Free Republic
Browse · Search
News/Activism
Topics · Post Article

Skip to comments.

Specialists Decry DEA Reversal on Pain Drugs
The Washington Post ^ | December 21, 2004 | Marc Kaufman

Posted on 12/21/2004 10:45:08 AM PST by neverdem

New Rules Called A 'Step Backward'

Three medical associations representing pain specialists have sent the Drug Enforcement Administration an unusual joint letter sharply critical of its recently revised guidelines on prescribing pain medicines.

The letter, signed by the presidents of all three groups, called a DEA policy statement published in November in the Federal Register "an unfortunate step backward" that encourages a return to "an adversarial relationship between [doctors] and the DEA."

Already concerned about what they saw as sometimes over-aggressive prosecutions of doctors, pharmacists and other health professionals who prescribe narcotic painkillers such as OxyContin, the specialists said the new DEA position threatens their ability to provide care to millions of patients.

The presidents wrote that despite the DEA's assurances that it does not want to discourage doctors from providing proper narcotic medication to people in pain, the new guidelines "will undoubtedly have the exact opposite effect on any practitioner reading them."

DEA spokesman Bill Grant said in response that the agency "wishes to reassure the public that the withdrawal of the August [statement] does not represent any change in DEA's investigative emphasis or approach. Physicians acting in good faith and in accordance with established medical norms should remain confident that they may continue to dispense appropriate pain medications."

He said the DEA is working on a process to gather the views of the medical community as it refines its policy.

The letter from the heads of the American Pain Society (APS), the American Academy of Pain Medicine (AAPM) and the American Society of Addiction Medicine (ASAM) is a response to a Nov. 16 DEA statement that repudiated some parts of a jointly negotiated set of guidelines that had been introduced with fanfare in August.

The August guidelines -- in the form of answers to 29 frequently asked...

(Excerpt) Read more at washingtonpost.com ...


TOPICS: Business/Economy; Crime/Corruption; Culture/Society; Extended News; Government; News/Current Events; US: District of Columbia
KEYWORDS: aapm; aps; asam; dea; healthcare; narcotics; pain; wodlist

1 posted on 12/21/2004 10:45:08 AM PST by neverdem
[ Post Reply | Private Reply | View Replies]

To: neverdem

I can only wish these bastards a year or two of chronic pain which could be treated by drugs but won't be because of government interference.


2 posted on 12/21/2004 10:48:03 AM PST by pabianice
[ Post Reply | Private Reply | To 1 | View Replies]

This is one area where the federal government is flat-out wrong, and where Ashcroft's leadership was extremely poor. Doctors are already afraid to adequately treat pain, it's like the DEA has a streak of sadism running through its decisonmakers.


3 posted on 12/21/2004 10:59:50 AM PST by seacapn
[ Post Reply | Private Reply | To 2 | View Replies]

To: neverdem

So non-narcotic pain relievers (Aleve, Bextra, others) will cause heart attacks and other such ailments, including liver problems, but the alternative is overly watched by the DEA?

Why do we even have prescription medicine then? To taunt and tease?


4 posted on 12/21/2004 11:02:57 AM PST by eyespysomething (Remember Christ our Savior was born on Christmas Day.)
[ Post Reply | Private Reply | To 1 | View Replies]

To: neverdem
I think the policy should be very simple. Doctor's who prescribe narcotic pain medicine should have a standard one page form to give to patients describing the possible harmful side-effects of narcotic pain medicine (i.e. dependence and addiciton). A signed copy of said form should provide the doctor with complete protection from government action for prescribing pain medicine.
5 posted on 12/21/2004 11:04:41 AM PST by Moral Hazard (With a pickle mind we kick the nipple beer.)
[ Post Reply | Private Reply | To 1 | View Replies]

To: neverdem

Pain is a versatile human resource management method that governments do not want to relinquish control over.

Ever.


6 posted on 12/21/2004 11:04:48 AM PST by headsonpikes (Spirit of '76 bttt!)
[ Post Reply | Private Reply | To 1 | View Replies]

To: neverdem

Wars are painful, even The War On Drugs. Some have to sacrifice for a Greater Good. No pain, no gain. It's for The Children.


