Reason.tv: When Cops Play Doctor—How the drug war punishes pain patients
The steady stream of celebrity stories about prescription drug abuse makes Americans keenly aware of the dangers of overdosing on medications like OxyContin and Vicodin. And from President Obama's Drug Czar to California Attorney General Jerry Brown, politicians are calling for greater power to monitor doctor-patient relationships in order to fight the "epidemic" of prescription drug overdosing.
But maybe the real epidemic is underdosing. Countless Americans suffer with severe chronic pain because doctors are afraid to treat them properly.
Michael Jackson's death unleashed a flurry of media stories about all aspects of the pop star's life, including his alleged prescription drug abuse. On the same day countless millions watched Jackson's star-studded memorial service, reason.tv interviewed another musician.
Seán Clarke-Redmond, a man who enjoyed an active live before the neurodegenerative disease ALS, often referred to as Lou Gerig's disease, rendered him nearly immobile-he can no longer even play the piano.
The disease also left him in almost constant pain. Redman is prescribed some medication, but not nearly enough to keep his pain under control. Dr. Frank Fisher says Redman's case is an appallingly common one.
"Chronic pain in America is an enormously under treated disease," says Fisher, a Harvard-trained physician. "It's a public health disaster."
Pain specialists like Fisher and patients' groups like the Pain Relief Network battle law enforcement officials who are forever on the lookout for "pill mills" and patients who misuse pain medicine. Fisher notes that the same medications so often associated with celebrity addiction are the same medications that combat pain most effectively.
Fisher has treated his patients with high doses of opioids-that is, until a swat team raided his clinic and threw him behind bars.
"They were trying to give me 256 years to life," says Fisher who argues that fear of prosecution often prevents doctors from treating chronic pain patients effectively.
What allows doctors' medical decisions to be overruled by police?
"What we're dealing with is a mass insanity," says Fisher. "We call it the war on drugs."
"When Cops Play Doctor" is written and produced by Ted Balaker and hosted by Nick Gillespie. Director of Photography is Alex Manning, Associate Producers are Hawk Jensen and Paul Detrick.
Approximately five minutes. For embed code, downloadable versions, and more, go here.
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In all fairness, we can't have doctors prescribing too many opiate based drugs. On one hand we have to feed the needs of the pharmaceutical companies. But we also need to feed the needs of organized crime. Anyone who isn't getting enough pain medication should make up the difference by buying on the street. You see, there's a balance that needs to be maintained. The needs of the patient are irrelevant. What's really important here is that the raw opium is properly distributed between legitimate pharma companies and organized crime. Why, you ask? Well, to provide price and market stability, why else? Organized crime exists to fill the needs of the people. Needs that the government won't let them have (for whatever reason). Drugs, gambling, prostitution, it doesn't matter. Appeasement of the masses is what is important. But, we can't appease too much. We need law enforcement to keep these "criminals", which the government created, in check. But wait. It's not just criminals that are criminals. I'm sure we can all agree that members of organized crime are criminals, but what about the non-criminals that upset the balance, the doctors that write legal prescriptions? Why, they are nothing more than criminals themselves. Providing drugs is not the crime, upsetting the government regulated balance, is.
It's all just a big circle jerk.
Actually there is a very effective non opiate analgesic that can be used for the treatment of chronic pain: Methadone.
But:
These are the soluble diskets.
Also noteworthy:
A week's supply will typically have a retail cost of $50-$70 in the United States, compared to hundreds of dollars for alternative opioids.
Someone told me a joke at the VFW about Obamacare and how everyone will get crack - but I can't remember the details. It's pretty funny though - anyone heard it?
you got to wonder how many cops are nothing but masochistic totalitarian pigs.
You mean sadistic, right?
The O is a breath of fresh air...naahhh, he's more like the stale air of the Bush administration after it's been in Warty's gym bag for a week.
