, the Justice Department's campaign against prescription drug abuse -- if you can call it that -- came in crushing fashion to Haysville, Kansas, last month. Now, a popular pain management physician and his nurse wife are being held without bond and more than a thousand patients at his clinic are without a doctor, but the US Attorney and the Kansas Board of Healing Arts say they are protecting the public health.

It all started December 20, when federal agents arrested Dr. Stephen Schneider, operator of the Schneider Medical Clinic, and his wife and business manager, Linda, on a 34-count indictment charging them with operating a "pill mill" at their clinic. The indictment charges that Schneider and his assistants "unlawfully" wrote prescriptions for narcotic pain relievers, that at least 56 of Schneiders' patients died of drug overdoses between 2002 and 2007, and that Schneider and his assistants prescribed pain relievers "outside the course of usual medical practice and not for legitimate medical purpose."

In their press release announcing the arrests, federal prosecutors also said that four patients died "as a direct result of Schneider's actions," but the indictment does not charge Schneider or anyone else with murder, manslaughter, or negligent homicide. In all four deaths, the patients died of drug overdoses, with prosecutors claiming Schneider ignored signs they were becoming addicted to the drugs or abusing them.

A handful of Schneider's former patients have filed malpractice lawsuits, claiming they became addicted as a result of his treatments. The Kansas Board of Healing Arts was investigating several complaints against Schneider before it backed off at the beginning of 2007 at the request of federal prosecutors seeking to build their case. (The US Attorney's office in Wichita denies that it asked the board to desist, but the board insists that is in fact the case.)

Under pressure from state legislators, the board acted this week, suspending Schneider's license to practice and effectively shutting down his clinic, which had remained open with physicians' assistants writing prescriptions. That move came as a surprise to Schneider's patients and supporters, who had been engaged in negotiations with the board to keep the clinic open.

But if federal prosecutors, the state board and a few patients are painting Schneider as a Dr. Feelgood, for some of his patients, he was a life-send. Debbie Sauers was one of those patients. Suffering from the after-effects of a dissecting aortic aneurysm and chronic pain from four failed back surgeries, the former nurse said she now has nowhere to go. "The clinic is shut as of tomorrow, and today was the last day to get prescriptions filled," she said Wednesday. "Dr. Schneider was the only one who would treat me with pain medicine, and now I don't know what I'm going to do," she said.

Her efforts to find another doctor to take her on have been a stark exemplar of the stigmatization faced by pain patients whose physician is accused of being a pill-pusher. "I've had doctors' offices refuse to see me or laugh in my face or tell me to check into drug rehab when I tell them I was one of Dr. Schneider's patients," she said. "If you go to the ER, they hand you a list of drug rehab places. They put my doctor in jail, and no one will treat me now." Sauers is currently on massive doses of morphine and high-dose Lortab and says her cardiologist tells her a rapid withdrawal could kill her. "I don't know what to do," she repeated.

Darren Baker is another patient who swears by Dr. Schneider. The operator of a tree gardening service, Baker has bone spurs in his knees from years of climbing, and two years ago, he fell out of a tree, shattering both his heels. "They put all kinds of hardware in my heels, and I have to have pain medications just to walk," he said. "With the pain meds, I can't walk real well, but without them, I can't walk, period. Dr. Schneider was the only one who would treat me."

Now, like Sauers, Baker is in search of a doctor. "I haven't found one yet," he said. "I got a list today, but most of them are turning you away if you're associated with Dr. Schneider. If I can't get another doctor, I won't have any option except to retire and go on disability. I take my medicine to be a productive member of society," he said angrily. "I need my meds to survive and pay my bills and fight the daily grind. This really goes against our constitutional rights. How the hell can I pursue happiness lying in bed?"

If convicted, the Schneiders face a minimum of 20 years in federal prison, and given the multitude of counts, they could theoretically face centuries. While, since their arrests, they have been excoriated in the Kansas press and by politicians, they have also received strong support, not only from patients, but also from a national pain advocacy organization, the Pain Relief Network. Headed by Siobhan Reynolds, a former documentary film maker turned crusader after her life partner suffered horrendously from lack of adequate pain treatment before dying in 2006, the network has done highly effective advocacy on cases ranging from that of imprisoned Northern Virginia pain specialist Dr. William Hurwitz to wheelchair-bound, formerly imprisoned, and now pardoned Florida pain patient Richard Paey.

