Policy

Why Would Anyone Object to Government Monitoring of Pain Treatment?

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Miami Herald columnist Carl Hiaasen is utterly baffled by Florida Gov. Rick Scott's opposition to an electronic monitoring system for prescription painkillers:

Said Scott: "I don't support the database. I believe it's an invasion of privacy."

His statement raises numerous questions, none of them comforting.

Has Florida finally elected a certifiable whack job as governor?

Is Scott himself overmedicating?

Undermedicating?

Why would any sane or sober public official go out of his way—very publicly—to protect pill pushers and crooked doctors?

The column goes on like that for another 732 words. Hiaasen never addresses Scott's avowed concern about privacy, except to dismiss it as an issue of interest only to "an ideological extremist who doesn't like any form of government snooping." And Hiaasen seems completely oblivious to the conflict between drug control and pain control—the fact that doctors are less inclined to prescribe opioids, even to legitimate patients in horrible pain, when they worry that regulators, police, and federal drug agents are looking over their shoulders, ready to second-guess every decision and transform honest mistakes or medical disagreements into felonies. The Drug Enforcement Administration likes to pretend this conflict can be resolved through a carefully balanced approach. But it can't. Because pain cannot be verified objectively, there is only so much a conscientious doctor can do to make sure a patient is not a malingerer, an addict, or a drug dealer. At a certain point, he has to choose between trusting his patients and helping the government enforce its arbitrary dictates regarding psychoactive chemicals. If he sides with his patients, he runs the risk of losing his license, his livelihood, and his liberty. If he sides with the government, it is inevitable that some patients will suffer needlessly. Every additional layer of scrutiny only compounds the drug war's chilling effect on pain treatment.

Perhaps Hiaasen would say that stopping people from using Vicodin or OxyContin to get high is so important that it's worth the agony inflicted on people in pain. Maybe he could come up with a moral argument in favor of saving people from themselves by punishing innocent bystanders. But before  taking sides in the controversy over inadequate pain treatment, which has been a topic of passionate discussion for half a century, he would need to be aware that it exists. He could start educating himself here.