7 posted on 12/21/2004 11:08:31 AM PST by Doctor Stochastic (Vegetabilisch = chaotisch is der Charakter der Modernen. - Friedrich Schlegel)
[ Post Reply | Private Reply | To 1 | View Replies]

To: neverdem

He probably wasn't the first but Shakespeare is often credited with the remark that "One man's meat is another man's poison."

In the '60s, biochemist Roger Williams was one of the most notable to note that human variability varied so greatly as to make gross generalizations about the study of human beings almost meaningless. The difference, he observed, between one person's miracle elixir and another's fatal dose typically was a factor of a thousand. Our most common awareness of this in normal contemporary life is that for some, milk is the "perfect food" while others will literally starve faster and die of dehydration from that consumption. Most of the latter don't because far before reaching those lethal levels, they figure out that something is drastically wrong. But those listening to the advertising instead of their actual experience may end up in the emergency rooms to learn the devastating news that they may be lactose intolerant.

That same kind of reaction is encountered with just about everything in this world. For some, apparently many, the NSAIDs are a dream come true in relieving their chronic tormenting pains -- while unsurprisingly, a few will have unfavorable reactions and outcomes.

To pronounce as safe only that which is safe to absolutely and unconditionally everyone without exception is an impossibility perpetrated by the priests and scribes of junk science, often as not, mainstream media.

While these bozos like to protest that one should not shoot the messenger but rather the message, the fact is, one can not have a greater understanding of a phenomenon than the understanding of the messenger. The charlatans of junk science exploit this fact and prey upon the gullibilities of ambitious journalists trying to make a name for themselves by distorting their misunderstanding to sensationalistic proportions, not understanding the fuller picture.

On a cycle of once a year when we've forgotten the last, we're offered the story that radio waves or microwaves destroys our DNA, causing cancers among other things -- while overlooking all the great advances in the quality of life incalculable. These purists believe we should abandon every vestige of technology and human understanding, and revert to the safety of burying our heads in the ground at every whiff of danger.

The researcher offering these proclamation of inevitable doom, are quick to add, "Nothing is conclusive yet; we'll just have to spend billions of dollars studying this more closely though. Quite conveniently, my facilities are ready to go." The newspaper editing usually omits those last provisos.





8 posted on 12/21/2004 11:11:09 AM PST by MikeHu
[ Post Reply | Private Reply | To 1 | View Replies]

To: neverdem

Drugs are bad. Nazis are worse.


9 posted on 12/21/2004 11:12:20 AM PST by Lexington Green (Pain makes its own rules.)
[ Post Reply | Private Reply | To 1 | View Replies]

To: Doctor Stochastic

I think the war on drugs will be still going on long after the war on terror is over.


10 posted on 12/21/2004 11:12:54 AM PST by neverdem (May you be in heaven a half hour before the devil knows that you're dead.)
[ Post Reply | Private Reply | To 7 | View Replies]

To: neverdem
Everything needs to be taken with the proverbial grain of salt. Some drugs are no doubt dangerous and others can be made so by abuse. Heck, even water can kill you if you drink too much of it. The balance will be most efficient in tort reform and allow some common sense (such as full disclosure by the manufacturers, coupled with responsibility of the patients using the drugs) to be part of the equation. Remember how if you fed a half-pound rat a pound of saccharin a day, it would get cancer?
11 posted on 12/21/2004 11:21:33 AM PST by trebb ("I am the way... no one comes to the Father, but by me..." - Jesus in John 14:6 (RSV))
[ Post Reply | Private Reply | To 1 | View Replies]

To: neverdem

Newbie here. I don't want to appear unsympathetic to pain but legal or illegal the treatment of non-cancer pain with those wonderful new oral opiates such as Oxcycontin has been a gold mine for the Methadone clinics and the coroners around the country. It is wonderfully addicting and creates a need for itself. You can't get better than that.


