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The treatment of chronic pain is an issue of national importance. If petitioner’s conviction is allowed to stand then any single opioid prescription can be called into question based upon misconceptions which should not be allowed to permeate the atmosphere of The American Courtroom.

Responding to what doctors and patients are calling a dangerous crackdown on people with chronic pain, [Pain Relief Network][prn] is seeking the protection of the courts, hoping to have the deadly disease of chronic pain declared a disability under the Americans With Disabilities Act.

“Ms. Treadway’s conduct in the case has been nothing short of shocking and ruthless; she has in fact displayed the kind of ‘win at all costs’ mentality that you have publicly stated your department will no longer tolerate,” Reynolds wrote in her June 18 letter to U.S. Attorney General Eric Holder… The ACLU has taken up the Reynolds defense in the grand jury proceedings, claiming in initial court papers that subpoenas sought by a “frustrated prosecutor seeking to silence a dissenting advocate” have a chilling effect on First Amendment rights.

[Dr. Johnston's] case offers the Obama DOJ the rare chance to reaffirm the architectural structure of our federal system by joining in the PRN’s 10th Amendment-based request for a full hearing by the court. [Reynolds:] “The Administration can also show substantive empathy right away, for the 50 million Americans in pain currently being denied pain treatment by doctors terrorized by the [DEA]. These desperate Americans shouldn’t be made to wait for the President to appoint a new justice.”

“Given the sweeping nature of the subpoenas here, their chilling effect on First Amendment rights, and the circumstances under which they were obtained – a frustrated prosecutor seeking to silence a dissenting advocate – this Court should quash the subpoenas as an unjustified infringement on Ms. Reynolds’ and PRN’s First Amendment rights,” the ACLU wrote in its pleading.

“I will not be intimidated and I will not be silenced,” said Reynolds, who founded PRN… “As I testified before Congress, an obsession with prescription drug abuse has resulted in the gross under-treatment of pain in this country. We have turned honest physicians and desperate patients into criminals, and policymakers and the public need to hear about it…”

Maybe we all deserve the pain. If we are too stupid to understand that aspirin kills way more people than morphine, and that there are a whole lot worse things for you and your damn Federal prosecutors to worry about than if maybe your neighbor is getting too much pain relief (sheesh!) – if you are that effin stupid then maybe you deserve the chronic pain which YOUR government has already imposed on you and your children as the defacto law of the land.

We keep hearing about how the War on Drugs has failed. But the truth is, the War on Drugs has been tremendously successful, that is if you wanted your country to be a police state, your Congress completely unresponsive to the needs of the people, and your doctors letting you and your loved ones live and die in unnecessary pain.

AUSA Treadway wants to drag Ms. Reynolds before a Grand Jury for, get this, obstruction of justice! in the case of U.S. v Dr. Schneider. If we were not talking about the mockery of American justice Bush appointees routinely make in cases like Schneider and Shaygan this would be really funny. Siobhan Reynolds is obstructing justice? Utter nonsense. It is prosecutor Treadway for the USA who, if not obstructing justice in this case, is surely doing everything she can to delay it.

Wow. To win acquittal on federal drug trafficking charges is very difficult and very rare, as I have [discussed before][rm]. A resounding win is almost unheard of. I will be very interested in the outcome of the prosecutorial misconduct case being brought by Dr. Shaygan’s defense attorney, Mr. Markus.

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]

Excerpt: “Dr. Mangino has been unjustly prosecuted and convicted in Pennsylvania. His case is unusual. He is currently incarcerated at SCI-Cresson… Essentially, in PA and nationwide, if this conviction is allowed to stand on the grounds presented by prosecution, then any single opioid prescription can be deemed illegal.” — Dr. Mangino

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.

Many physicians are concerned that prescribing opioid analgesics in chronic pain treatment is accompanied by an unacceptable risk of unwarranted prosecution. The validity of this fear is evaluated by examining the standards through which physicians are targeted and prosecuted. Prohibition law is identified as an error in social policy that distorts medical standards.

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.