by Admin
DEA Response to War on Pain Medicine
2:37 am in Medical, News by Admin
Feb 25, 2010
By: John Stossel
Fox Business Network
In this week’s show “Hands Off My Meds” (re-airing tonight at 10pm ET, Saturday at 7pm ET, and Sunday at 11pm ET), I ask: Why does the DEA, in its zeal to prosecute the disastrous War on Drugs, frequently harass and prosecute doctors who prescribe pain medicine with opiates—legal medications like oxycontin, vicodin and percocet—to patients with chronic pain? Ron Libby, a professor of political science at the University of North Florida and author of “The Criminalization of Medicine: America’s War on Doctors,” says this government crackdown leaves thousands of patients in pain. The Association of American Physicians and Surgeons says this to its members: “If you’re thinking about getting into pain management using opioids as appropriate: DON’T. Forget what you learned in medical school – drug agents [from the DEA] now set medical standards.”
The DEA declined to be interviewed. They sent us this instead:
DEA’s mission is to protect the public health and safety. In the performance of this mission, DEA targets and investigates those individuals who violate the law, regardless of their profession. American jurisprudence is deeply rooted on the fundamental principle of equal justice under the law. Coinciding with this basic principle is another overarching principle – no one is above the law. When seeking medical care, the American public must be able to trust their doctor. They have a right to know that their doctor isn’t going to trade prescriptions for sex, file millions of dollars worth of fraudulent insurance or Medicare claims, or be impaired from self abuse of controlled substances while treating patients. Fortunately, the vast majority of doctors are outstanding professionals who truly desire to provide medical care and treatment to patients, to heal. Doctors who issue controlled substance prescriptions for a legitimate medical purpose in the usual course of professional practice have nothing to fear from the DEA. But rather than extinguish this fear with facts, Mr. Libby stokes the ambers of fear with false or misleading information that only perpetuates misconceptions and fear. On average, DEA arrests only 85 doctors annually of the more than 750,000 medical doctors and doctors of osteopathic medicine. Most DEA investigations of physicians are initiated due to information provided by a medical or pharmacy board, an employee of the doctor, a patient or other law enforcement agency. More often than not DEA utilizes its regulatory authority rather than its criminal investigative authority to administratively sanction practitioners and other DEA registrants. If a criminal or civil case is warranted, the determination to prosecute rests with the State or Federal prosecutor. Mr. Libby, however, believes that is implausible for a doctor to commit a criminal offense or that they should somehow be immune from prosecution. He further believes that if law enforcement uncovers criminal activity involving a doctor, officials should simply advise the doctor to stop violating the law. Apparently, he believes that doctors should never be held accountable for their actions.
It is Mr. Libby’s belief that doctors are simply duped into committing criminal offenses. The facts, however, are quite different. The doctors investigated by the DEA have committed acts that are far from the mainstream of medical practice. For example, a doctor in Spring Hill, Florida anesthetized his patient and then attempted to have nonconsensual sex with the patient. Several physicians were associated with 34 rogue Internet pharmacies in 2006 who dispensed more than 98 million dosage units of controlled substances to patients they never met, examined, or performed diagnostic tests to make an appropriate diagnosis. . How about the pain clinic in Florida whose employees had to stage a burglary at the clinic to cover for the thousands of dosage units its doctor doled out as if every day were Halloween or the doctor in Taylor, MI who falsified and instructed others to falsify patient files; prescribed controlled substances in such combinations that they were likely to cause death; and provided prescriptions for controlled substances to individuals the doctor knew were addicted or who would sell the drugs illegally.
Mr. Libby has stated on several occasions that he is concerned about the under treatment of pain in the U.S. He apparently has not visited South Florida lately where there are more than 500 pain clinics in just a three-county area alone. These clinics advertise that walk-ins are welcome and that there is no waiting. However, of the top 100 practitioners that dispense oxycodone from their office, 96 of them are in Florida and 86 are in the same three-county area. The proliferation of pain clinics in one South Florida county has been so great that city and county officials are looking to enact ordinances to ban any new ones from opening. DEA is statutorily responsible for enforcing the Controlled Substances Act which is designed to prevent and detect the diversion of controlled substances. In executing its responsibilities, DEA does not enforce the law in a “cafeteria style” – picking and choosing which provisions of law it will enforce and which ones it won’t.
DEA does not target physicians based on their practice specialty or medical conditions that they diagnose and treat. DEA encourages doctors to treat pain, or any other medical condition, as medically warranted and under the regulations and standards established by the practitioner’s licensing/professional board. DEA does not want to interfere with the legitimate practice of medicine. DEA routinely meets with medical groups and medical associations to achieve an appropriate balance between the practice of medicine and law enforcement.
Mr. Libby claims that DEA is demonizing pain doctors for practicing medicine. Ironically, his accusations against DEA seem to demonize legitimate law enforcement.