Reynolds senses a similar injustice on the Kansas prairies. "Dr. Schneider is a wonderful doctor and he ran a wonderful clinic," she said. "But the Justice Department comes in here and after the fact characterizes his medical practice as drug dealing and also after the fact decides that a patient death is caused not by a doctor but by a 'drug dealer,' making it now tantamount to murder, with a 20-year mandatory minimum. If anyone wonders why doctors don't take care of sick people, this is why."

The root of the problem, said Reynolds, is the Controlled Substances Act, under which the Justice Department determines what constitutes proper medical practice and what doesn't. "Under the act, the exchange of money for drugs is presumptively illegal, and doctors have to show they are doing medicine in an 'authorized fashion' approved by the Justice Department. Under the act, doctors are effectively presumed guilty until proven innocent. It's backwards, and it helps explain why it is so difficult to win these cases," she said.

The Pain Relief Network will shortly bring a federal lawsuit challenging the Controlled Substance Act, Reynolds said. "The act is profoundly unconstitutional and unlawful. It reverses the presumption of innocence, and we think we can win that challenge, even if we have to go to the Supreme Court."

While the network had vowed to file the lawsuit last month, it hasn't happened yet. That's because the network has been too busy putting out fires in Kansas, she said, adding that the lawsuit will be filed soon.

Meanwhile, Dr. Schneider and his wife remain jailed without bond at the request of federal prosecutors pending a first court date later this month. His patients are now scrambling to find replacement doctors with little success, especially now that other local doctors see what could await them if they apply aggressive opioid pain management treatments. And a chill as cold as the February wind is settling in over pain treatment on the Kansas plains.

Perhaps Dr. Schneider is guilty of failing to adequately screen his patients, said Darren Baker, but that's not a crime. "Pain meds are narcotics," he said. "Some people have to have them to survive, but other people just want them. I think Dr. Schneider should have covered his ass more. A drug addict is going to get his drugs, whether through a doctor or on the street. They can buffalo a doctor. But when they abuse their prescriptions, how can it be the doctor's fault? Maybe he could have done things differently, but he operated in good faith."

Pain Medicine: Advocacy Group to Challenge Controlled Substances Act In Lawsuit Aimed at Protecting Physicians, Patients

Haysville, Kansas, physician Dr. Stephen Schneider and his nurse wife, Linda Schneider, were arrested on a 34-count federal indictment last month for allegedly improperly prescribing opioid pain medications and causing the deaths of at least four patients. The Schneiders are only the latest pain management health care providers to fall victim to the federal government's war against prescription drug abuse and diversion, and now a leading pain relief advocacy group is vowing to take the government to court to block further harassment of physicians and the pain-ridden patients who rely on them.

Last Friday, the Pain Relief Network announced it will seek a civil injunction barring the Justice Department from prosecuting the Schneiders. But the lawsuit could have much broader implications than the couple's freedom. It will argue that the way the federal Controlled Substances Act is applied to doctors and patients is unconstitutional.

"I want a judge to take a look at this and see if the United States has authority to prosecute," Pain Relief Network head Siobhan Reynolds said during a press briefing last Friday. Reynolds cited a ruling in a similar case that such prosecutions give the government unrestrained power to interfere in the doctor-patient relationship.

The real victims of the government's crackdown on the Schneiders and other health care professionals prescribing opioid pain medications are patients, said Reynolds. "These patients are in real harm's way," Reynolds said. "They are being attacked by the Department of Justice."

While some of Dr. Schneider's former patients have filed malpractice lawsuits claiming they became addicted because of his prescribing, other patients said he had been a godsend and that they are suffering now without him.

One was Jamie McGuire, 49, who had been receiving pain meds for severe arthritis in his spine, hips, and shoulders resulting from an auto accident. Since Schneider was jailed, he has been unable to even get a referral to another doctor. "I think they railroaded him," he said of the prosecution. McGuire told reporters he is almost out of pain medication and his situation is dire. "If they don't do something, I will take myself out," McGuire said.