When I first read the headline I thought it may be referring to this...
http://www.chicagobreakingnews.com/2009/09/nurse-sues-chicago-cop-who-arrested-her.html
I have suffered with intractable chronic pain for 10 years - ever since a botched C1/C2 cervical fusion. Do you think that a single day goes by that I don't wish I could give my pain just for a week to the bureaucrats and the doctors who make it impossible for me to get effective treatment out of some self righteous, Carrie Nation, puritanical fear that someone somewhere might be using pain medication for recreational purposes?
My god, Dr Fisher has Gillespie hair!
Fucking imbecilic asshole prohibitionists wetting the bed over sick people possibly getting too much pain relief really pisses me off. Hell, I've only been writing "The War on Drugs
If at first you don't succeed ...
Fucking imbecilic asshole prohibitionists wetting the bed over sick people possibly getting too much pain relief really pisses me off. Hell, I've only been writing "The War on Drugs Sanity for three or four years here. These delusional simpletons at the DEA actually think they are doing a service to America.
Note to self - Preview is your friend.
Sick, sick, sick. Note to self: never, ever get any kind of sickness, illness, or disease.
What I don't understand is why more pain patients don't get on methadone maintenance, since that seems to be the gov't-honored form of "addiction" rx.
This problem will disappear when the DEA and the doctors merge into a single organization.
methadone is an opoid.
You mean opioid....he cant spell, but hes right. Sorry Tricky.
methadone is a just as restricted as opioids.
Methadone is 100% synthetic. There is no opium used in the production of Methadone. It acts like an opioid.
Check WIKI
Although chemically unlike morphine or heroin, methadone also acts on the opioid receptors and thus produces many of the same effects
I strongly believe that future generations will look back on our drug war with the same distaste that we view slavery, women as chattel, japanese internment, and other crimes of society in the past.
methadone is a just as restricted as opioids.
True. Methadone is a Schedule II. But I doubt DEA would pursue doctors for "over prescribing" it like they would for oxys.
I love the beginning of the War on Drugs! Has anyone read up on that? It's fucking hilarious how obviously racist and special-interest motivated they were when they decided marijuana would be illegal!
I am so glad to see a cogent article written on this subject. I work in healthcare and it is sad to see people who could so easily be helped, have to suffer needlessly because the govt has decided that doctors are the problem. I actually resent the govt managing how much medicine a doctor should prescribe as much as I resent insurance companies deciding what procedures are appropriate for patients insteads\ of doctors. I want the govt to manage our infrastructure, including that we have enough police, fewer homeless and safe roads. Otherwise, get out of my life.
We need a new system. We all agree that we shouldn't prosecute legitimate doctors or pain patients, but opiates are to dangerous to not be monitored.
1) Doctors need to learn to use safer alternatives like NSAIDs more often.
2) The DEA and police need to be better educated on what is a correct amount of pain meds.
3) All prescribing records should be submitted to a database so the police and DEA can data mine it to better identify doctors that are prescribing too much or patients that are doctor shopping and/or potentially addicts.
1) Doctors need to learn to use safer alternatives like NSAIDs more often.
Sure, why not.
2) The DEA and police need to be better educated on what is a correct amount of pain meds.
No. They are not doctors, and without years of training and direct contact with a patient cannot know what the correct amount of pain meds for that patient is.
3) All prescribing records should be submitted to a database so the police and DEA can data mine it to better identify doctors that are prescribing too much or patients that are doctor shopping and/or potentially addicts.
What could possibly go wrong with giving medical records to a cop database?
Just 2 weeks after undergoing quadruple bypass surgery my mom had run out of her Vicodin for pain relief and had to beg to get more. Her chest had been sawed open and a vein cut from her leg but her regular doctor felt Tylenol was good enough. Thank God the surgeon felt differently or she would have needlessly suffered.
I hope the drug warriors' dentists all run out of lidocaine just before their endodontic appointments.
1) Doctors need to learn to use safer alternatives like NSAIDs more often.
