DEA: The Drug Enforcement (And Pain Patient Suffering) Administration
Radley Balko writes at the HuffPo about how little the government cares about people in chronic, terrible pain -- as long as they can stop other people from getting high:
The government agency that controls the supply of opioid pain medication in the U.S., the DEA, is specifically charged with eradicating drug abuse. There's no countervailing charge in the DEA's mission to ensure that legitimate pain patients have access to the drugs that can give them relief. The incentive is to err on the side of control and restricted access.It's the type of error that "Mike," a New York City artist who wrote to HuffPost, has been on the wrong end of too often. "I've suffered from severe refractory migraines my entire life, and am forced to take pain killers. It is insane the degree of time, money and effort I have to go through to get medicated for what is clearly a legitimate, refractory (unresponsive to typical treatments) disease." Mike writes that he's tried other treatments, but only opiod painkillers work. The problem, he says, is that "doctors are afraid to prescribe them, or they think I am an addict," even though he's been at the same dose for years. "It's insane and extremely depressing," he writes. "I live constantly in fear of either getting a totally debilitating headache or of running out of meds. I have had the headaches my entire life, and finally found a drug regimen that allows me to function -- to keep my job and get up and do everyday things -- yet I am treated like a criminal."
Russell Portenoy, who chairs the Department of Pain Medicine and Palliative Care at the Beth Israel Medical Center in New York, is a leading supporter of opioid treatment. He said there's a concerning lack of balance in the dire warnings about painkillers. "There are just as many deaths associated with the use of anti-depressants, or from liver failure associated with the use of acetaminophen, but you don't see the same sort of language about risks associated with those drugs. Opioids are just a medical therapy," he says. "They need to be carefully managed, but there's this age-old fear of them that seems to make them more urgent than other public health concerns."
Christopher says while there are references to patients concerns, but they're drowned out by warnings. "You might see a line, really a throwaway line, in some of the press releases about how these recommended new policies won't preclude or limit access to patients, but the reality is, they do exactly that."
Doctors are terrified of criminal or administrative investigations, which can end their medical careers, even if they're eventually cleared, Christopher says. "They feel besieged. And it's not necessarily even a fear of criminal charges. It's about getting investigated, about having the DEA come and say, 'We'd like to look through your files.' You then have to pay for a defense, and take time away from your practice to defend yourself." This, Christopher and other patient advocates say, is why it's so difficult for pain patients to find conscientious doctors to treat them.
Another example from earlier in the piece:
One Indiana pain patient who wrote to HuffPost tells a typical story. Faced with debilitating pain from spinal stenosis, she was told by local doctors she was displaying the drug seeking signs of an addict, and they refused to treat her. "I have never used an illegal substance, and seldom have a glass of wine- I've never had a beer in my life," she writes. She was finally able to find a pain specialist, but in California. She makes the trip every three months for the high-dose opioid therapy she says makes her life bearable. But the cost of flying to the west coast ever few months is taking a toll on her finances. "I have asked for help finding a pain management doctor closer to Indiana," she writes. "I have searched online. I cannot find any one willing, or qualified to take me. I am a Christian and I do not believe in taking my own life, but I pray for an answer before I have no way to survive. I am not alone. There are so many pain patients whose lives are a living hell -- waiting and praying to die."
From a commenter, wsr1500, at the HuffPo:
Letting the DEA set quotas for drug production is a travesty. There are supply problems not only with pain medications but also some of the drugs used for attention deficit disorders. As a pharmacist for many years, I have dealt with the DEA. On one occasion they audited the hospital where I practiced.They arrived and announced they would start the audit the next day. They tried to be intimidating, were very rude, apparently had already decided we were criminals, threatening to close the pharmacy if the records were not produced, even though no one had raised any objection. We decided to perform our own audit, and worked late into the night. The next day they proceeded with their audit and found that drugs were "missing" Having done our own audit we knew that this was not the case.
When confronted with this evidence they backed down and accepted the fact that our records were correct. They have enormous power over practitioners as they can suspend the DEA license without the level of proof required for a criminal conviction. They have no interest in the welfare of the patients. Trying to limit the supply of legal drugs is of course easier than actually stopping the diversion into illegal channels. The problem is the diversion will continue meaning that legitimate users are the ones who suffer.
This is a common tactic used by "enforcement" officials (read: thugs) that know they don't have a leg to stand on if it were taken to the level of proof required in of a court of law. If the interrogated person/org hesitates -- the thugs assume that they person/org is deliberately lying, not that they don't look at the records and/or audit every single day.
Jim P. at March 11, 2012 2:10 AM
[Gog McGog, shoot me an email]
Crid [CridComment at Gmail] at March 11, 2012 3:25 AM
Don't be surprised about the DEA.
BATFE does this regularly.
Radwaste at March 11, 2012 5:44 AM
I get occasional migraines. When I do, what works is an NSAID with Vicodin. It's nigh impossible for me to get them to give the vicodin and I end up feeling like a junkie asking for it. Even though I use maybe 20 pills a year. It's insane. I've never been for legalization but to end this nonsense? I'd go all libertarian and let people g et whatever drug they want. It's got to be better than people in pain.
momof4 at March 11, 2012 8:35 AM
It's much more infuriating when you see that true drug seekers/addicts have much _less_ problem getting their fix.
In many cases, due to directives by the government.
You'd better NOT accuse THEM of being drug seekers, or else.
But the people in real need, it's paradoxically safer to deny them, go after the doctors servicing them, all while loudly proclaiming that we've always been at war with Eastasia.
Unix-Jedi at March 11, 2012 9:48 AM
(Oh, yeah, that's right. Few years back, "The Joint Commission" (and I think they changed their name to reflect what they smoke on a regular basis) decreed that drugs had to be behind the automated dispensing system - even the crash cart drugs.