I find Mr Libby much more convincing than the DEA.
http://stossel.blogs.foxbusiness.com/2010/02/26/dea-response-to-war-on-pain-medicine/
As always where bureaucracies are, aside from just how much power and profits affect their actions being missing from this show, they always seem to take reductio ad absurdam into the real world. They go much too far. The FDA was created because food makers and drug companies were selling literal poisons, rotten meat, non-food animals, even human flesh from injured workers to citizens as safe, healthy foods and drugs. It’s reasonable to control that kind of thing. The trouble is that more than science affects the decisions about what drugs we can and can’t have. Addicts, poor people, blacks and Hispanics use marijuana, and there are myths all through our society about it, much of incorporated in illegal government propaganda. They use that to keep it away from us, even to keep it from people whose lives could be restored by it. After Thalidomide they initiated a hugely expensive, long-term process for vetting drugs that stated removing ever more rights from people. What the situation stands at now is that if the DEA, DOJ, law enforcement in general, the private prison industry plus those industries who use the effective slave labor of the incarcerated to replace paid workers all make more money from keeping certain drugs illegal, so illegal they remain.
The government should be able to say “We don’t believe this substance is safe for human consumption, and this is why.” They should be able to say, “This company is including dangerous additives in their food, putting it into containers that leech poisons into the food, we believe they’re hiding studies that show this drug to be dangerous, and we don’t think you should consume any of it.” What they should NOT be able to do is say, “You’re just going to have to go ahead and die of your medical condition because we’re afraid that the side effects of the medication that might save your life might also make you sick or even kill you.” That is INSANE! If a patient said, ‘Well sure, this drug might save my life, but it also might make me throw up, so I won’t take it,” that patient would be judged incompetent.
So why, when the FDA or the DEA condemns people to suffering and slow death, or certain death by withholding medication, are they NOT judged incompetent? Simple answer: because of the profits and the huge amounts of almost unaccountable power to be gained. They are all out of control. The welfare of the people those agencies were created to protect is no longer their guiding principle – their own gain is. If we are to survive, and especially if we are to become something other than an expendable resource for these soulless agencies run by crony corporatists and power-hungry wannabe dictators, these agencies must be destroyed or altered, trimmed back to what they should be. Adult, competent citizens should NOT be dictated to by agencies that make their decisions independently of input from We the People, who are per the Constitution and the Declaration of Independence the sole source of all authority in America! Over many decades there has been a coup in America that was completed in the past four or five administrations that removes power from the people, placing it into the hands of corporate leaders who are so isolated from most of humanity, the “common people” are to them little more than animals, to be used and discarded when their usefulness ends. They have stated that the world would work much better if 90% of the human race were to die, and both US policy and the guiding policies of these agencies appear to working toward that goal.
At this point, we must act or die. It’s that simple, and that hard.
Ian MacLeod
The DEA piece above was not on the page when I added the above reply.
If they only busted doctors who tried to rape sedated patients and that sort of thing, they’d be derelict. There ARE doctors who abuse their power and privileges in other ways, some criminally. Instead though, they’ve gone the other way and are complicit in setting doctors up with unreasonable requirements and even entrapment and outright false charges. “Usual practice” IS usual because doctors are rightly afraid to prescribe as the Medical Standard of Care says they should. The MSOC is what the textbooks, what the real experts, say to do, not the “Old Guard” doctors who were taught that opiates will take over the life of anyone who uses them as though the drug was a demon determined to destroy them. The number of pills, the amounts of opiates consumed per day by a patient, mean nothing in and of themselves, but juries are told that such things are all that count. They ignore the return of functionality, they ignore the MSOC and the science behind it. They ignore the welfare of the patients completely.
Is it legitimate to arrest a doctor who follows the MSOC and out of perhaps hundreds of patients, a couple of well-coached DEA agents or addicts manage to fool him, so they prosecute? Is it legitimate to try a doctor in the local media every time, long before he’s ever brought to trial, much less convicted? Is it legitimate, for instance, to accuse a doctor of murder because a patient of his died with opiates in his system in a car wreck – when he died as a passenger in that car? The DOJ blackmailed two, I believe, women and forced them to lie on the stand and accuse their doctor of trading sex for drugs or go to prison for all the opiates the doctor legitimately prescribed for them. When they recanted later they went to prison for it, and the conviction was upheld anyway. This is “legitimate” law? For that matter, what’s the reasoning – aside from publicity – for attacking an open clinic with DEA agents in full SWAT gear, holding patients at gunpoint, stealing their files (when the patients can’t get them back, no doctor will treat them because they have no records)?
As for clinics springing up, every time the DEA “takes down” another clinic, more doctors fire their pain patients or under-treat them so badly they MUST leave, try to find treatment that will allow them to work, or just to survive. Those patients are often forced to leave the state searching for treatment, even for ordinary problems like heart conditions, because doctors in their own states fear to give them ANYTHING, even insulin or heart meds, for fear of attracting the DEA. And of course, the DEA classifies traveling long distances to see a doctor as drug seeking behavior. And the DEA does not appear to recognize the concept of “pseudo-addictive behavior,” either.