NSAIDs aren't necessarily safer (e.g., stomach bleeding).
John: "but opiates are to dangerous to not be monitored. "
Dangerous to who?
It's tough for me to be objective here, because I have a very close family member who is an addict, and whose horrific demise has been aided by a ready willingness from numerous doctors to give her more and more opiates, without any responsible follow up. Family members have contacted these doctors, they know that she ends up in emergency at least 3 times a year due to overdose or withdrawal because she took a month supply in a week, yet only one of them has ever taken any steps to cut off/monitor her supply. I'm sure that the majority of patients out there do not fall into this category, but I do think that the doctor has a responsibility when he/she has been informed that the said patient is an addict.
...safer alternatives like NSAIDs more often.
What, like Vioxx?
Opiates are the safest; when taken responsibly. They are safer than NSAIDs, Tylenol and Methadone. Yes, all those years we were told Tylenol is safe was a lie.
Methadone has some nasty side effects when mixed with benzos. Never take Methadone and Valium!!!
NSAID's are pretty much bullshit. Good enough if you are a little achey, but won't do shit for you otherwise.
If you are really in pain, you need something a bit stronger.
Do some people have a hard time with opiates sure, but some people have a hard time with just about anything. Whether Alochol, or gambling, sleeping around, whatever. Just because one person has a problem with it, doesn't justify restricting it to more responsible people.
No. They are not doctors, and without years of training and direct contact with a patient cannot know what the correct amount of pain meds for that patient is.
More than twice the average prescribed by doctors is too much, for example.
Yes, all those years we were told Tylenol is safe was a lie.
No, it is dangerous, but it is added to opiates to prevent overuse, for example in Vicodin.
I guess one of the biggest problems I have with this is that something as relatively harmless as marijuana is illegal, yet we give a very select group of individuals the ability to dole out much more powerful and potentially harmful drugs. I think someone mentioned it above...it's the ultimate class/race discrimination. I got out of jury duty one time by telling the judge and prosecution on a crack dealing case that I thought our whole system was horribly flawed when a poor black man would go to jail selling drugs to support himself, but a rich white doctor gets paid to do it:-)
Some of you have bad information on addiction. Narcotics have an affect but basically addiction is a psychic disorder. Remove narcotic from the earth and these people will get addicted to tree bark. The other 95% of us who can control the problem are suffering as a consequence. Before 1913 you could buy anything you desired at the pharmacy. The addiction rate now is the same as before 1913. The "war on drugs" has done nothing. In Spain and India you can obtain most medications without a prescription, including narcotics. There addiction rates are lower than ours. We need to return to pre 1913 laws and regulations and get the government out of our lives.
[We need a new system. We all agree that we shouldn't prosecute legitimate doctors or pain patients, but opiates are to dangerous to not be monitored.]
We already have a system that will work if law enforcement will allow it to. This system consists of trained professionals called doctors deciding when and how people called patients use narcotic painkillers for medical treatment. Many things are very dangerous. Shall we have government monitor them all (even more than they already do?
[1) Doctors need to learn to use safer alternatives like NSAIDs more often.]
They already do use them more often. That's the problem.
[2) The DEA and police need to be better educated on what is a correct amount of pain meds.]
Every patient is an individual with specific medical needs and problems. No DEA or police chart or table is going to be able to encompass everyone's specific needs.
[3) All prescribing records should be submitted to a database so the police and DEA can data mine it to better identify doctors that are prescribing too much or patients that are doctor shopping and/or potentially addicts.]
Of course! What could possibly go wrong with this? This is a complete breach of doctor/patient confidentiality. What part of none of the government's business is so difficult to understand?
To clear up some misconceptions. NSAIDS are not safe. They cause gastric erosion and subsequent GI bleeding, renal failure, liver failure, and so forth. Narcotics relatively safe in this respect and unless you are an addictive personality they are not a problem.
