The Drug War's Dangerous Distortion of Medical Standards

We 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.
Permission to Reprint: This article is licensed under a modified Creative Commons Attribution license.
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Thanks Dave

I wonder how many of us there are that did not go to prison, but have had our lives destroyed, nonetheless. I spent half the night up, worked up , responding to the brainless comments about Michael Phelps' "indiscretions". The war on drugs continues to try to destroy all that is god in America, or should I say Amerika!

I too have been writing about Michael's apology

Michael Phelps did nothing wrong in toking on a bong! This is nothing for which he should apologize! It's no different than Prez. Obama taking a drink of bourbon after dinner, other than that some arbitrary rulemakers decided people should not have a choice of intoxicants and labeled it illegal.

I'm pro-choice on EVERYTHING!

This also affects children...

Here's an article in the NYT that talks about how this kind of thinking is affecting school children - schools now have apparently started prohibiting kids from bringing things like Aspirin to school, and in at least one case a child was strip searched over an accusation that she had an Ibuprofen on her.

Re: Also affects children.

Chilling twist on same old sh*t. I'm 28 and clearly remember two things from school. One was being treated like a criminal due to my school backpack having been used during a camping trip and some of my stepfather's non-narcotic prescription medication being left in the backpack and, by accident, taken to school. Even though I'm the one that brought the fact to my teacher's attention when I noticed the pill bottle in my backpack, I was sent to the principle's office, further searched, accused of taking/trying to sell the pills and threatened with being charged with possession of a controlled substance on school grounds.

As a result of this I also clearly remember being shown where it was stated in the student handbook that it was not allowed for students to carry any form of medication on them, even Aspirin. I was around 12 at the time, making this about 16 years ago.

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