Making life worse for those in pain

During the Christmas season, 1994, the federal Drug Enforcement Administration put Las Vegas medical doctor Dietrich Stoermer, who had treated our troops in Vietnam, on trial here for writing “too many” painkiller prescriptions.

Since other doctors worried about being “red-flagged” by the drug police if they took on the cases of chronic pain patients, Dr. Stoermer was often the refuge of last resort for such sufferers. He ended up with a lot of them.

So a parade of sick people, some doubled over with cancer or spinal disease, testified at trial that Dr. Stoermer had been a God-send, had literally saved their lives.

The government, on the other hand, contended he was a mere “prescription factory,” issuing scrips for pain medications in order to profit from his $60 charge per office visit.

The Las Vegas jury weighed the evidence and unanimously acquitted Dr. Stoermer. He held out his hand to the federal prosecutor, that Christmas Eve, saying “No hard feelings.”

But there were hard feelings. The federal drug police declined to renew Dr. Stoermer’s federal license to write painkiller prescriptions, claiming they had a “different standard of evidence” than that used by juries.

Unable to earn his livelihood here, he was forced to return to his native Australia.

Do you think other doctors don’t watch such outcomes? That they have no impact on the treatment of patients seeking legitimate pain relief?

A Stanford study puts the number of under-medicated chronic pain patients at about 50 percent, Zachary David Skaggs, a fellow specializing in pharmaceutical policy at the Competitive Enterprise Institute, wrote in 2007. “According to the American Pain Society, fewer than 50 percent of cancer patients receive sufficient pain relief. …

“Since 2000, the Drug Enforcement Administration has embarked on a muscular campaign against prescription painkiller abuse,” Mr. Skaggs wrote in the Washington Times. “It has utilized undercover investigations, SWAT raids, asset forfeiture, and high profile trials against ‘kingpin’ doctors. These tactics should be familiar to anyone who has studied the drug war, but the results are a shocker. Prescription opioids have actually grown scarce. To put it bluntly, the DEA has finally found a drug war it can win.”

“Opiophobia” is a term that describes doctors’ increasing unwillingness to prescribe opioid painkillers — a class of drugs that includes Vicodin and OxyContin — and especially high-dose opioids, to those in pain. “This fear is rooted in the DEA’s practice of jailing those doctors it deems are prescribing outside ‘legitimate medical standards,’” Mr. Skaggs wrote.

The result is predictable: radical under-treatment of pain, along with an absurd proliferation of treatments, some well-intended, some verging on quackery, which go under the general heading “pain management,” but which should really be called “things we might try if we didn’t already known about opium and some similarly useful and inexpensive solanaceous alkaloids.”

(Needless to say, pharmaceutical firms manufacturing patented synthetics on which they can make hefty profits have little reason to promote or defend morphine, codeine, or the like, simple derivatives of organic opium on which any patents have long since expired, and which can be therefore manufactured at low cost by anyone with a basic commercial chemistry set.)

Now comes Nevada state Sen. Tick Segerblom, D-Las Vegas, a trial lawyer by profession, with Senate Bill 75, which would instill further fear and trepidation in any doctor who even considered prescribing effective painkillers, by making it easier for Mr. Segerblom’s fellow trial lawyers to sue pharmaceutical manufacturers and doctors should a patient become addicted to prescription pain medication.

(You doubt the link? Sen. Segerblom chairs the Senate Judiciary Committee, which means he was in charge of Wednesday’s hearing on his own bill. When Dr. Ivan Goldsmith began to testify that Sen. Segerblom was paving the way for frivolous lawsuits and “shilling” for the plaintiff’s bar, his microphone was turned off. And what makes Sen. Segerblom’s new assault on medical liberty all the more ironic is that he’s also sponsoring a bill this year to legalize marijuana for recreational use in Nevada. So it’s OK to self-medicate with marijuana, but chronic pain patients should just blow their brains out, since doctors who prescribe opiates for such patients now risk being run out of business?)

As Dr. Annette Teijeiro testified via live video link from the Grant Sawyer Building in Las Vegas Wednesday that this would be equivalent to making “casinos and slot machine manufacturers civilly liable for … gambling addictions, or bartenders and liquor manufacturers civilly liable for … alcoholism.”

Yes, many chronic pain sufferers acquire their drugs through illegitimate channels — precisely because the DEA has been so busy poisoning legitimate medical channels.

Besides, they’re only “illegitimate” because lawmakers arbitrarily made them so. If they’d stuck to guaranteeing purity and truth in labeling — as they promised up and down was their only goal when they introduced the Harrison Narcotics Act in 1914, vowing they’d never restrict a doctor’s right to prescribe or a patient’s right to obtain any medicine — patients who found themselves developing tolerance and habituation would have a medical problem, not a reason to associate with criminals and end up in jail.

Mr. Segerblom’s bill is opposed only by doctors, patients, drug manufacturers, libertarians, and the Chamber of Commerce. “I’ll have to do something to this bill to get it passed,” Mr. Segerblom admitted Wednesday.

Here’s a better idea: Legislators, police and judges should all be happy to learn the Bible instructs us that every flower-bearing plant and tree — including the poppy — was given to man for his use, and further that we actually have trained professionals in this country who know best how to evaluate, treat and manage pain. Most of them are called doctors.

Doctors and patients should be set free to work out these matters, which are not appropriate concerns of police, judges, or state lawmakers.

Mr. Segerblom should do the merciful thing. He should take this bill out behind the statehouse and put it out of its misery.

# # #

Remember Barack Obama’s big end-of-the-world “Sequester” speech of Feb. 19?

Using a bunch of uniformed cops as props, the president warned against “these automatic, brutal spending cuts that are poised to happen next Friday.”

“Air traffic controllers and airport security will see cutbacks, which means more delays in airports across the country,” the president warned. “Thousands of teachers and educators will be laid off, and thousands of parents will have to scramble to find child care for their kids. Hundreds of thousands of Americans will lose access to primary care, preventative care, flu vaccinations and cancer screenings.”

For starters, of course, there are no cuts. Even after this pathetic 2.2 percent reduction in what the Incumbent Republicrat Party wanted to spend on “non-entitlement” allocations in 2013, Uncle Sam will still spend more this year than last.

After a decade, these pathetic “cuts” simply mean the federal government will be on track to spend about $4.5 trillion a year instead of $4.6 trillion — up from $3.5 trillion today, 40 percent of it borrowed.

Dramatizing how terrible this is by selectively canceling air shows and White House tours? Pure political theater.

My point is simply that you should get out one of those little pocket Constitutions, turn to Article I Section 8, and run down the list of things on which Congress is authorized to spend funds.

Is the federal government authorized under Article I Section 8 to have any role in searching travelers and their belongings with no warrants or probable cause? Funding teachers or day care anywhere outside the District of Columbia? Playing any role in regulating, providing, or paying for our health care?

Yes, Mr. Obama did mention cuts in Defense spending. But even this fellow couldn’t bring himself to claim these “cuts” wouldn’t leave enough money to provide our troops, on whatever lonely no-win foreign adventure they’re now launched, with sufficient boots, cartridges and Meals Ready to Eat.

Instead, the Defense cuts were generally bemoaned as hurting Defense CONTRACTORS, which could result in a bump in the unemployment rate, as though the Defense Department is little more than a huge federally funded jobs program — which is probably as good a description as any.

The Founders gave us a central government of powers sharply limited to those expressly listed. What have we got, now?

3 Comments to “Making life worse for those in pain”

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