The examples the DEA give in the piece above here are, if they are true, exceptions, and not related to the problem: doctors who are treating pain correctly being railroaded into prison! The DEA refuses to offer guidelines or to hold to the ones they did offer, so doctors never know when or how they might offend and find themselves under attack by the DEA. With all of the wrong information, if we’re being charitable, about opiates out there, of course some family member might complain about the number of pills! And they too ignore the return of function to the patient, or the deterioration after the meds are removed.
Doctors are afraid to prescribe opiates, period. The DEA can deny it all they like. The fact remains that finding correct, legitimate pain treatment in America is all but impossible! There are an estimated 70 MILLION people with chronic pain in America, almost ALL of them under-treated or untreated. And ALL of the blame can be laid at the doorstep of the DEA and the complicit enablers of the DOJ and complicit Bush era appointed federal judges. The only comfort pain patients have, and it’s a cold and useless one, is that if these soulless thugs ever manage to get old, or have a bad wreck or other accident, they will find their former “comrades” in the drug war treating them as traitors, because then and only then it seems, they finally see the light. By then, though, they’ve joined the enemy – chronic pain patients.
Ian
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I am a pain doc. On March 23, 2010 at about 10:00 AM a large number of armored and armed people came crashing into my home/office. They eventually showed me a search warrant stating that they were looking for property that showed evidence of criminal activity. They never told me what they were looking for or why they were looking.
My practice is in the smallest county in this state; 8,000 people. The nearest town of any size (9,000) is forty miles away and is the source of nearly all of my approximately 100 patients. Nearly all of these are chronic pain sufferers. About 40% of these are pro bono. My practice is fee-for-service and I charge a whopping $60 per visit. New patients get at least two hours for the first visit and followup visits are a full hour.
In addition to pain management I provide comprehensive care for nearly all of these people.
The raiders took all of my charts, my computer, receipt books, appointment book, checkbook; everything that had anything to do with the practice. While this raid was in progress my wife, who is a school teacher was being questioned at her school which is 40 miles away.
I was told that everything would be returned in two weeks. They were three weeks late with this. Copies of my charts were returned and these are mostly in disarray.
I am the only doc in two counties who will consider treating chronic pain patients. I am also the only doc who does office based opioid abuse treatment.
There are a lot more patients with chronic pain in the community but I do not dare take any more into my practice with the present threat. I have not yet been charged with anything but do not feel even a littl safe. I am demoralized thinking about what will happen to my patients if/when I am taken out of circulation. There are several who might die, there are many who will not be able to return to work, many who will not be able to continue working and all will be miserable.
Ianm and Mike, you both have stated my thoughts exactly. The scum that calls itself the PR dept. in the DEA cannot wash away the stench of their treachery with a slickly worded statement that is 75% lies, the rest being merely distractions from the real problems caused by them. They did not really answer or account for any of the damage they have wrought in people’s lives. May they suffer the effects of their policies themselves, although they dont have to follw the rules they impose on others. I bet the agents who do these good deeds are not left with Motrin and advice on relaxing when they have serious pain issues.
John.Mike Ianm,ZD,my thoughts exactly and Mike,I’m so sorry this has happened to you,for nothing more than Charity work,you should be given Honors, GOD BLESS YOU,its way past time for marches and Protest,NON STOP Till they do what the people say,”Remember,For The People By The People?”every body unite on this form then others,I for one will attend EVERYONE I Possibly CAN,I’m tired of good people going to jail from false unproven claims,how much longer will we get help from Doctors or even deserve it if we dont stop this Grave injustice or support those who have lost everything supporting us? Its High PAST TIME PEOPLE,time for a NEW COMPASSIONATE REVOLUTION IN OUR MEDICAL FIELD AND PROTECTION FOR OUR DOCTORS! WHAT ARE WE WAITING FOR? THE GOVERNMENT IS NOT LISTENING TO THE PEOPLE! Franklin said those who give up their Freedoms for tempoary safety Deserve Neither Both! I want to continue being a proud American,I want to continue TO BE an American,…how about you?
The FDA functions to protect the drug companies not the people of the US! At Much Kneaded Massage of NYC I ask my clients to try meditation before medication. I’ve personally been down the pain med road myself (severe rheumatoid arthritis). After years of taking toxic drugs by best results been achieved with natural therapies such as massage, vitamins, organic vegetarian diet, exercise, and a positive can-do attitude. Now I’m a massage therapist helping others turn their quality of life back to the positive side.
By the way Montel Williams also exercises, takes vitamin supplements and eats very well too (lots of fresh fruits and green veggies). He doesn’t only rely on drugs to allay his pain.
Till they do what the people say,”Remember,For The People By The People?”every body unite on this form then others,I for one will attend EVERYONE I Possibly CAN,I’m tired of good people going to jail from false unproven claims,how much longer will we get help from Doctors or even deserve it if we dont stop.
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