12 posted on 12/21/2004 11:29:58 AM PST by Shisan (Dyspaerunia is better than no pareunia at all.)
[ Post Reply | Private Reply | To 1 | View Replies]

To: neverdem

Newbie here. I don't want to appear unsympathetic to pain but legal or illegal the treatment of non-cancer pain with those wonderful new oral opiates such as Oxcycontin has been a gold mine for the Methadone clinics and the coroners around the country. It is wonderfully addicting and creates a need for itself. You can't get better than that.


13 posted on 12/21/2004 11:31:27 AM PST by Shisan (Dyspaerunia is better than no pareunia at all.)
[ Post Reply | Private Reply | To 1 | View Replies]

To: Shisan

There are always abuse potentials and double-edges in life. People sometimes use cars to run other people down. The question is, would you like your pain releif held hostage to vague concerns?


14 posted on 12/21/2004 11:38:43 AM PST by seacapn
[ Post Reply | Private Reply | To 13 | View Replies]

To: neverdem
The DEA is a massive failure, and is the biggest Bill of Rights offender. The government should have absolutely no role in dictating what an individual puts in his or her own body.

Note : I use no illegal substances, and I would not use them if they were legal.
15 posted on 12/21/2004 11:44:17 AM PST by mysterio
[ Post Reply | Private Reply | To 1 | View Replies]

To: mysterio

Purdue Pharma bamboozled the FDA into approval with bogus examples based on MS Contin. How could the FDA have not concluded in its own clinical trials that intense addiction would not lead the addict to mayhem. Dr. Art Van Zee of St. Charles Virgina is leading a movement to get Oxycontin recalled and pulled off the market.


16 posted on 12/21/2004 12:28:52 PM PST by massgopguy (massgopguy)
[ Post Reply | Private Reply | To 15 | View Replies]

To: eyespysomething
Why do we even have prescription medicine then? To taunt and tease?

To provide extra revenue to doctors.

17 posted on 12/21/2004 12:38:09 PM PST by secretagent
[ Post Reply | Private Reply | To 4 | View Replies]

To: El Gato; JudyB1938; Ernest_at_the_Beach; Robert A. Cook, PE; lepton; LadyDoc; jb6; tiamat; PGalt; ..

FReepmail me if you want on or off my health and science ping list.


18 posted on 12/21/2004 12:38:51 PM PST by neverdem (May you be in heaven a half hour before the devil knows that you're dead.)
[ Post Reply | Private Reply | To 10 | View Replies]

To: massgopguy

Dr. Van Zee may be too late. The patent time has run out for Purdue and permission for cheaper knockoffs has been granted to two other companies. Everybody gonna be without
pain (or feeling).


19 posted on 12/21/2004 12:52:28 PM PST by Shisan (Dyspaerunia is better than no pareunia at all.)
[ Post Reply | Private Reply | To 16 | View Replies]

To: neverdem

Each year my arthritus gets a little worse. I've had 3 rotator cuff surgeries. Every disc and vert. in my neck is bad, and so surgery is off the table there. Lower back is worse. I have tried the pain clinic approach, but after a few years, I forgot what it felt like to be alive. As for the oxycontin, one of the better things was that you only had to take it every 12 hours. Didn't seem to have as many problems as the every 6 hour stuff. You don't feel as tethered to a perscription bottle or pharmacy. These doctors that abuse the system and dole out thousands of pills to a patient just screw it up for those of us with no options left on the table other than to face each minute of each day with grinding pain. You just try to hold on.


20 posted on 12/21/2004 2:12:57 PM PST by W.Lee
[ Post Reply | Private Reply | To 1 | View Replies]