Louisiana catalogs the prescriptions that we write and as a result patients are in pain and suffering. That because we will not face the issue that only a handful of people get addicted to drugs and they will do so not matter what.
Get government out of our lives. They do not need to be governing our bodies and how we take care of ourselves.
Get government out of our lives. They do not need to be governing our bodies and how we take care of ourselves.
For the most part, correct, however, addiction affects all of society, so they have a legitimate business governing the proper use of dangerous drugs.
Sure, I have no problem with the government restricting sales to minor's without a prescription.
Let the rest of us self medicate if we choose.
The only thing I probably wouldn't let people get on their own is anti-biotics. Just because so many dumb asses take them for viruses etc, and that DOES effect how well they work on others who truly need them.
John,
Addiction to illegal drugs effects all society. Addiction to drugs in general has little effect. Consider this, due to making drugs illegal we are funding gangs, mafia, terrorist, third world countries that don't like us and so on. Without the US imposing its will on drugs, the funding for most evil would disappear or become much less.
Also, consider the consequence of making drugs illegal. The propagation of AIDS, hep C, bacterial endocarditis and other illnesses for which you are paying the health care cost as these people do not pay their share of the bill. Consider the cost of the DEA and the fact that over 50% of prisioners are in jail for drugs, not violence.
When is it going to stop?
mkkdash1, I'm sorry to hear about your family member, I have one in a similar state. But I have a question for you, what would be the difference if her problem was alcohol?
The only thing I probably wouldn't let people get on their own is anti-biotics. Just because so many dumb asses take them for viruses etc, and that DOES effect how well they work on others who truly need them.
There is no reason to treat these differently from any other drug or medicine that should be the choice of the individual.
As soon as you put a mechanism in place to restrict the one drug you think individuals should be monitored over, you have put the drug war back into place.
This issue hits a little too close to home for me. I'm 24 years old and I have a debilitating degenerative genetic condition. It causes intolerable pain all throughout my body, deep in the flesh. It's in part due to a mutation of certain fat and protein cells, but mostly it's caused by a twist somewhere in my genetic code that has led my body to developer 2- to 4- times as many nerve endings as the average human being. This combination of mutated cells and extra nerves leaves my body crippled most days, to the point where the pain is so bad I simply can't get out of bed. It's as if someone ramped up the volume on my body, where my nerves are screaming at me ever louder each and every day, the pain compounding the longer it goes on. And since I can't remember the last time I had a day without pain, you can imagine how loud that screaming pain is by now.
Like the poor man in the video, I wasn't always like this. I was an active, healthy, normal child until the age of 11. A doctor made a mistake, he lied about it, covered it up, and consequently I ended up spending five long years fighting a horrific bone infection. I didn't know at the time that I had this rare genetic disease, which was triggered into effect when my body became exhausted from fighting the infection for so long. I had one year of normalcy after the infection was finally cured by amputation. Then things just went down hill.
I'm in pain literally every day. Thankfully, for the most part, I've been lucky to find doctors who care, who can give me the pain medication I need. Because of the nature of my pain, the only thing that even comes close to touching it is narcotics, like those discussed in this film and article.
But unfortunately, the pain management doctor I've relied on for years, his partners just forced him to close down his pain practice. I've been bouncing from doctor to doctor ever since. As soon as I think I'm settled with a new one, they end up having to close their offices because of the enormous expense and the intense scrutiny. It's horrific. Now I not only have to live with the intense pain, but now I have to live with the overwhelming fear that I might one day have to go without the narcotics that simply make life bearable. Not enjoyable, not pain-free, but at least bearable to the point where the pain isn't so bad I just want to die to escape it.