Another patient, Martin Beatty, 46, also showed up to support his doctor. He said he opted for a regime of pain meds rather than surgery or steroids after falling from a roof 12 years ago and had been a patient of Schneider's for three years. He admitted being dependent on his pain meds, but said that shouldn't matter. "Addiction doesn't mean I am going to be a bad person," Beatty said. Now he worries about going through withdrawal without being under a physician's care.

This week, patients and advocates continued to fight for Dr. Schneider, who, along with his wife, remains jailed. They gathered at his offices to show support and sign petitions, one to join the federal lawsuit, the other to keep the Kansas Board of Healing Arts from moving to suspend his license. According to Reynolds, the clinic will be forced to close because the physician assistants now writing prescriptions are doing so under the auspices of working for a clinic owned by a licensed physician. Other doctors who once practiced at the clinic have been run off by fears of federal prosecution, she said.

"Right now we are calling on the medical board to refrain from joining in this attack on this clinic. This clinic has been hobbled by the Justice Department. These patients are living in mortal fear," Reynolds said.

Pain Medicine: Emergency Room Doctors More Likely to Prescribe Opioids to Whites Than Minorities

A new study has found that while emergency room prescribing of opioid pain medications for ER patients complaining of pain has increased in recent years, doctors are less likely to prescribe them for minority patients than white ones. Even in cases where patients complain of severe pain, such as kidney stones, the difference holds.

The study, "Trends in Opioid Prescribing by Race/Ethnicity for Patients Seeking Care in US Emergency Departments," was published this week in the Journal of the American Medical Association. It analyzed more than 150,000 ER visits between 1993 and 2005 and found racial differences in prescribing in all US regions, in both urban and rural hospitals, and for all types of pain.

The study found that the prescribing of drugs for pain in the ER rose during the period in question, from 23% of those complaining of pain in 1993 to 37% in 2005. That increase reflects increased understanding of the necessity of pain management by physicians. Now, doctors in accredited hospitals must ask patients about pain, just as they monitor vital signs. But while prescribing is on the increase, the racial divide remains.

According to the study, 31% of white patients in pain were prescribed opioids, compared to 28% of Asians, 24% of Hispanics, and 23% of blacks. When it comes to the severe pain related to kidney stones, whites got opioids 72% of the time, compared to 68% for Hispanics, 67% for Asians, and only 56% for blacks.

"The gaps between whites and nonwhites have not appeared to close at all," said study coauthor Dr. Mark Pletcher of the University of California, San Francisco.

Researchers are looking for reasons for the discrepancy. Pletcher suggested to the Associated Press that minority patients "may be less likely to keep complaining about their pain or feel they deserve good pain control."

Linda Simoni-Wastila of the University of Maryland, Baltimore, School of Pharmacy told the AP the findings could reveal some doctors' suspicions that minority patients could be drug abusers lying about pain to get narcotics. She said that according to her own research, blacks are the least likely group to abuse prescription drugs.

The study's authors suggested that the finding could indicate either that doctors are less likely to see signs of pain reliever abuse in white patients or that they are underrating pain in minority patients. Whatever the reason, it seems that the racial injustice associated with drug prohibition reaches even into the emergency room.

"It's time to move past describing disparities and work on narrowing them," Dr. Thomas Fisher, an emergency room doctor at the University of Chicago Medical Center who was not involved in the study, told the AP. Fisher, who is black, said that even he needed to be careful not to let subconscious assumptions inappropriately influence his prescribing decisions. "If anybody argues they have no social biases that sway clinical practice, they have not been thoughtful about the issue or they're not being honest with themselves," he said.

Europe: British Drug Council Calls for Heroin, Cocaine Prescribing By Nurses, Pharmacists, Chides Government's Drug Strategy Consultation

The British Advisory Council on the Misuse of Drugs (ACMD) has criticized the Labor government's ongoing consultation on a new 10-year drug strategy as a "missed opportunity" because the government created a consultation paper that was "self-congratulatory" and focused on trying to claim the current 10-year strategy is a success. A day later, the ACMD's head announced the council was recommending that doctors be allowed to prescribe controlled substances such as heroin and cocaine.