That actually made it out to hospitals before somebody with some sense got that reversed.)
Unix-Jedi at March 11, 2012 10:00 AM
"I've never been for legalization but to end this nonsense?"
Gross Conceptual Error.
This IS "legalization", entirely due to the illegal traffic in legal drugs. That an agency tramples the 4th Amendment and/or makes it difficult or impossible for lawful person to get their prescription is a seperate failure. It's a more-complicated, more elaborate version of the convenience store clerk checking to see if you're old enough to buy beer by rectal exam.
That solution is actually clear instructions to agents as to the law, and the placement of sensible people in office. I don't see that happening any time soon because of squealing single-issue folk, but there's no simple fix.
You elected people to pass laws, and by God you're gonna GET those laws!
Radwaste at March 11, 2012 10:58 AM
The only law I want to see on the put on the books is that every federal law is automatically sun-setted at ten years from the day it went into effect unless re-approved by a super majority of both houses of Congress.
That includes laws that were implemented in 1787 until now and in the future.
Actually it should be a Constitutional amendment. That would mean that Congress would have to review and re-approve everything from the EPA to the 68 Gun act to FHA/FNMA/Freddie, to not being on the gold standard.
Jim P. at March 11, 2012 11:29 AM
But Jim, if we did that the congress wouldnt have time to pass non binding resolutions condeming the use of guns in crimes, or hold hearings with the political groups formed by their wives to condem rock and roll, or R&B,
I mean just think what would happen if they acctually had to work for a living, the country might just run smoothly which means they could spend less time fixing the problems they create. Why its almost as if we wouldnt need them at all
And they cant have people thinking that
lujlp at March 11, 2012 11:43 AM
Somehow I could live without Mordor on the Potomac being up my butt 24/7. Maybe we could get back to what the fed is responsible for: treason, piracy and counterfeiting.
Jim P. at March 11, 2012 5:04 PM
We can all thank ex-President Richard M. Nixon (http://www.justice.gov/dea/pubs/history/1970-1975.html) for the DEA (Drug Enforcement Atrocity). We all live in a country where the government feels it necessary to protect its citizens by virtue of a "nanny" state mentality. Once an agency-such as the DEA-is established, they'll do anything and everything to create 'job security' for themselves. This has nothing to do with protecting society, and everything to do with protecting their agency.
They're given so much power and authority they're reminiscent of the KGB and Gestapo. They make people who suffer from pain feel like dope fiends. They prevent doctors from properly practicing medicine, and they take away "quality of life" from those who suffer from intractable pain. It is my right to have relief from pain, yet the government does not think so.
As for including acetaminophen to opiate medications, the sole purpose of adding acetaminophen to opiates is a nefarious attempt at preventing users from abusing such medication, because they don't care if you kill yourself due to liver failure from an acetaminophen overdose, they only want to control the use of opiates by any means possible, even if it kills the user. All of this talk of banning certain narcotic medications due to its acetaminophen content is idiotic, because rather than banning such drugs, they could simply reduce or eliminate the acetaminophen content from the drug. And for those who believe that the acetaminophen additive makes a difference in pain relief, they are sorely mistaken (no pun intended).
I too have been a sufferer of migraines throughout my life, with no relief from the standard migraine medications prescribed to me. Because I am unable to find a doctor who is willing to provide me with the medications that work in eliminating my pain, I'm forced instead to endure the pain for up to several days, sometimes wishing that I could just fall asleep and never wake up because the pain can get that bad for me.
The latest act of stupidity conducted by the DEA involve the current restrictions placed on medications used to treat ADD, which make it virtually impossible to find a pharmacy that has this type of medication in stock. Once again, sufferers are forced to try locating a pharmacy that carries this medication, while stressing over where to get next month's refill.
I don't feel the government has a right to tell me whether I can or cannot take a certain medication. Moreover, I don't believe the government has the right to force me to wear my safety belts or a helmet if I don't want to. I choose to do those things because I am educated enough to understand the risks of not doing so, however, that should be my prerogative, not the government's.
LisaN at March 12, 2012 6:04 AM
I'd still rather drive, walk, whatever past 20 drunks, druggies, etc than one panhandler that I know has his a government paid apartment, food stamps, and bus pass.
What has the panhandler learned -- he is not responsible for his actions.
What have the 20 drunks, druggies, etc learned. To be accepted into a program, you have to follow the rules and be responsible for your own actions.
I'm not saying don't support the person born and lives with a permanent birth defect. If someone suffers a catastrophic accident at 25 and hasn't really planned for it, I can deal with it. But I ran into a guy that was 4'3". He was on lifetime SSI for being a midget/short person. I'm sorry, f'ing deal with it.
I've recently ran into a lady that is in the 4'+ category. I'm thinking about asking her for a date. Take a guess -- she works for a living.
I truly believe in content of character.
Jim P. at March 12, 2012 11:13 PM
First of all, I agree that there are many deficiencies innpain treatment, drs scared to prescribe etc. Absolutely. That being said I hate the anecdotes in these stories. They all depend on people believing the person really has untreated chronic pain. And (presumably) because they're more dramatic the reporters choose the most suspicious stories. (After all an intrepid reporter could never be fooled by someone who has spent years honing their ability to lie. Right?) I'm looking at you Ms. "I have CT proven cause of pain, but no one in the entire frickin country except California will treat my pain" Here's one. Russel Portnoy from the article seems like he would treat you and he's a lot closer than California. Again, I totally agree that there are many people with chronic pain not adequately treated for the reasons given in the article. I just think the anecdotes in these stories always suck.
Michael at March 14, 2012 10:02 PM
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