To: Shisan
"Newbie here. I don't want to appear unsympathetic to pain but legal or illegal the treatment of non-cancer pain with those wonderful new oral opiates such as Oxcycontin has been a gold mine for the Methadone clinics and the coroners around the country. It is wonderfully addicting and creates a need for itself. You can't get better than that." I agree oxycontin was created for terminal illness, not every day use. However, these new rules don't just affect that drug. They affect all narcotics used to treat pain. Even the ones that are appropriate for chronic pain in non-terminal patients. I've had 4 back surgeries and 1 brain surgery and am fused from T9-S1. My pain management includes some narcotic medication. Pain managment doctors know how to treat pain without letting you get addicted. It's easy for people who don't have pain to say things like "some people have to sacrifice for the war on drugs". They aren't the ones in pain. Quality of life has to be a part of medical care. If you ever have chronic pain, you'll quickly realize that.
21 posted on 12/21/2004 2:34:58 PM PST by Giliad (Ouside of a dog a book is man's best friend. Inside of a dog it's too dark to read.)
[ Post Reply | Private Reply | To 13 | View Replies]

To: Moral Hazard
"I think the policy should be very simple. Doctor's who prescribe narcotic pain medicine should have a standard one page form to give to patients describing the possible harmful side-effects of narcotic pain medicine (i.e. dependence and addiciton). A signed copy of said form should provide the doctor with complete protection from government action for prescribing pain medicine."

Most pain management specialists that I know of do this....we call it a "narcotic contract". It also specifies other things, such as that the patient agrees to have his narcotic regimen managed by only that particular physician.

This step was almost made necessary by the fear of federal and state agents prosecuting physicians in their attempt to alleviate chronic pain.

I wouldn't practice these days any other way...

22 posted on 12/21/2004 3:35:57 PM PST by Ethrane ("semper consolar")
[ Post Reply | Private Reply | To 5 | View Replies]

To: pabianice

I second your sentiments. I've had to deal with doctors who were so worried about over prescribing that they'd rather let their patients be in pain. This is a really sore subject with me, if you'll pardon the pun.


23 posted on 12/21/2004 7:58:09 PM PST by Amore (First, let's kill all the lawyers!)
[ Post Reply | Private Reply | To 2 | View Replies]

To: Shisan

I was on OxyContin for 2 years for back problems. 120 mg per day.

Once I got the back problem resolved, I no longer needed the narcotics. The pain clinic I went to tapered me down over a 2 week period. Not pleasant, but not as bad as I expected.

That was over 2 years ago and I have not needed or wanted any narcotics since.

Properly used, these drugs are safe and effective.

Dependence which ALWAYS occurs is different from addiction, which is a psychological need for the drug.

There is WAY too much hysteria about narcotics, and when you need them, you need them.

Regarding non-cancer pain, when nerves are pinched or damaged, the pain can be every bit as intense as cancer pain.

Limiting the use of these drugs to cancer patients only is inhumane.


24 posted on 12/21/2004 8:36:39 PM PST by EEDUDE (Time flies like an arrow. Fruit flies like a banana.)
[ Post Reply | Private Reply | To 13 | View Replies]

To: EEDUDE

Perhaps you are right. I am sure a certain number of people
can take controlled amounts of these drugs for a period of time but many cannot. (I have read of it being as high as 90% cannot). You were motivated and have done well. I get a skewed sample in the work I do with those who cannot and tend toward pessimism.


25 posted on 12/22/2004 5:49:16 PM PST by Shisan ("Pain don't hurt".)
[ Post Reply | Private Reply | To 24 | View Replies]

To: Shisan

I also have a friend down down in Alabama who has had a total of 4 spinal surgeries as the result of an auto accident.

She was in constant pain and totally unable to function unless she was on 500 mg of MS Contin per day plus medication for breakthrough pain.

She now has a pump implanted that's delivering 5mg morphine/day directly into her spinal canal. She's doing great and now able to get out and look for work. (She has a PhD in psychology)

An interesting fact is that after a week on the same dose of OxyContin or any other narcotic I was on there is no "high".

People that really get strung out on OxyContin are people who either snort it or shoot it. In other words, intentionally abusing it.

The pain clinic I went to was REALLY strict. Random tests to make sure you were not on any other med than what was prescribed. Random tests to make sure you were taking what WAS prescribed.

Show up positive for any illegal substance or get a DUI and you were OUT on your ass.

I just hate that the DEA is making it so hard for legitimate pain patients and Doctors, when the price of heroin on the street is at an all time low and the purity at an all time high. (source DEA)

Pain patients and Dr's are just an easy target in my opinion.


