One egregious and less-than-publicized side of the drug war is its interference with doctors and their ailing patients, especially those suffering from chronic pain.
WND’s “Babe in the Bunker,” Barbara Simpson, wrote recently about a lawsuit aimed at one Dr. Wing Chin, an internist sued by the family of cancer patient William Bergman for not adequately treating his pain. Bergman is now dead, but the family scored a purse of $1.5 million in general damages.
The only reason punitive damages weren’t heaped atop the judgment, presumably, is that the doctor did not act with any malice. He was only doing his job – even if inadequately.
In an age of HMO-baiting and health-care calumny, it’s easy for a jury to blame doctors or the system for their callous disregard for the welfare of patients – easy, but not necessarily accurate.
As much as doctors may want to help patients, they are constricted and constrained by narcotics laws. “The most effective analgesic drugs are opiates,” writes psychiatrist and addiction specialist Thomas Szasz, listing morphine, heroin, dilaudid, codeine and methadone. The trouble is, as Szasz points out, “Opiates are the most strictly controlled of our controlled substances.”
In order to prescribe opiates, which are classed as Schedule 2 drugs (except heroin, which classed as Schedule 1 and cannot be prescribed for any medical purpose), doctors are subject to monitoring by narcotics officials. “The Drug Enforcement Administration,” sarcastically says Szasz, “watches doctors prescribing opiates like customs agents watch dark-complected travelers at Kennedy Airport.”
Fearing negative sanctions from drug officials, such as jail or revocation of their licenses, doctors prescribe powerful analgesics less and less. The result? In the words of Dr. Russell Portnoy of the Pain Center at Sloan Kettering Memorial Hospital, “The undertreatment of pain in hospitals is absolutely medieval.”
The fear and idiocy that churns under the surface of this issue is best seen in the recent flap about OxyContin, a synthetic opiate which debuted in 1995 with the promise of effective pain relief for chronic sufferers. Like any psychoactive substance, of course, some people are bound to experiment with its less-than-medicinal qualities, which in our present political environment is completely inexcusable and requisite of swift action to nip its use in the bud – which, while apropos, is not intended as a pun for medical-marijuana activists.
Fueled by abuse and scare stories, like that in a January 2001 issue of Time magazine, media and law enforcement are bucking for recognition as the latest incarnations of Eliot Ness. After publicly announcing a crackdown, DEA is now setting its sights on “over-prescribing” physicians. As with any painkiller, of course, dosing is relative to the pain, and since nerve-endings tend to reside in the bodies of patients, not DEA rulebooks, the definition of over-prescribing is more than subjective.
As Sandeep Kaushik recounts for a June 4 AlterNet article, “One doctor in southern Virginia recently reported that 30 minutes after a visit from a Purdue sales representative [the company which manufactures OxyContin], local DEA agents descended on his office to question him about what the rep had told him and whether he intended to prescribe the drug to any of his patients.”
Szasz says the necessary result of such politicking and busybody police work from drug cops is the undermining of the doctor-patient relationship, sharply criticizing any doctor who would “be seduced by economic and political enticements into abandoning his role as healer and betraying his ethical obligation to the patient (Primum non nocere! First of all, do no harm!), and assuming instead the role of referee – arbitrating the conflict between the patient who wants a powerful analgesic and the state that wants to withhold it from him.”
As a healer, the doctor’s role in many cases is to mitigate and reduce pain. The drug laws prevent this by outright prohibition (heroin cannot be used, despite its successful use in terminal cancer cases), overarching regulation (limiting the use and amount of certain painkillers) or in-your-face intimidation (prosecuting doctors who violate some fungible and subjective standard of over-prescription – or threatening to do so).
“Among the remedies which it has pleased the Almighty God to give to man to relieve his sufferings,” said Dr. Thomas Sydenham in 1680, “none is so universal and so efficacious as opium.”
Drug warriors apparently know better than God – and doctors.
© 2001 WorldNetDaily.com
Written by Joel Miller for WorldNetDaily.com, and published on DrKelley.info, July 12, 2001. Embedded links (if any) may no longer be active. (Ed. 12.31.10)
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