<http://www.abqtrib.com/albq/op_columnists/article/0,2565,ALBQ_19865_4737140,00.html>
Barbara McKee: End war on drugs
Misguided DEA's witch hunt leaves patients hurting

By Barbara McKee

Tribune Columnist, May 30, 2006

Chronic pain management is officially part of the war on drugs.

The Drug Enforcement Administration and the Justice Department have had
such bad results with controlling the illegal importation and use of
heroin and cocaine that both departments have turned their focus on
pain-management clinics to get some "success" stories.

With a growing population of people suffering from severe chronic pain,
prescribing strong opiates such as Oxycontin, have risen. Oxycontin, a
Schedule II drug, gives up to 12 hours of time released pain control.

But it has also become the favorite drug of choice for illegal sale on
the streets. Why? If you crush the pill, the user gets an instantaneous
high similar to heroin - without using a needle. Since it's a legal
prescription drug, finding an unscrupulous doctor is much easier than
finding a heroin dealer.

This has resulted in a war between physicians, the DEA and patients who
truly need strong medication. The DEA doesn't care about the enormous
impact they are having on the good doctors and patients who follow the
law. The DEA is watching pain-management clinics, mostly those owned or
operated by minorities, to find a rotten apple in the barrel.

But if you're rich, like conservative talk-radio host Rush Limbaugh or
Rep. Patrick Kennedy, the Massachusetts Democrat, there's no need to go
through the "prove it" gauntlet. All they have to do is lay out the
cash. Only the poor have to prove the pain.

Doctors have had to find a way to demonstrate to the DEA that patients
are not selling their prescriptions on the streets. Some clinics have
devised a prescription contract that the patient and physician must sign
outlining how the patient will receive the medications they need.

Many physicians have stopped prescribing opiates, sending patients to
pain-management clinics that are more expensive. Pain-management clinics
must prove what treatments have been tried and failed by ordering
several tests, which can take as long as six months before they conclude
how severe the patient's pain is.

Federal law classifies most opioids as Schedule II drugs, the same
classification given to cocaine and heroin, despite a growing body of
opinion among the medical community that opioids should not be
classified with these substances.

One of the DEA'S few Congressional critics is libertarian Republican
Rep. Ron Paul of Texas. "Unfortunately, patients often must consume very
large amounts of opioids to obtain long-term relief. Some prescriptions
may be for hundreds of pills and last only a month. A prescription this
large may appear suspicious.

"But according to many pain-management specialists, it is medically
necessary in many cases to prescribe a large number of pills to
effectively treat chronic pain. However, zealous prosecutors show no
interest in learning the basic facts of pain management."

The war on drugs has failed. It's time to admit it and move on - to
rewriting drug laws that are realistic and effective.

McKee, a wheelchair user, is a freelance writer and producer. You can
e-mail her at chairgrrl@chairgrrl.com.