Everything about the current situation with pain management in this country is wrong. But I don't want people to think our problems are unique - other people in other countries have it far less than we do. I have close friends in the UK, France, Australia, and Canada who have the same disease I do. Because it's so rare, so tedious, so expensive to treat, their government-run health care has flat out turned them down for any treatment whatsoever. They're strung along for years, put on waiting lists, told they've been assigned to doctors that are four hours away, making it impossible for them to make it to appointments. Eventually, after all efforts are made to make it as difficult as possible to get treatment, their governments finally just tell them 'tough luck.' One woman I know was literally told to "just go home and die" because her care was "just too expensive."
Believe me, the government means what they say: this disease is fatal if left untreated. Not only are they dealing with excruciating pain without the aid of medication - narcotic or otherwise - they're dying a slow, painful, horrific death because they're flatly being denied care.
This part of the system is so terribly broken. And, in my opinion, it's yet more evidence that the government needs to be completely removed from the medical equation. Sure, we need some regulation to prevent abuse. But those of us who have a legitimate need for pain medication certainly deserve to be cared for. You have no idea how glad I am to see this issue being discussed. Maybe then we might be able to find a solution to this disgusting, inhuman problem.
I'd like to urge you to learn about the disease I have. Unfortunately, it often goes undiagnosed, which leaves people suffering and dying without ever knowing the cause. Please, if one more person hears about this disease, perhaps one more life can be saved.
It's called Dercum's Disease. Please, Google it. Or, you can click on the url I've included with this comment - http://www.DercumsDisease.com.
Thank you.
Let the rest of us self medicate if we choose.
I don't think so. Take an 80mg oxy contin and see what happens, if you don't have a tolerance built up. I'll send flowers.
Just untie doctors hands and remove the Schedule II classification and the restrictions associated with them.
Simple.
The Wiki page says this Tricky:
"Methadone (Symoron, Dolophine, Amidone, Methadose, Physeptone, Heptadon, Phy and many others) is a synthetic opioid, used medically as an analgesic, antitussive and a maintenance anti-addictive for use in patients on opioids. It was developed in Germany in 1937. Although chemically unlike morphine or heroin, methadone also acts on the opioid receptors and thus produces many of the same effects"
Tricky left out the part that says it is an opioid.
Once again Tricky has been exposed as a homosexual!
I've actually taken an oxy or two before, and they do have a pretty good kick, lol. But taking to much of anything can be bad.
Also, no you wouldn't get a new drug war over anti-biotics. They can't get you high, so there would be very little black market for them. I've purchased plenty of illegal drugs before, and yet strangly I've NEVER seen anyone selling AB's.
See the difference bewteen AB's and say coke, is that if you do to much coke you are really just harming yourself. To many people using AB's that aren't needed helps to create super bugs that are AB's resistant, and increasing the chances of a super plague.
So...
Getting AB's from a doctor makes perfect sense, there are very real dangers to society as a whole, and very little incentive for a black market.
Whose idea was it to make it illegal to obtain painkillers without a prescription?
And yet, people continue to blame the insurance companies for what is wrong with health care.
This incident shows that government is the problem.
hi most everything, i read here , i agreed so strongly about, it was like some of you were taking the words right out of my mouth!! i especialy agreed with..i also, resentthe government managing how much medication a dr. should prescribe...ow the hell can the government know about each individual case! and i also resent the insurance co. decding what procedures are approprate for patients, instead of drs., are those ins. co. in the room w/ the dr. and patient when he/she decides what kind of procedure, etc. should be done??? this all angers me to no end, it is just not fair!!! cindi
Re: Reason.tv: When Cops Play Doctor-How the drug war punishes pain patients, http://reason.com/blog/show/136205.html
This email is a comment on the article.
