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I am republishing these “Principles of Opioid Management of Pain“, by Dr. Joel Hochman, et al., because of the explosion of deeply flawed and misguided “Guidelines” for pain management in recent years. This document stands alone in meeting the (textbook, ‘responsible physician’) standard for pain management while not violating core ethical obligations of the doctor-patient relationship and is useful, I think, for comparison when studying promulgated Guidelines. [See also: The Distortion of Medicine and Confusion of Standards]

In pain medicine we have the deeply disturbing situation that what most doctors do (medical community norm) is at odds with, and clearly below, the medical standard of care. Literally, in the treatment of chronic pain, an ethical physician attempting to practice in good faith, according to the clinical literature, is an outlier deviating from how most reputable physicians would practice.

Article by Dr. DeLuca regarding Jacob Sullum\’s comments about a recent SAMHSA analysis showing low addiction rates for most substances of abuse, and also discusses Hurwitz\’ excellent 2005 analysis of Government data, the peer reviewed

Blog post about a legal brief (full text link provided), a Memorandum and Order setting conditions for and releasing Dr. Stephen Schneider pending trial.

Blogged analysis by DeLuca about a confused opinion article in Wall Street Journal regarding the relationship between law enforcement imperatives on doctors and the resulting routine undermedication of pain patients. [...]

Blog post about Utah AG Brett Tolman, who has indicted several pain doctors as drug dealers, including Dr. Warren Stack, and now Dr. Ray Taylor, whose Initial Media Smear is just now beginning. Prosecutor Tolman has discovered what AG Tom Corbett (Pennsylvania) already knows very well: shooting doctors caught in the Controlled Substances Act barrel is just too easy, too profitable, too fun to forgo.

Blog post about the case of U.S.A. v Dr. Rosa Martinez by Dr. Alexander DeLuca, defense medical expert. Case involves federal overreaching, and groundless charges that Dr. Martinez was drug criminal instead of the caring family doctor caring for her chronic pain patients entirely up to the medical standard of care for pain management.

Two poems by Dr. William Hurwitz: “Billy’s Lament” and “The Appeal”; published doctordeluca.com; 2005. I like these poems. I’ve characterized the voice as Dr. Suess Meets Lenny Bruce, and I mean no disrespect to any of these three poets. In these two poems Dr. Hurwitz also reviews his conviction and the basic strategy for his appeal.

Blog post about the conviction of Dr. William Mangino for violations of the state drug act and medicaid fraud. Link to full text of Mangino’s Omnibus Motion which pertains to request for summary Not Guilty and discussion of Jury Instructions. This document is discussed. Mangino Verdict III will concern bail and defense fund matters.

Blog post about the indictment of Dr. Jennifer Zampogna, and the initial media smear mounted by Attorney General Tom Corbett of Erie county, PA. One would have thought we\’d seen how low Attorney General Tom Corbett could go, in the Dr. Paul Heberle case, but apparently not. This Zampogna case is embarrassing – a pathetic joke. Here is the MAIN charge, the best they got… After that, the charges get too silly to bother with here. He\’s kidding, right? The good people of PA are going to pony up for a hideously expensive criminal investigation and trial to convict a …

Press release from the Pain Relief Network Re: moral victory in St. Thomas in the case of Dr. Maynard, who was sentenced to 7 months which was less than sentencing guidelines.

Impressions of the re-trial of Dr. William Hurwitz by Dr. Alexander DeLuca who witnessed the courtroom proceedings of 2007-04-17, as the trial drew to a close. Excerpt: “Still I was struck, as I always am observing war on docs prosecutions, at how tilted the playing field is, at how much more difficult the defense’s task is. The defense must convince a jury of medical lay people that complicated medical decisions made in very complicated cases were reasonable and well-intended; the prosecution need only sling mud. The former task requires the judge and jury have a medical student level understanding of …

No Relief in Sight (full text plus Related References) – by Jacob Sullum, Senior Editor of Reason Magazine, 1997. Source. ‘Brief Note’ added: 2009-07-14. **Brief Note:** A true classic in the annals of the pain crisis in America. This article, as much as any other one thing I can think of, altered my life from practicing physician to practicing pain relief advocate. I am also a big fan of Mr. Sullum’s 2004 book, *Saying Yes: In Defense of Drug Use*. ..alex… “Torture, despair, agony, and …

On Delivering One’s Wife to Federal Prison (full text) Ed Swaim (husband of Dr. Bordeaux); Addiction, Pain and Public Health website; 2006-06-07. Comment (DeLuca): Letter from Ed Swaim to the pain management advocates of the listServs of the Pain Relief Network] (PRN) and the National Foundation for the Treatment of Pain (NFTP). His wife, Dr. Deborah Bordeaux, a noble and brave soul and fine physician, is now in federal prison. She had to report on June 5, 2006, and will be serving two years. This is a black day for us. See also: Why We Lost – Deborah Bordeaux, …

Judge Clips Jail Time for Myrtle Beach Drug Doctors (full text) Kenneth Gailliard; The Sun News, Myrtle Beach Online; 2006-03-28. Excerpt: “A federal judge [Houck] on Monday slashed prison sentences for three former doctors from a now-closed Myrtle Beach pain clinic where federal prosecutors say drugs were illegally prescribed. <A Fed> appeals court ruled in 2005 that Houck… could have used more discretion in those sentences.” Comment (DeLuca): NOT. GOOD. ENOUGH. Dr. Bordeaux et al. deserve ZERO prison time – anything else reinforces the ‘chilling effect’ and deepens the Pain Crisis in America. Defense attorney Stutsman plans to ask the Supreme Court to review …