DEA Causes Real Pain, Says NY Times

The New York Times' personal health columnist takes on an issue that Reason has been addressing for years--the Drug Enforcement Administration's jihad against doctors who try to treat chronic debilitating pain in their patients. Brody cites a new article in the New England Journal of Medicine, "The Big Chill: Inserting the D.E.A. Into End-of-Life Care," warning that if the government

oversteps its legitimate role and expertise, allowing DEA agents, trained only to combat criminal substance abuse and diversion, to dictate to physicians what constitutes acceptable medical practice for seriously ill and dying persons, it will undermine palliative care and pain management for the much larger number of seriously ill patients in all states. Physicians may become hesitant to prescribe the best available medications to manage the pain, agitation, and shortness of breath that sometimes accompany the end stages of illness. As a result, they may, in essence, abandon patients and their families in their moment of greatest need.

Thanks to the indefatigable efforts of the DEA, when patients die screaming in agony, they'll at least die clean and sober.

Comments

[Jennifer]

As The Onion so wisely asked, why can't sick or dying people play music or sports, or paint or read books, instead of using drugs?

Hobbies, people. Get yourselves some hobbies.

[Mr. Nice Guy]

If the AARP isn't taking on this issue already, they will. And woe to the DEA.. 'cause nothing is going to stand between these codgers and their drugs.

[Number 6]

Agony-my anti-drug.

[Robert]

"If the AARP isn't taking on this issue already, they will. And woe to the DEA.. 'cause nothing is going to stand between these codgers and their drugs."

Actually the pro-control side is remarkably advantaged, because of perspectives. They always assure people that legitimate treatment is not and ought not to be inhibited by such oversight. And people think, my doctor isn't a drug pusher, so I'll never have a problem with this. So this one is perpetually someone else's problem, and even an organization like AARP is loathe to consider it their own constituents' problem.

[Mr. Nice Guy]

The thing is, Robert, if these old folks are denied pain treatment, they are going to scream bloody murder. And politicians are terrified of this huge (and getting bigger), highly motivated, and highly organized voting block.

For once, these AARP bastards might do us a favor. If only we can sell them on the concept of medical marijuana..

[R C Dean]

I'm not sure if the oldsters are going to see the connection between their increasingly puny medications and DEA jackboots. Not many doctors are likely to say "I'd like to prescribe X, but I'm afraid I'll get in trouble with the feds if I do."

[Jennifer]

Robert and RC are probably right.

There's also the fact that generally speaking, these old folk aren't going to know any better--it's not like they used to get sufficient pain medication, but now they're cut off; they will probably just think that a certain level of pain is what they have to suffer at their age.

[Qbryzan]

but now they're cut off; they will probably just think that a certain level of pain is what they have to suffer at their age.

I find it hard to believe that members of the baby boomer generation will tolerate any pain whatsoever as they age.

[Jennifer]

I find it hard to believe that members of the baby boomer generation will tolerate any pain whatsoever as they age.

Sure they will. Just tell them it's for The Children.

[Mr. Nice Guy]

Q:

Exactly. The Boomers are going to outright demand unfettered access to free pain medication, and they will get it. All the jackboots in the world wouldn't be able to stop them.

I'm certainly making a real mixed-bag argument here.

[Qbryzan]

I'm certainly making a real mixed-bag argument here.

It's still a reasonable argument - who wouldn't want a mixed bag of free pain medication? Or was that not your point?

[Mr. Nice Guy]

Q:

There's not going to be mixed bags of ANYTHING for Gen X. After the Boomers completely bankrupt the system, there's going to be a nasty backlash against elder entitlements.. just in time for us.

Save your money, folks. There's not going to be golf vacations, early retirement, or free health care/drugs for us. Not by a long shot.

[johnl]

A lot of people would rather be in pain than on drugs. They will watch their friends die, undermedicated, in agony, and find comfort in the fact that their friends died without becoming adicts. All that's their right, it's just bad that those people also want to make sure that folks who don't share these concerns will also die in agony undermedicated.

[Native NYer]

Mr. Nice Guy, you are so right!!

[Warren]

I don't hold much hope for the AARP seeing reason on this. The membership consists overwhelmingly of folks who swallowed the cool-aid on the evils of drugs. Those that do suffer from chronic pain will not be very effective advocates. What it will take is large number of people who have to watch their loved ones suffer, and also realize that they are suffering needlessly for the sake of WOD dogma.

[Ed]

Sheesh, was everyone here born after 1964? I have news for you: The first boomers are nearly 60 and are already in pain. And the AARP signs you up when you're 50. So the boomers have been living in pain for a while now and don't seem to be making much headway against the DEA. And stop your whining, Xers. You'll have access to medicines the boomers could only dream of. If Iran doesn't nuke you first.

[Randolph Carter]

Does the generation that's now between ages 20 and 25 have a name? Because we're going to enjoy picking up the pieces from the rest of you alphabetically-inclined generations.

[booty0]

According Ray Kurzweil, death will soon be an antiquated notion.

[Jennifer]

Does the generation that's now between ages 20 and 25 have a name? Because we're going to enjoy picking up the pieces from the rest of you alphabetically-inclined generations.

I recommend "Generation Table Scraps." Because after paying off the national debt and all the other bills society's currently racking up, that's all you're going to get.

[Randolph Carter]

I'm going for "Generation Thunderdome"

[Born in 1980]

Randolph, we got named Generation Y. Damned Boomers labeled us without our permission.

Personally, I prefer the term coined by a colleague: IMGen, referring to our collective addiction to Instant Messenger.