In its response to the consultation, the ACMD was decidedly undiplomatic in its overall comments: "It is unfortunate that the consultation paper's 'key facts and evidence' section appears to focus on trying to convince the reader of success and progress; rather than providing an objective review and presentation of the current evidence. The ACMD found the consultation paper self-congratulatory and generally disappointing," the council complained.

The ACMD also scolded the government for lacking a firm evidence base and failing to acknowledge it: "It is of concern that the evidence presented, and the interpretation given, are not based on rigorous scrutiny. It is not acknowledged that in many cases the information is uncertain and sometimes of poor quality. It is disappointing that the consultation paper makes no mention of needing to improve the evidence base of drug misuse and treatments nor makes use of international evidence, for informing and guiding policy," the council chided.

"We consider that an opportunity has been missed to address the public health problem relating to drug misuse and the balance with law enforcement and the criminal justice system. We would also have welcomed a statement of ambition for the drug treatment system," the council added.

The ACMD was created as part of the 1971 Misuse of Drugs Act and it is mandated to advise the Home Office on drug policy. One of its primary functions is to recommend which classification various drugs should go in. While the ACMD is critical of the government's drug policy consultation process, it itself has been criticized for a lack of scientific basis in the drug classification system, most thoroughly by the Science and Technology Select Committee's 2006 report, Drug Policy: Making A Hash of It?

The ACMD's caustic words for the process gave fuel to the political opposition, with the Liberal Democrats quick off the mark. "The failures of the government's drugs policy are laid bare for all to see when their own advisory committee condemns the Home Office as being misleading and self-congratulatory," said Liberal Democrat leadership contender Nick Clegg. "When will the government wake up and acknowledge something many members of the public know: we are losing the war on drugs?" Clegg asked.

It wasn't just political foes. Steve Rolles of the Transform Drug Policy Foundation had last month called the consultative process "a sham," saying the government had already made up its mind to continue the current strategy. "The consultation process behind the new strategy has been woeful," he said.

Then, last Saturday, ACMD chairman Sir Michael Rawlins announced during the group's first public meeting in its 36-year existence that he had sent a letter to the Home Office proposing that the drug law be changed to allow nurses and pharmacists prescribe heroin and cocaine to hard-core users and pain patients. He wrote a letter to Home Office minister Vernon Coker making the proposal in a bid to help patients manage pain better, he said.

That proposal prompted quick criticism, too, this time from political opponents on the right, who called it a "white flag" approach. "If Gordon Brown signs up to this, it would show yet again that Labour merely seek to manage drug addiction rather than end it," said Conservative shadow home secretary David Davis. "The Conservative approach is different. We would stop -- not swap -- drug addiction by focusing the drugs budget on expanding the use of abstinence-based drug rehabilitation programs. This method has proved far more successful at getting people off drugs than the Government's white flag approach."

And so it goes in the countdown to the new British drug strategy, which is due in the spring. Meanwhile, the ACMD is considering whether ecstasy should be down-scheduled and marijuana up-scheduled. The drug debate in Britain is going to stay lively for awhile.

Update on Pain Physician Dr. William Mangino

In July and September I wrote here about the plight of Bill Mangino, a Pennsylvania physician who was decent enough to treat patients with the pain medications (opiates) that they needed, and was punished for these good deeds with a prosecution and now imprisonment -- all over a crime that never happened and for which no evidence exists happened. Yesterday I heard from Dr. James Stacks, a Mangino supporter and board member of the Pain Relief Network, with the news that Dr. Mangino had asked we post correspondence he sent to a judge prior to a hearing today that he hopes will get him a new trial and freedom in the meantime. The briefs were put together by Mangino himself, written by hand, but has been scanned for our edification online as well. Interested parties can read some commentary on it by Alex DeLuca here, or go straight to the briefs online here or here. A cutting quote that Dr. Mangino used as his signature line in the documents:
Statutes must mean what they say... and say what they mean.
Location: 
PA
United States

Paey Starts Afresh with Call from Crist

Location: 
FL
United States
Publication/Source: 
St. Petersburg Times
URL: 
http://www.sptimes.com/2007/09/22/Pasco/Paey_starts_afresh_wi.shtml

Pain Patients: Florida Prisoner Richard Paey is Pardoned

Richard Paey, the wheelchair-bound Florida pain patient sentenced to 25 years in prison as a drug dealer for seeking desperately-needed medications, may be a free man by the time you read this. Florida Gov. Charlie Crist (R) granted Paey a full pardon on Thursday after a brief hearing in Tallahassee. Paey and his family had only sought clemency.

