The Pain Relief Network

Dec 27, 2004
By: William J. Walker
Painreliefnetwork.org

Dec 17, 2004
By: Various
Painreliefnetwork.org

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Letter to Michele M. Leonhart

Jan 1, 2004
Author Unknown
Edwardjayepstein.com

On the night of April 23, 1973, Herbert Joseph Giglotto, a hardworking boilermaker, and his wife, Louise, were sleeping soundly in their suburban house in Collinsville, Illinois. Suddenly, and without warning, armed men broke into their house and rushed up the stairs to the Giglottos’ bedroom. Giglotto later recalled, “I got out of bed; I took about three steps, looked down the hall and I [saw] men running up the hall dressed like hippies with pistols, yelling and screeching. I turned to my wife. ‘God, honey, we’re dead.’ ” The night intruders threw Giglotto down on his bed and tied his hands behind his back. Holding a loaded gun at his head, one of the men pointed to his wife and asked, “Who is that bitch lying there?” Giglotto begged the raiders, “Before you shoot her, before you do anything, check my identification, because I know you’re in the wrong place.” The men refused to allow the terrified couple to move from the bed or put on any clothes while they proceeded to search the residence. As books were swept from shelves and clothes were ripped from hangers, one man said, “You’re going to die unless you tell us where the stuff is.” Then the intrusion ended as suddenly as it began when the leader of the raiders concluded, “We made a mistake.”

The night raiders who terrorized the Giglottos that April night were members of a new federal organization called the Office of Drug Abuse Law Enforcement (ODALE) On the same evening in Collinsville, another group of raiders from ODALE kicked in the door of the home of Donald and Virginia Askew, on the north side of town. Virginia Askew, who was then crippled from a back injury, fainted as the men rushed into the frame house. While she lay on the floor, agents kept her husband, Donald, an operator of a local gas station, from going to her aid. Another agent kept their sixteen-year-old son, Michael, from telephoning for help by pointing a rifle at him. After the house was searched, the agents admitted they had made another mistake and disappeared. (Virginia Askew the next day was rushed to a mental hospital for emergency psychiatric therapy.)

In another demonstration, that Easter week, of their extraordinary powers, a dozen agents of the Office of Drug Abuse Law Enforcement broke into a farmhouse on Cemetery Road in Edwardsville, Illinois, and imprisoned one of the occupants of the house, John Meiners, a salesman for the General Electric Company, for seventy-seven hours. “I was asleep about three A.M.,” Meiners said, “when the agents rushed in and pushed me against the wall.” A pistol was held to his head, and, in Meiners’ words, “they began to ransack the house.” Walls were smashed and windows were broken, and stereo equipment, a shotgun, golf clubs, and a camera were confiscated by the agents. Meiners was then forcibly taken to police headquarters and questioned for more than three days without being told of the crime he was alleged to have committed or being allowed to telephone a lawyer or anyone else. Finally, the General Electric salesman was released without a charge ever being filed against him.

None of the ODALE agents who broke into these homes carried the required search warrants, nor did they legally have any authority to enter forceably any of these homes to effect an arrest. The Fourth Amendment of the Constitution of the United States guarantees “The fight of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures” and that “no Warrants shall issue, but upon probable cause, supported by Oath or affirmation, and particularly describing the place to be searched and the persons or things to be seized.” The warrantless raid, by the ODALE agents were subsequently characterized as “extra-legal” by Myles J. Ambrose, director of that office, and the agents were suspended. In an interview in U.S. News & World Report in 1972, prior to the Collinsville raids, Ambrose explained that extraordinary procedures, to the limit of the law, were necessary because the nation was engaged in an all-out war against drugs and that the very survival of the American people was at stake. One purpose of the Office of Drug Abuse Law Enforcement was to facilitate the arrests of pushers on the street, Ambrose said further. In effect, this meant that local Justice Department lawyers assigned to ODALE could obtain warrants to authorize agents to break into homes in order to effect an arrest. The office further had the power to go before special “grand juries” to seek indictments of the arrested individuals.

These particular incidents were reported in the press because they involved “mistaken identities” (agents had broken into the wrong homes). These agents were immediately Suspended and a full-scale investigation was launched, although they were finally acquitted after being tried on criminal charges. However, at the time, little attention was paid to the unique powers of the Office of Drug Abuse Law Enforcement. Indeed, most commentators on these particular cases, though outraged that innocent people had been terrorized, did not question the legitimacy of ODALE itself, or question the need for deploying strike forces with extraordinary powers against narcotics dealers, who were presumed to be an equally extraordinary enemy.