Of course, the current thinking about this issue and its resultant policies are both scientifically wrong and inhumane. And, we all need to acknowledge this, it is wrong from both sides of the policy debate, theirs and "ours." The policy "debate" has been wrong headed from the beginning, from all sides of the debate; from both the drug warrior side and the anti-drug warrior side. The reason for this wrong headedness is that the critical issue in this "debate" is not the policy issue but the addiction causation issue. The current debate is warped and ruined by the assumption that the current addiction causation theory, the hijacked brain hypothesis, the moral (not scientific) theory we use as a basis for deriving the drug war policy, is irrelevant to the policy decision-making process when, in fact, it is the most relevant issue. The principle being that the wrong theory leads to wrong policy. And this is true even if the policy seems to be right, as in our anti-drug war stance. Thus, if we continue on the tract we are currently taking, fighting the policy war rather than the theory war, leaving the HBH out of the argument, we will make no progress turning this mess around. I wrote a paper on this long ago when I made my first inroad into helping correct his issue, The Drug War War: (#4 at) http://www.nvo.com/hypoism/articlesbyandforhypoicspage2/ . Read the paper to see what I mean. Too bad it was ignored.
In a nut shell, this means that until we begin using the correct theory of addiction causation as the basis of our argument for policy change, we will continue going around in circles and never get the policy changes we want or the policy changes that are effectively correct; correct scientifically, correct humanely, and correct functionally. If we allow the hijacked brain hypothesis, a proven wrong theory of addiction causation as disproved here, ( http://www.nvo.com/hypoism/hypoismhypothesis/ ) remain the ruling theory paradigm, there's no way we can move forward to the effective and humane policies we need and deserve. [My blog discusses this many times as well.] The proof of the genetic paradigm of addiction- Hypoism - causation has, for this reason, been my primary goal, and this has been completed in the last several months. The HBH has definitively been proven wrong and Hypoism proven correct. This theory change must be relayed to the public so they can turn around their thinking on the actual cause of addictions, from the moral paradigm (HBH) to the involuntary genetic/biological (Hypoism) paradigm. Once the "immorality" of addiction and drugs is removed and once it is realized that only hypoics get addicted, not just anyone, then the public will be able to see the need to change their fears and beliefs to an understanding that the policy changes we suggest not only make sense but also are the only policies that can cure the addiction epidemic, our main goal, and the reason the drug war was begun in the first place. But they must be made under the aegis of the Hypoism paradigm, otherwise they will be done wrong and won't work. If, on the other hand, we let the HBH stand, the public has no rational reason to change their thinking and attitudes that will allow change to the correct policies. As I say in the #4 paper, the choice to let the theory stand or make the change to the correct theory is your choice. If you choose to let the HBH stand as the ruling paradigm, as the government and the addiction establishment want, then you are responsible for the continued results of that theory on policies. I've done all the leg work to help you do this. It's now your responsibility to take the bull by the horns and do it. Otherwise it will remain a drug war war and all the murderous and inhumane behaviors that stem from this are your responsibility. This is your choice.
How refreshing.I too suffer in chronic pain for years.I was dx with fibromyalgia in 99 went (what I thought was remmision.Now I have been dx with hep c.I had a blood tranfusion with my first child 1986.I also may have aplastic anemia.I have to start interferon in two weeks.,I am being under treated for pain.vicoden x6.I should NOT be taking any TYLENOL!My pharmacist of 20 years reccomended demerol.Alot of doctorsthink they are God.I know more about MY own medical conditions and pain ,more than anyone.An M.D. is so snotty none of them will listen to a pharmacist of 30 years.They have all said "shes only a pharmacist"Phamacists only study DRUGS interactions etc.Always ask your pharmacist about any new drug prescribed.I too , spend much of my day in bed.I can not drive because my right shoulder is soo painful.I have been unable to bath myself everyday.I have lost 54 lbs without trying..and I`m still waiting on disability.I NEED money for food.What has happened to America?
Welcome to the police state of American medicine. Pain in this country is grotesquely under treated for a lot of reasons not the least of which is a Calvinist mentality that somehow pain and suffering have redeeming value. The DEA should leave doctors alone. I can't believe we actually allow these morons with no medical training to determine medical outcomes resulting in the suffering of millions of patients. It is time to abolish this rogue agency. They are every bid as bad as the drug dealers they seem so inept at catching.