Paey was severely injured in a 1985 auto accident. A New Jersey physician provided him with prescriptions for necessary pain relievers, but when Paey moved to Florida he took pre-signed prescription forms with him. He was arrested in 1997 and charged with illegally possessing and trafficking in about 700 pain pills obtained with those prescriptions.

Under Florida's draconian drug laws, persons in possession of that amount of pain medication are treated as drug traffickers. Standing on principle, Paey refused plea offers from the state and was ultimately convicted and sentenced to the mandatory minimum 25-year sentence.

Paey's case became a cause celebre for the country's growing pain patient and doctor movement. In August, the governor's office announced that it would grant a waiver allowing Paey to seek clemency. In most cases, inmates cannot seek clemency until they have serve 1/3 of their time.

Thursday, Gov. Crist and three members of the Florida cabinet heard Paey's appeal for clemency. Though the state's parole commission had recommended against granting time-served, Crist went further, granting him a full pardon and ordering he be released immediately. According to the St. Petersburg Times, Crist allowed Paey's attorney, John Flannery to speak for nearly 30 minutes -- the usual time limit is five minutes, then allowed Paey's wife, three children and a family friend to speak as well.

Crist then commented, "I want to move that we grant a full pardon," continuing, "We aim to right a wrong and exercise compassion and to do it with grace," the governor said. "Congratulations... and I state he should be released today."

For further information on the Paey case, click here.

Two People I Know Were Sentenced to Prison Last Week

The Paey Pardon, as Scott blogged about here and here, was a nice piece of news, of the kind that doesn't come around too often. The last such pleasant surprise I had came in late 2000, when Kemba Smith and Dorothy Gaines were pardoned by then-President Clinton. I immediately left a message for my friend Rob Stewart, who had played a major role in bringing the Gaines case to prominence by writing it in the old Drug Policy Letter (Drug Policy Foundation, predecessor to Drug Policy Alliance), which led to coverage of her case by Frontline. Rob told me later he had two messages on his voicemail -- one from me and one from Dorothy Gaines. These moments are rewards for all the rest of it. Unfortunately, not many political leaders seem to be of the moral caliber of Gov. Crist, and there are many more victims of the drug laws who remain unpardoned. Two of them, whom I happen to know, were sentenced to prison a week ago. One of them was Bryan Epis, the first person prosecuted by the feds for medical marijuana. He received the same 10-year sentence. The other was William Mangino, a pain physician in Pennsylvania, sentenced to 8 1/2 - 20 years. Bryan was allowed to remain free pending appeal. See our upcoming Chronicle newsbrief for some detail. Bryan actually told me a few days before the court date that he anticipated getting another 10 years, but being allowed to stay free pending appeal, and he was right. He says he has a good chance on appeal, and it sounds like it -- the prosecution really acted unethically in his case, and the judge, who is by no means biased toward defendants, commented that there are issues the appellate court may want to look at. Dr. Mangino predicted a harsh sentence, and that he would not be allowed to stay free pending appeal. Unfortunately, he was right too. Christine Heberle's blog post on the War on Doctors/Pain Crisis blog lays out the glaring absence of any crime. Accountability for injustices committed under the guise of law may be too much to hope for. But at least we should have justice now. I simply don't feel that letting people like Richard Paey and Bryan Epis and Bill Mangino live their lives unmolested by the government is asking for too much.
Location: 
United States

Richard Paey's Torturers Must be Held Accountable

As we celebrate Richard Paey's freedom today, it is important to remember that his tragic fate was no accident. Many people worked very hard at tax-payers' expense to put this innocent and miserable man behind bars. They deserve recognition today as well.

