David Borden, Executive Director, [email protected], 9/26/03
Years back in my Boston days, I often rode the "1" bus along Massachusetts Avenue traveling between Boston and Cambridge. There was another frequent passenger on the bus whom I've never forgotten, a woman suffering from some medical condition which would cause her extreme pain anytime she had to stand up, or sit down, or walk, or navigate stairs. Each time getting on and off of the bus, she would cry out in agony, multiple times, to the horror of other riders. I'm sure they remember her too.
At the time, I wondered, is there nothing that could be done to bring her relief? Has she just not seen the right doctor, or any doctor? Could she be steered in the right direction?
Now, of course, I understand very clearly what the likely reasons were for her uncontrolled pain. Some level of treatment with opioid drugs (also known as narcotics -- morphine, codeine, etc.), would probably have provided her some degree of relief. She probably did seek such treatment; in fact, she probably sought it multiple times. But the doctor or doctors she saw were probably too scared to write those prescriptions, in the quantities she needed. They probably feared that if they did, a sneaky drug agent and an overzealous prosecutor would come after them and put them in prison and out of business. And it's quite possible that that is what would have happened.
I am speculating, of course, but there's a strong chance that I'm right. And if I'm not, the issue is no less important, because that is exactly what is happening to huge numbers of chronic pain patients in America today. How many of Dr. Hurwitz's patients were unable to find adequate pain treatment after he closed his practice with advance notice last year in anticipation of government action against him? I will also speculate and say that US Attorney for the Eastern District of Virginia Paul McNulty probably ordered Hurwitz be arrested on Thursday to ensure he would spend the weekend (and Jewish New Year) in jail before a judge could decide whether to hold or release him on bond, even though Hurwitz is clearly not a flight risk.
In the decades following abolition of slavery but preceding the gains of the Civil Rights movement, the south's most racist would lynch the occasional black man. They didn't need to wage full scale riots or pogroms against the southern black population, at least not most of the time. They could simply kill or beat one or a few people, once in awhile, to keep the rest of them in line.
Similarly, one bad prosecutor can go after a pain doctor -- just once -- and frighten the rest of the doctors into submission. They won't prescribe opioids, at least not in the quantity needed by my fellow bus rider in Boston, certainly not if she had a substance abuse history or once she developed tolerance to the drugs and needed more for the same effect. And without the doctors to prescribe them, the patients can't get them, at least not without resorting to the black market and all the risk and harm that goes along with that. Narcotics remain demonized, diversion bureaus' budget stay strong or go up, and McNulty gets a promotion or runs for office. It's very simple, and for the likes of him very easy.
Of course, McNulty is a respected government official carrying out his duty, not a member of a lynch mob committing murder. If his charges are off base, if his evidence is weak, Hurwitz and his lawyers have the opportunity to make that case in court. But I don't buy that argument. If the case isn't there -- and I am very confident in this case that it's not -- then it shouldn't be brought. There is no moral difference between an unjustified prosecution brought for political purposes and a kidnapping done for ransom, and lynch mobs also operated with tacit sanctioning by the authorities.
The harm to the good doctor's finances is enormous, and the government isn't going to pay that back. McNulty can't undo the damage his Thursday press conference caused to Hurwitz's reputation, or the strain that the ordeal of fighting a possible life sentence must take on Hurwitz and his family. And the collateral consequences for patients will be only marginally less with an acquittal than a conviction, at least in the short term. The official who commits an act of unjust persecution is not less guilty than the criminal who does so, but more: In addition to all the same crimes and outrages, he has also betrayed the public's trust, and like a terrorist has committed his evil acts while claiming they are good.
I don't know whether Paul McNulty is a monster devouring the lives of doctors and patients for his personal political gain, or just a misguided zealot led astray by the people around him. But the effects of his actions are equally terrible in either case. Just as the Civil Rights movement rose up half a century ago to stop the injustices of lynchings and Jim Crow, just as medical marijuana patients have risen up to demand their right to medicine, the pain patient movement is rising now as well, to beat back the prosecutors and stop the lynchings of their doctors. McNulty will soon realize he's made a mistake to regret the rest of his life.
Please read the next article as well as the leading newsbrief -- below or at http://stopthedrugwar.org/chronicle/304/prn.shtml and http://stopthedrugwar.org/chronicle/304/hurwitz.shtml -- for recent important information on this issue.