26 posted on 12/22/2004 6:14:58 PM PST by EEDUDE (Time flies like an arrow. Fruit flies like a banana.)
[ Post Reply | Private Reply | To 25 | View Replies]

To: neverdem

Thanks for posting. I really wish that non-medical people would get out of the doctors' business.

Honestly, as far as I'm concerned, pain assessment and adequate treatment are as important to patient health as any other single factor.


27 posted on 12/22/2004 6:23:22 PM PST by Judith Anne (Thank you St. Jude for favors granted.)
[ Post Reply | Private Reply | To 1 | View Replies]

To: EEDUDE

What they were doing by being so strict was conveying to you the potential for harm of the drugs you were receiving.
That means they cared. Many out there prescribing narcotics do not care enough to let the patient know and many patients run into trouble accidently, as it were.
I have always felt that the DEA and the FDA are bloated, inefficient bureacracies and I would not interfere with the doctor-patient relationship (if it exists) but the indiscriminate prescribing of pain meds is like giving a child a loaded gun.


28 posted on 12/23/2004 10:57:38 AM PST by Shisan ("Pain don't hurt".)
[ Post Reply | Private Reply | To 26 | View Replies]

To: pabianice

"I can only wish these bastards a year or two of chronic pain which could be treated by drugs but won't be because of government interference."

Thanks, you've stated my feelings very nicely.


29 posted on 12/27/2004 3:01:38 PM PST by Amore (First, let's kill all the lawyers!)
[ Post Reply | Private Reply | To 2 | View Replies]

To: Doctor Stochastic
the purpose of the war on drugs is to provide funding for the DEA, and to increase government power. check the long list of civil liberties set aside to support the "war on drugs".

like a chinese finger puzzle, the harder you crack down on drugs, the more valuable the payoff to those who sell. its the capitalist system. the BIGGEST backers of the war on drugs are the drug lords -- think about it.

the DEA is completely oblivious to the needs or desires of society, and would allow the entire population of the US suffer rather than to allow people in pain to have a minutes respite.

this just to follow a puritan mandate which busy-bodies use to involve themselves in the lives of others...

30 posted on 12/27/2004 3:15:51 PM PST by chilepepper (The map is not the territory -- Alfred Korzybski)
[ Post Reply | Private Reply | To 7 | View Replies]

To: chilepepper
the purpose of the war on drugs is to provide funding for the DEA, and to increase government power. check the long list of civil liberties set aside to support the "war on drugs"...

this just to follow a puritan mandate which busy-bodies use to involve themselves in the lives of others...

You nailed it. Check out any thread on this site with the word "marijuana" in its title and see the usual busy-body drug warriors with their bad assumptions, bad data and all around bad attitudes pummeling anyone who dares have an opinion that it just might not be anyone's business but their own.

Who are we trying to fool? We LOVE drugs in this country... it's what we teach our children every day with beer drinking for sport, multiple exotic hayfever drugs, pretty anti-cold capsules rolled out every winter...this time with the "extra-strength" pain releaver. Now we have can buy drugs for instant erections and to keep us from wetting our pants. If you are having trouble paying attention, try out this new citrus-colored pill to help you focus. Sheesh! The war on drugs? Don't make me laugh, a huge waste of time and money and just a way to funnel federal cash to cops.

31 posted on 04/17/2005 5:41:04 AM PDT by rhombus
[ Post Reply | Private Reply | To 30 | View Replies]

To: headsonpikes
Pain is a versatile human resource management method that governments do not want to relinquish control over.

Ever.

You got that right!

32 posted on 04/17/2005 6:36:07 AM PDT by Smokin' Joe (Grant no power to government you would not want your worst enemies to wield against you.)
[ Post Reply | Private Reply | To 6 | View Replies]

Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.

Free Republic
Browse · Search
News/Activism
Topics · Post Article

FreeRepublic, LLC, PO BOX 9771, FRESNO, CA 93794
FreeRepublic.com is powered by software copyright 2000-2008 John Robinson