Pain Docs, Drug War Scapegoats, Speak Out

Pain Docs, Drug War Scapegoats, Speak Out; Alex DeLuca; Pain Relief Network; 2008-12-10.

Permalink: http://doctordeluca.com/wordpress/archive/docs-scapegoats/
Refers in large part to:
Conviction without a Crime: a True Story (PDF)
Dr. Michael D. Jackson, J. Amer. Physicians and Surgeons, 13(4), 2008.
See also:
Third Circuit Gives New Meaning to Term “Criminal Justice System” (PDF)
Dr. Bernard Rottschaefer, J. Amer. Physicians and Surgeons, 13(2), 2008.

I am very glad to see physicians, who have themselves been savaged by the government, publishing their stories. Consider Dr. Jackson’s article, Conviction without a Crime, to be a companion piece to Dr. Rottschaefer’s article discussed in the previous item here, The Criminal Criminal Justice System. Together these two articles will give the reader a good sense, I think, of the utter breakdown of professional ethics, common sense, and fairness in any case involving controlled substances.

The drug war distorts law enforcement and the practice of law as thoroughly as it does the practice of pain medicine.¹ The difference is that it’s the docs who are labeled “drug criminals,” and patients who can’t find treatment become “doctor shoppers,” both to be hunted down and the jailed while the cops, lawyers and judges all get paid and get to go home at night.

Dr. Jackson briefly reviews one of the most outrageous cases in modern war on doctors history.² Indeed, it was Siobhan Reynold’s efforts in, and experience gained from, what I call The Myrtle Beach Massacre that lead directly to the founding of the Pain Relief Network (PRN). Jackson describes the legal skulduggery that has become routine in these trials: the withholding of exculpatory evidence, prosecution witnesses coerced into perjury by plea-bargaining deals, the usual conflation of addiction with dependence, and a “jury of his peers” not one of whom, I am sure, could explain the difference between the “medical standard of care” and “what most physicians in community would do.”³ Dr. Jackson writes:

“While engaging in the conscientious, legal practice of my profession, I was the victim of a crime perpetrated by dishonest patients without my knowledge or consent… Yet the DEA and the U.S. DOJ… told Americans that I was a drug dealer, rather than a physician treating patients in good faith…

“Reassuring statements may be made by law enforcement agencies that one has nothing to fear if one is practicing good medicine and has signed pain contracts.⁴ Nothing could be further from the truth. I had these protections in place, but they did not matter. There is no guarantee that you will be safe from the government agencies that are persecuting the very people they are sworn to protect.”⁵

Footnotes

See: The Distortion of Pain Medicine – Alex DeLuca, War on Doctors/Pain Crisis blog, 2007-10-19. “[Doctors generally] prescribe very low dose regimens to begin with. Which might be okay if they saw the patient every few days and aggressively titrated up the dose and changed to more potent medications at the right time such that the patient was titrated to analgesic effect which is the medical standard of care for the treatment of chronic pain. (I think it is important for pain patients to really understand what these phrases mean, and to thoroughly grasp the modern, medical understanding of chronic pain –> see: the Recommended Reading section at end of this article. ↩
The Myrtle Beach Massacre is indeed one of the “most outrageous cases in modern war on doctors history,” but an even partial, off the top of my head, list of physicians savaged by the government for practicing compassionate medicine to the standard of care for pain management is getting shockingly long. The cases of Drs. Nelson, Hurwitz, Heberle, Bordeaux, Knox/Boone, Fisher, McIver, Rottschaefer, Mangino and others are (mostly thoroughly) covered in the archival series: The War on Pain Sufferers Special Collections. See also the cases of Dr. Rosa Martinez and Dr. Stan Naramore and Dr. Robert Weitzel. For an even more depressingly comprehensive listing of persecuted pain doctors, see the Chronic Pain Politics page at the Our Chronic Pain Mission website. ↩
See Part 5 of 6 of raw interview footage of me done in March 2008 by the Competitive Enterprise Institute (CEI) as part of their Politics of Pain initiative entitled, Why I Don’t Practice Medicine, Anymore. I discuss ’standard of care’ vs. ‘community medical norms’ starting about 6 minutes, 45 seconds into the video, using the federal trial of Dr. Rosa Martinez, December 2008, as an example. ↩
This is equally true regarding similar reassuring statements recently issued from the odd cabal of organizations that has apparently congealed around the belief that the status quo in which adversarial, and medically ignorant, law enforcement is immutably in charge – setting medical standards and defacto regulating medicine, which is unconstitutional. This belief system, known as the Central Principle of Balance (CPB), reduces physicians and public health experts to negotiating, as if supplicants before an angry God, grave matters of medicine and public health, with policemen who are untutored and uninterested in clinical pain medicine being focused solely on catching addicts. Here is an example of a “reassuring” article written by authors representing the three major forces desperately pushing the CPB belief system – 1) the same academics and researchers who got their asses kicked in the Amazing Vanishing DEA FAQ Debacle, 2) regulators and prosecutors, and the National Association of Attorneys’ General (NAAG), and 3) (oddly, given that the article entirely ignores ethical dilemmas at the core of the pain crisis) the Center for Practical Bioethics – entitled: Physicians Charged with Opioid-Analgesic Prescribing Offenses (PDF), Goldenbaum et al., Pain Medicine, 2008. ↩
Conviction without a Crime: a True Story (PDF) – Dr. Michael D. Jackson, page 109, J. Amer. Physicians and Surgeons, 13(4), 2008. Also from the Conclusion: “There are 37 different pain management associations, not one of which attempted to help me or my colleagues.” In this regard see also Footnote #4, above. The mainstream pain societies and organization all subscribe entirely to the Central Principle of Balance belief system, yet it has become painfully clear in the years since the Myrtle Beach Massacre that the CPB is a failed strategy that could only serve to cement the current doc-cop status quo that created and maintains the crisis of undertreated pain in America. CPB focuses only on doctors and patients, ignoring entirely issues of medical ethics, federalism, rational (scientifically led) public health policy development, law enforcement and prosecutorial abuses, and documented massive theft at the wholesale/pharmacy level having nothing to do with the doctors and patients. It therefore does not address the direct and root causes of the distortion of medical ethics and practice by drug-war police imperatives, laws, and regulations – rather it accepts them as givens. The CPB could not possibly be a strategy for real change. More about this soon. ↩