Despite the matter-of-fact acceptance of the Office of Drug Abuse Law Enforcement by the press and the public, there was little precedent in the annals of American law enforcement (or government) for such an investigative agency. It had been established on January 27, 1972, by an executive order of President Nixon, without approval or consideration by Congress. The office operated out of the Department of Justice, but, interestingly, its director, Myles Ambrose, also had an office in the Executive Office of the president. ODALE was empowered by presidential order to requisition agents from other federal agencies, including the Bureau of Narcotics and Dangerous Drugs, the Bureau of Customs, the Internal Revenue Service, and the Bureau of Alcohol, Tobacco and Firearms, and to redeploy these agents into strike forces. These forces could use court-authorized wiretaps and no-knock warrants, as well as “search incidental to arrest” procedures. This unique office could also feed the names of suspects to a target-selection committee in the Internal Revenue Service, which would then initiate its own audits and investigations. The office received most of its funds not from congressional appropriations but from the Law Enforcement Assistance Administration (LEAA), an appendage of the Justice Department created by Congress in 1968 for the purpose of financially assisting state and local law-enforcement units (not presidential units). Most of its operations were financed by funneling grants from the LEAA to local police departments that participated with ODALE in its raids against narcotics suspects. This method was necessary because LEAA was never authorized by Congress to disburse its funds to federal agencies.

As long as President Nixon could focus the attention of Congress and the press on the “menace” of heroin addiction destroying America, the hope was that this new office could execute his orders free of any normal restraints from the “bureaucracy,” from congressional subcommittees, and from the press, which normally reported only the stories presenting the government’s statistics in the war against drugs. The power of this new instrument thus depended directly on the continued organization of fear by the White House.

http://www.edwardjayepstein.com/agency/prologue.htm

Dec 31, 2004
By: Siobhan Reynolds
Painreliefnetwork.org

Dear Drs. Brown, Hassenbusch, and Turk,

The field of pain medicine finds itself at a critical juncture in its relationship with Federal law enforcement. We are heartened to learn that your organizations are now condemning the DEA’s recent disavowal of the FAQs document. At the same time, we are troubled by the fact that academic leadership continues to maintain certain crucial premises that perpetuate the damage being done to pain victims and their families through the government’s ongoing persecution of pain-treating physicians.

One of these premises becomes apparent when your letter states that “At times patients were allowed to suffer because physicians had unrealistic fears of sanctions for legitimate prescribing.” This statement is misleading. Physicians do not “at times allow” patients to suffer. Allowing patients to suffer is in fact the manner in which the vast majority of physicians, and the medical profession as a whole, deals with those in chronic pain.

Available evidence delineates the lack of available care that patients face. At a recent congressional briefing, Dr. Ronald Libby stated that “only 16 doctors in Florida prescribed more than $1 million in opiates during 2003, and out of 56,926 physicians, only 574 prescribed as much as $100,000 worth. (Sun-Sentinel,
“Deaths Mount as Doctors, Pharmacists and patients abuse the Medicaid System,
November 30, 2003.) Note: The vast majority of these deaths were inaccurately attributed to opioid overdose.

The above data reveals that only one percent of the physicians in Florida are responsible for prescribing substantial amounts of opioid analgesics. Assuming that the Florida numbers are representative of the country as a whole, only one percent of the 963,385 total physicians, or less than 10,000 are responsible for treating the estimated 30 to 80 million patients who suffer from chronic pain in our country. Additionally, this data suggests that the risk of criminal prosecution posed to pain-treating physicians is two orders of magnitude higher than that recently stated by the DEA, in a belated attempt to reassure members of the medical profession.

Given these circumstances, it is untenable for your organizations to continue to assert that physicians’ fears of regulatory intrusion are unrealistic. The maintaining of such a posture serves only to isolate your most loyal colleagues, those who follow the science and believe reassurances that they will not be persecuted for their good faith treatment of patients suffering from chronic pain.

At PRN, we have encountered a great deal of resistance when it comes to awakening the public and the Congress to the reality that pain is vastly under treated. This is largely due to the fact that your organizations have failed to tell the public and your memberships the truth. This was perhaps understandable when it was generally believed that the pain crisis could be resolved through cooperation with law enforcement. In light of recent developments around the FAQs document, the DEA’s ongoing denial of the existence of a pain treatment crisis, and the fact that this crisis results from the regulation of medical practice by law enforcement, your organizations’ assent is no longer acceptable.

While pain leadership and the DEA were “working together to ensure patient access to opioids,” the DEA continued its rampage prosecuting innocent physicians. The amount of damage done to our communities, both to pain treating physicians and to the patients who were served by them cannot be overstated. To continue to ignore what has been happening over these last several years is to compound the harm.

