Pubdate: Thu, 15 Dec 2005
Source: Arkansas Times (Little Rock, AR)
Copyright: 2005 Arkansas Times Inc.
Contact:  http://www.arktimes.com/
Details: http://www.mapinc.org/media/583
Author: Doug Smith
Cited: Common Sense for Drug Policy http://www.csdp.org
Cited: CSDP ads http://www.csdp.org/publicservice/
Bookmark: http://www.mapinc.org/find?232 (Chronic Pain)

LAWMEN VS. THE DRUG WARRIORS

Attorneys general seek change in DEA policy.

For months, full-page advertisements challenging government policy 
toward pain management doctors have been appearing in national magazines.

"The government is waging an aggressive, intemperate, unjustified war 
on pain doctors," the headline on one ad says. It goes on to quote 
from a study published by the Cato Institute, a libertarian "think 
tank" in Washington:

"By demonizing physicians as drug dealers and exaggerating the health 
risk of pain management, the federal government has made physicians 
scapegoats for the failed drug war. Even worse, the Drug Enforcement 
Administration's renewed war on pain doctors has frightened many 
physicians out of pain management altogether, exacerbating an already 
serious health crisis - the widespread treatment of intractable pain. 
Experts agree that tens of millions of Americans suffer from 
undertreated or untreated pain ... according to one 1999 survey, just 
one in four pain patients received treatment adequate to alleviate 
suffering." The ad was placed by Common Sense for Drug Policy, a 
"drug reform"organization.

Another ad, placed by the same group, quoted from a Jan. 19, 2005, 
letter to the DEA signed by 30 attorneys general: "We, the 
undersigned Attorneys General, "We have learned that adequate pain 
management is often difficult to obtain because many physicians fear 
investigations and enforcement actions if they prescribe adequate 
levels of opioids or have many patients with prescriptions for pain 
medications. We are working to address these concerns while ensuring 
that individuals who do divert or abuse drugs are prosecuted ... "

One of the signers of the letter was Arkansas Attorney General Mike 
Beebe, who is now a candidate for the Democratic gubernatorial 
nomination. A Beebe spokesman had little to say about the letter 
except that it grew out of discussions within the National 
Association of Attorneys General, a common occurrence, and that three 
attorneys general had been in the forefront of drafting the letter 
and seeking support. One of those was Oklahoma Attorney General Drew 
Edmondson. (Beebe might not be so willing to join with Edmondson 
today. In June, Edmondson, a Democrat, filed a lawsuit against 
Arkansas poultry plants, accusing them of polluting streams that flow 
into Oklahoma. Beebe said the suit was improper and asked the U.S. 
Supreme Court to stop it. Edmondson said Beebe was carrying water for 
corporate polluters.)

Edmondson, Maryland Attorney General Joe Curran and Vermont Attorney 
General Bill Sorrell met with DEA Administrator Karen Tandy in April. 
Neither side has given a full accounting of the meeting. Rogene Waite 
of the DEA public affairs office in Washington said the meeting was 
"excellent and positive" and suggested that further questions be 
submitted to the attorneys general. Edmondson said in a news release 
that he and the other attorneys general had spoken "openly and 
frankly" about the pain management issue: "Many physicians have 
expressed a reluctance to prescribe needed dosages of pain 
medications because they fear DEA prosecution." He didn't describe 
Tandy's response, but he concluded, "I think this meeting in the very 
least puts us on the road to finding workable solutions."

On the road, perhaps, but not very far down it, sounds like.

Mike Beebe's likely opponent in the 2006 gubernatorial election is 
former Congressman Asa Hutchinson, who is seeking the Republican 
nomination. Hutchinson is a former head of the DEA. Asked his 
reaction to the letter from the attorneys general to the DEA, 
Hutchinson said that as he read it, the letter was calling for a 
return to a DEA policy that was adopted in 2003. Hutchinson, who left 
the DEA in January 2003, said that policy was an outgrowth of his 
negotiations with pain-management physicians who said they were 
reluctant to prescribe drugs because they feared the DEA. "We 
recognized their position, and they recognized the importance of the 
role of the DEA in preventing diversion." (Diversion is the illegal 
sale of drugs by people who obtained the drugs legally from 
physicians.) Hutchinson said that if his reading was correct, he had 
no quarrel with the letter or with Beebe for signing it.

The letter does indeed speak favorably of the 2003 policy and 
unfavorably of a DEA policy statement issued in November 2004 that 
"emphasizes enforcement, and seems likely to have a chilling effect 
on physicians engaged in the legitimate practice of medicine."

Anything that has a chilling effect on physicians who prescribe pain 
drugs will have an even more chilling effect on their patients. And, 
as in all such matters, it is the people at the bottom of the 
economic ladder who get chilled the most. A University of Michigan 
Health System study published in October 2005 found that patients in 
minority and low-income neighborhoods were much more likely to lack 
access to pain medications than patients in whiter and more 
prosperous neighborhoods.

The war on drugs has many casualties. And they're all people, not drugs. 
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MAP posted-by: Richard Lake