Jewish World Review July 4, 2003 / 4 Tamuz, 5763
Drs. Michael A. Glueck & Robert J. Cihak
The Painful DEA II: War on legal drugs ensnares too many doctors and not enough dealers
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Prosecutors and law enforcement officials throughout the country are
egregiously targeting doctors for helping patients manage crippling pain
with controlled, legal drugs.
We've addressed this topic before ("The Painful DEA") but find the need to
keep commenting until justice is done and the Drug Enforcement
Administration (DEA) and other government officials get it right. Judging
from letters we've received, many people â?" particularly seniors, the
chronically ill and disabled â?" are very upset about the DEA's
interference with their ability to receive appropriate medical treatment.
For example, in an overzealous prosecution, the Arizona medical community
was shocked by the indictment of Tucson physician Jeri Hassman, M.D., on
charges stemming from her legal prescriptions for pain relief for her
patients.
Speaking at a news conference on June 26 at Hassman's Tucson offices, Jane
M. Orient, M.D., Executive Director of the Association of American
Physicians and Surgeons, explained why AAPS has decided to support Dr.
Hassman: "Throughout the United States, physicians are being threatened,
impoverished, delicensed, and imprisoned for prescribing in good faith with
the intention of relieving pain."
For some government officials, the "War on Drugs" has come to also mean a
war on lawful drugs and against the doctors who prescribe them and the
patients who take them. Some prosecutors try to make political careers out
of high-publicity cases involving the hot "drug du jour" such as OxyContin.
But this war is causing enormous collateral damage and deaths to innocent
patients from "friendly fire."
Physicians have been drummed out of practice, jailed and even driven to
suicide in the face of these 21st century witch hunts. "These doctors are
treating patients at great personal risk. If this continues, not one doctor
will be willing to prescribe the medications that patients so desperately
need," warned Dr. Orient.
The real problem is not drugs, but drug misuse. Drugs are dangerous and
must be treated with respect. Yet to many patients, drugs are life-saving.
"Law enforcement agents are using deceitful tactics employed to snare
doctors, and prosecutors manipulate the legal system to frighten doctors
and patients who might be willing to testify on behalf of the wrongfully
accused doctors," said Orient. For example, she explained that law
enforcement sends undercover actors to doctors to feign pain and beg for
drugs.
Several of Hassman's patients spoke about the debilitating pain they suffer
and their problems finding doctors to treat them now that their doctor's
license and ability to write prescriptions have been suspended. Physicians
at the press conference confirmed they now practice in an atmosphere of
fear and intimidation.
Physicians and pharmacies already do report potential "drug-seeking"
patients to law enforcement, yet are never warned by law enforcement
officials about patients they believe are "drug seekers" trying to take
advantage of physicians or pharmacies. Communication is flowing in only one
direction.
Law enforcement uses outdated norms for assessing excessive prescribing.
Investigators frequently look at the volume and duration of drug use as the
primary trigger for an indictment. This is no longer appropriate, as
standards for appropriate and accepted treatment have changed, leading to
indictments of pain specialists simply due to the volume of their necessary
prescriptions.
To stop the misuse of prescribed drugs without depriving patients of
life-saving medication requires cooperation between police and physicians,
not persecutions and prosecutions In order to focus the debate on criminals
rather than innocent patients and doctors, AAPS kicked off a national
three-point "Communicate and Cooperate" campaign at the press conference to
work with law enforcement, making the following recommendations:
1. Work Together
Doctors, pharmacists and law enforcement officials should work together to
track and report potential drug abusers to each other.
2. Professional Medical Review of Potential Cases
Before charges are filed against a pharmacist or doctor, a review board of
medical professionals should meet under the auspices of the Department of
Justice to assess a physician's practices, rather than totally relying on
judgments made by non-medical police and prosecutors.
3. Mutual Training and Communication
Law enforcement investigators should received training in modern medical
treatment and current trends. Medical professionals should be informed of
suspected drug abusers.
Notes Orient, "In the art of medicine, investigators must be able to
distinguish between a difference of opinion in what is proper treatment,
and specific criminal intent. The DEA could pull the plug on most drug
diversion by working with doctors instead of against them."
Currently the war on legal drugs ensnares too many doctors and not enough
dealers. Those who require legal medications ought to be able to receive
them without their doctors and pharmacists going to jail!
Michael Arnold Glueck, M.D., is a multiple award winning writer who
comments on medical- legal issues. Robert J. Cihak, M.D., is past
president of the Association of American Physicians and Surgeons.
Both
JWR contributors are Harvard trained diagnostic radiologists.
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