The issue of good faith is central to the ongoing debate. On December 7th 2004, while the witch trial of Dr. William E. Hurwitz was proceeding, DEA
Administrator Karen Tandy reassured American physicians in a USA Today editorial that those physicians who prescribe in good faith are safe from prosecution. However before the ink was even dry on that editorial, the
Assistant United States Attorneys prosecuting Dr. Hurwitz, were in the courtroom demanding that Judge Wexler not instruct the jury that good faith is a defense against the drug distribution charges he faced. In the absence of a good faith jury instruction, Dr. Hurwitz was effectively convicted criminally of medical negligence.

At this juncture, one might note that while a gram of oxycodone, the active ingredient in Oxycontin, was calculated as the equivalent of 500 grams of marijuana for sentencing purposes in 2001. Under current Federal Sentencing
Guidelines the multiplier has changed to 6700 grams. The result is that a physician will now draw a life sentence if convicted for having improperly prescribed as little as one bottle of Oxycontin. Given this knowledge, only a fool or a saint would prescribe opioid analgesics to patients in chronic pain, and the vast majority of physicians, as you know, are neither.

Cooperation with law enforcement can never produce a resolution to the pain crisis, because the regulation of pain management by law enforcement precludes evidence-based standards from taking hold in the medical community. This is because law enforcement pursues a drug war agenda, rather than one that is based on science and humanitarianism. Current standards require the medical profession to function in a quasi law enforcement role as the administrator of a system of drug control. Within this paradigm, the availability of pain control will continue to remain a myth that receives only lip service.

Under the present law enforcement based standard for pain management, patients’ lives are being destroyed. As physicians, your medical practices are under constant threat and the ethical practice of medicine is foolhardy. It is time for your organizations to tell the truth, and to bring this monstrous charade to an end.

As the voice of suffering patients, we at PRN request that you disavow your organizations’ head-in-the-sand attitude towards the ongoing and worsening public health disaster that is the undertreatment of chronic pain. We call upon you to work with us to bring about a US Commission on Pain, which will air these disturbing truths, and bring about the necessary changes in social policy that will make available treatment of chronic pain a reality.

At the upcoming hearings, please call for the end of the regulation of medical practice by federal law enforcement. By standing with us in support of a system that regulates controlled substances rationally, you will legitimize the field of pain management, as well as rescue it from impending extinction.

Very Truly Yours,

Siobhan Reynolds
President
Pain Relief Network

Dec 18, 2004
By: Siobhan Reynolds
Painreliefnetwork.org

Letter to the New York Times

Dear Mr. Okrent,

I have written your office on several other occasions and have not received a reply. Following the Times’ failure to cover the criminal trial of Dr. William Hurwitz and the pain movement that is being crushed by the United States government, I felt that I had to voice my complaint again and request a meeting with you.

I supplied Adam Liptak with a letter from 6 former presidents of the American Pain Society denouncing the testimony of the government’s key expert witness against Dr. Hurwitz. The language could not have been stronger, an astonishing political development-that has again, gone unreported.

I have spoken to several reporters at the Times who made it clear that the paper was aware of the trial and of the other cases that PRN is supporting, we were yet again on the front page of the Washington Post when Dr. Hurwitz was convicted, the DEA withdrew its FAQ document and has since openly intimidated the medical community with a new statement of the law-the intimidation acknowleged by the AMA! and still nothing from the New York Times.

Celebrex and Vioxx have been shown to be tremendously dangerous and have been withdrawn from the market while opioids are nontoxic to major organ systems but their availability is actively suppressed by the US Department of Justice-we have a CSA that judges drugs according to law enforcement notions rather than scientific ones, and still the New York Times cannot find the story.

Patients and doctors are intimidated. Families are being ruined. Physicians are being required to act as policemen in the doctor patient relationship-the DEA says that doctors acting in good faith have nothing to fear and the SAME DAY that Tandy announces this “reassuring” position in USA Today, the US Attorney prosecuting Hurwitz asks the judge to leave the good faith instruction out of his charges to the jury which this unapologetically biased judge did.

Still nothing.

Dr. Hurwitz had his 2 million dollar bond revoked and was thrown in jail immediately-someone who could not again commit the crime he had been convicted of-and still nothing.

What, Mr. Okrent, does it take to persuade the New York Times to cover this story?

I live in New York City and will be available to meet at your convenience. Given the fact that your paper looked at the ethical problems surrounding Barry Meier’s reporting and gave yourselves a clean bill of health, I would have thought you would be eager to avoid any more misunderstandings regarding your coverage of the pain issue. I must say that I am shocked by your paper’s failure to cover this story.

Thank You for Your Prompt Attention to This Matter,

Siobhan Reynolds
President
Pain Relief Network