Certainly, these events vividly depict the insanity of a war on drugs that targets seriously ill people for trying to treat their own pain:
State prosecutors concede there's no evidence Paey ever sold or gave his medication away. Nevertheless, under draconian drug-war statutes, these prosecutors could pursue distribution charges against him based solely on the amount of medication he possessed (the unauthorized possession of as few as 60 tablets of some pain medications can qualify a person as a "drug trafficker"). [National Review]
Yet, as Radley Balko revealed at National Review, the persecution of Richard Paey involved so much more than the reckless enforcement of short-sighted laws. This was a prolonged and deliberate campaign on the part of malicious prosecutors and vengeful prison officials.

*Prosecutors blamed Paey's harsh sentence on Paey himself, claiming that he should have accepted a plea bargain. As Balko explains, they essentially retaliated against him for asserting his factual innocence and insisting on his right to a jury trial.

*Prison officials transferred Paey further away from his family after he gave a New York Times interview that was critical of the State of Florida.

*Prison medical staff threatened to withhold Paey's medication, also in apparent retaliation for his interview with the New York Times. Since he could die without it, this was the functional equivalent of a death threat and caused him great distress.

Now that Florida's Governor and Cabinet have concluded that Paey did nothing wrong, it is time to examine the way he was treated throughout this great travesty. If there are sociopaths working in Florida's criminal justice system, that's something Governor Crist would want to know about. If we can afford to imprison people for decades in order to protect ourselves from drugs, surely we can also afford to evaluate public servants who wield extraordinary power in order to ensure that they aren't deeply disturbed.

Mentally healthy people do not persecute the seriously ill, even if the drug war says it's ok.
Location: 
United States

Drug War Issues

Criminal JusticeAsset Forfeiture, Collateral Sanctions (College Aid, Drug Taxes, Housing, Welfare), Court Rulings, Drug Courts, Due Process, Felony Disenfranchisement, Incarceration, Policing (2011 Drug War Killings, 2012 Drug War Killings, 2013 Drug War Killings, 2014 Drug War Killings, Arrests, Eradication, Informants, Interdiction, Lowest Priority Policies, Police Corruption, Police Raids, Profiling, Search and Seizure, SWAT/Paramilitarization, Task Forces, Undercover Work), Probation or Parole, Prosecution, Reentry/Rehabilitation, Sentencing (Alternatives to Incarceration, Clemency and Pardon, Crack/Powder Cocaine Disparity, Death Penalty, Decriminalization, Defelonization, Drug Free Zones, Mandatory Minimums, Rockefeller Drug Laws, Sentencing Guidelines)CultureArt, Celebrities, Counter-Culture, Music, Poetry/Literature, Television, TheaterDrug UseParaphernalia, ViolenceIntersecting IssuesCollateral Sanctions (College Aid, Drug Taxes, Housing, Welfare), Violence, Border, Budgets/Taxes/Economics, Business, Civil Rights, Driving, Economics, Education (College Aid), Employment, Environment, Families, Free Speech, Gun Policy, Human Rights, Immigration, Militarization, Money Laundering, Pregnancy, Privacy (Search and Seizure, Drug Testing), Race, Religion, Science, Sports, Women's IssuesMarijuana PolicyGateway Theory, Hemp, Marijuana -- Personal Use, Marijuana Industry, Medical MarijuanaMedicineMedical Marijuana, Science of Drugs, Under-treatment of PainPublic HealthAddiction, Addiction Treatment (Science of Drugs), Drug Education, Drug Prevention, Drug-Related AIDS/HIV or Hepatitis C, Harm Reduction (Methadone & Other Opiate Maintenance, Needle Exchange, Overdose Prevention, Safe Injection Sites)Source and Transit CountriesAndean Drug War, Coca, Hashish, Mexican Drug War, Opium ProductionSpecific DrugsAlcohol, Ayahuasca, Cocaine (Crack Cocaine), Ecstasy, Heroin, Ibogaine, ketamine, Khat, Marijuana (Gateway Theory, Marijuana -- Personal Use, Medical Marijuana, Hashish), Methamphetamine, New Synthetic Drugs (Synthetic Cannabinoids, Synthetic Stimulants), Nicotine, Prescription Opiates (Fentanyl, Oxycontin), Psychedelics (LSD, Mescaline, Peyote, Salvia Divinorum)YouthGrade School, Post-Secondary School, Raves, Secondary School

StopTheDrugWar Video Archive