When Stopping Drug Abuse Becomes Pain Patient Abuse
AEI's Dr. Scott Gottlieb (a former FDA deputy commissioner) has a piece in the WSJ, "The DEA's War On Pharmacies -- And Pain Patients." He contends that medical regulators should be put in charge of monitoring opiate consumption and abuse -- not the DEA.

Last month, the Drug Enforcement Administration abruptly revoked the narcotics license held by the distributor Cardinal Health, preventing that firm from shipping prescription pain drugs to thousands of Florida pharmacies and hospitals. It's the latest tactic in the DEA's struggle to stem the illicit use of prescription painkillers like OxyContin and Vicodin.

The agency is going after professed "chokepoints" in the drug-supply system, including pharmacies and, now, drug distributors.

This approach is burdening a lot of innocent patients, including those with legitimate prescriptions who may be profiled at the pharmacy counter and turned away. Others have in effect lost access to care, because their doctors became too wary to prescribe what their patients need. But the DEA tactics aren't stemming the illegal activity.

...The DEA's strategy is having its intended effect. Drug distributors have grown wary about whom they sell to. Cardinal has suspended sales to hundreds of pharmacies that it deems "suspicious," even those in good standing that retain their DEA license to sell narcotics. It's just too bad if a pharmacy is located close to a hospital or serves a nursing home, where it might see a higher volume of scripts for pain pills. Pharmacies, in turn, are closely scrutinizing which prescriptions they will fill, making things like baggy pants and a tattoo a liability if you need medicine.

...The problem is, the DEA may be the wrong enforcer here. It's very difficult to separate appropriate use from illicit use with law-enforcement tools alone because much of the illegal diversion starts in the same places where legitimate prescriptions are also satisfied--with a doctor who prescribes too casually, refilling obediently when patients "lose" their prescription; or the pharmacy that knowingly fills suspicious refills from the same patients. When authorities respond with law enforcement methods, important medical distinctions get lost.

He suggests Health and Human Services take over.

A good line of demarcation would be at the point of care. Doctors prescribing narcotics, drug distributors and pharmacies could come under the supervision of HHS. The department would also take responsibility for apportioning active ingredients to manufacturers of narcotics, educating doctors on proper prescribing, and investigating pharmacies and providers who appear to have gone rogue.

I see HHS becoming the DEA under a different name.

I suggest personal responsibility take over. I'm serious.

I could get heroin easily. Or all sorts of other drugs. I don't. I could also get drunk off my ass day and night. I don't.

Are you not getting drugged or drunk simply for lack of availability or might there be some other reason?

And are our drug laws and controls stopping people from getting illegal drugs -- or are they stopping people with prescriptions they're entitled to from getting the drugs they need -- or stopping people from getting the prescriptions they need (now that doctors need to be as or more concerned with doing time than patient care)?

Radley Balko on patients' suffering: Part One, Part Two, Part Three. Here's a quote from Part Three:

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."

Government is beautiful, huh?