[Randolph Carter]

What the hell? Generation Y? Whoever comes up with this crap isn't very creative. This is why we need to be Generation Thunderdome, to have a constructive way to settle disputes like these.

[Jennifer]

Randolph, the fact that you'd name your generation after the wacko behind the Holy Christ Almighty Snuff Film is yet another example of What Is Wrong With Kids Today.

[Eric the .5b]

I always thought it was funny that the original article that used the term "Generation X" to refer to those shiftless, no-good kids was written in 1964 and referred to the baby boomers.

[Randolph Carter]

It's not so much what I want for my generation, but more what I see coming.

N.B. it's not Generation Mad Max, it's Generation Thunderdome. Jeez.
Since I have no faith in the ability of elected officials to do their jobs, I can only pin my hopes on the following vision:

(House of Reps floor)
Speaker pro tem: The gentleman from Missouri yields the remainder of his time. We will now have a voice vote on H.R. 45523, the Republicans are Stronger than Democrats Act

Chorus of Representatives: Two reps enter, one rep leaves! Two reps enter, one rep leaves!

then Kucinich would jump on Kennedy's back like Master Blaster, and C-SPAN's ratings would skyrocket

[AmyLou]

Randolph: haha,hahahahah, ha ha, haha. Heee!

[cliff]

I can only hope that any DEA / LEO involved in cases regarding harrassment of pain patients and / or doctors who prescribe pain meds will have to deal with a severe illness or injury where they will be denied adequate pain meds.

[cliff]

"I recommend "Generation Table Scraps." Because after paying off the national debt and all the other bills society's currently racking up, that's all you're going to get."

Wait till the Chinese calls the marker due on our debt.

[AmyLou]

There are some pain-medication advocates who argue that there really isn't such a thing as "addiction" to medication but rather "chronic patient overuse" of pain medication. I come across this all of the time in my personal research on issues of potential addiction to/overuse of migraine medication.

Whatever euphemism you care to use to name the issue, the fact is, opium-based and opiate-derivative pain medications are flatly addictive. But they are also legal, and should therefore not fall under the jurisdiction of the DEA. There is nothing illegal about their use when prescribed and taken under the supervision of a licensed physician.

I also wonder about the ethical considerations for doctors and their patients when faced with a situation in which chronic and devastating pain is part of the end of illness. The doctor has an obligation to provide for the care and comfort of his/her patient, and also must do no harm and abstain from "hastening death." Is there a paradox between doing no harm and hastening death? If a patient is living miserably and needs high doses of morphine, et. al. to live his last days/months/years in peace, and the doctor cannot give the patient this medication, then has the doctor done harm by forcing the patient to live in pain (even though the doctor has abided the law)? On the flip side, if the patient is given enough pain killers to hasten his death (ergo, put out of endless misery), then hasn't the doctor violated an ethical code and done harm?

What is truly pointless is the equation made between patients in chronic pain who need painkillers to ease their last days, and flat-out addicts who use illegal measures to obtain Darvocet, Percodan, Oxycontin, or whatever you choose, to feed an addiction rather than treat a medical condition.

If a patient is prescribed pain medication and said medication is used under the proper supervision of a doctor, and then the medication is no longer needed (patient recovers, pain subsides, etc.) then couldn't the physician also use a program of planned withdrawal to ease the transition from the opiate-induced state to one where the patient is no longer dependent, mentally or physically, on the drug?

[Captain Holly]

Sorry to burst your bubbles, but the AARP doesn't have a very good track record against powerful federal bureaucracies that ban wonderful pain treatments for arbitrary reasons.

Otherwise, Vioxx would still be on the market.

[Robert]

"I can only hope that any DEA / LEO involved in cases regarding harrassment of pain patients and / or doctors who prescribe pain meds will have to deal with a severe illness or injury where they will be denied adequate pain meds."

Don't you think they'll have connections?

[Damned if you do]

"If a patient is living miserably and needs high doses of morphine, et. al. to live his last days/months/years in peace, and the doctor cannot give the patient this medication, then has the doctor done harm by forcing the patient to live in pain (even though the doctor has abided the law)? On the flip side, if the patient is given enough pain killers to hasten his death (ergo, put out of endless misery), then hasn't the doctor violated an ethical code and done harm?"

If only the patient could somehow communicate their wishes.

[Lowdog]

Agony - my anti-drug.

HAHAHAHAHAH!!! Hi-lar-i-ous!

[johnl]

Amylou your assumptions are all wrong.

Opium addiction is no big deal. It stops up your gut. When you stop taking it, it unstops. Nothing that can't be treated with Charmin and showers.

There are some people who find they can't cope without opium. This never happens to most people, but for those folks it happens to it can be a real problem, mostly since opium is illegal. But this need for stupefaction is not related to opium's addictiveness.

About pain mediation hastening death, that's a faulty conclusion. You might blame trama surgeons and oncologists for causing death as well.

[cliff]

"Sorry to burst your bubbles, but the AARP doesn't have a very good track record against powerful federal bureaucracies that ban wonderful pain treatments for arbitrary reasons."

I heard that last year some time, AARP was going to come out in favor of MMJ with a favorable editorial, but a government agency or agencies forced them to spike it.

[Mr. Nice Guy]

"And stop your whining, Xers. You'll have access to medicines the boomers could only dream of. If Iran doesn't nuke you first."

Cromulent points. But let's address the "whining" stereotype..

What's the defining movie of your generation? "The Big Chill", perhaps?

What's the defining tv show of your generation? "30-something", perhaps?

But, I'll give you this - you got Hendrix.