Dr. Feelscared

Drug warriors put the fear of prosecution in physicians who dare to treat pain.

Maia Szalavitz from the August/September 2004 issue

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Stutsman intends to use similar reasoning in his appeal of Deborah Bordeaux's conviction. Her prescribing never exceeded manufacturers' recommendations or those of her state medical board; there was no exchange of drugs for sex or other evidence that she was not practicing real medicine. "What makes this particularly outrageous," says Stutsman, "is their confusion of civil and criminal standards to start with. It's an excessive exercise of federal power based on a misapplication of federal law."

Suicide Is Painless

Kathryn Serkes, spokesperson for the Association of American Physicians and Surgeons (AAPS), sees these cases as part of a long-term trend toward increased prosecutorial power that includes sentencing guidelines, mandatory minimums, and forfeiture laws. The Coalition Against Prosecutorial Abuses, a group she is organizing to fight this trend, declares: "There's still one group of trial lawyers that has been left alone to go about their dirty work with few restrictions -- and all at taxpayers' expense. These are the government prosecutors."

The AAPS, along with the Pain Relief Network, has been vocal in denouncing the federal and state doctor prosecutions. The group's Web site warns: "If you're thinking about getting into pain management using opioids as appropriate: DON'T. Forget what you learned in medical school -- drug agents now set medical standards." The AAPS urges doctors inclined to ignore this advice to be aware of the risks, including "years of harassment and legal fees," loss of income and assets, and professional ostracism.

Despite increasing outrage from physicians and patient advocates, the DEA maintains that people in pain have nothing to fear from the crackdown. "A legitimate patient with legitimate medical problems should have no problem getting another doctor if their doctor has been arrested," says the DEA's Willis.

Anti-pain activists vigorously dispute that. "This is causing doctors not to prescribe," says the Pain Relief Network's Siobhan Reynolds, "and that means patients will be in hell." Several of the prosecutions have been associated with suicides by devastated patients who couldn't get effective treatment elsewhere. Common Sense for Drug Policy reports that one of William Hurwitz's patients killed herself on March 16. Frank Fisher says one of his patients drove her car in front of a train.

In a forthcoming documentary by Reynolds, pain patient Skip Baker says, "It's a devastating health care crisis, to the point that thousands are committing suicide that nobody knows about. Most pain patients know -- everybody's planning to run into this bridge abutment or that tree or whatever to make it look like an accident." Ronald Myers, a Mississippi physician and minister who founded the American Pain Institute, observes:

"They want to talk about deaths associated with OxyContin. But no one wants to talk about these deaths. There's been an epidemic of suicide."

Laura Cooper, an attorney with multiple sclerosis and a former patient of Hurwitz, moved to Oregon when his practice was shutting down. Her new doctor "is also under the microscope," she says. "All of these guys are on their way out -- if not on their own, the government is on the way to putting them out. Anybody who would treat me the way I need to be treated is not long for American medicine. When my doctor goes down, I don't know what I'll do."

Since Cooper lives in Oregon, she notes, "by law I can get drugs to kill myself, but not to treat my pain. The doctor could say, in effect, 'I'm not trying to treat pain; I'm trying to kill her,' and that would be more acceptable. Clearly, something's a little off kilter. My medical needs are less important than their war on drugs."