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[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.”

“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…”

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.

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

“The practice of medicine IS the practice of harm reduction. It is a fundamental principle of medical care that the patient has the right to disagree, to be non-compliant, to choose a path or a goal other than the one we might desire for them. The physician’s job is to do everything possible to help such a patient do the best he can, to minimize harm since, at least temporarily, it cannot be eliminated. Only in addiction medicine is it insisted that patients and staff hew to a ‘philosophy’ of ‘total abstinence’ rather than support appropriately individualized goals.”

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.

criticisms and description of federal prosecutorial behavior rings true to me from my experience and knowledge of war on docs/pain crisis cases. Our justice system is withering, ‘the drugs exception to the Bill of Rights’ has gone from being a tragic lawyers joke to business as usual, and we now routinely apply asset forfeiture and RICO laws, intended by Congress to combat drug cartels, to individual pain-treating physicians. Doctors and sick people are easy, profitable prey for law enforcement and federal prosecutors pandering to the electorate through a media willing to be exploited for their share of the spoils.

There are so many who need opioid pain medications and can not get them… These people have their lives destroyed every day as they drag themselves from doctor to doctor being lied to, verbally and sometimes physically abused, forced into unnecessary rounds of expensive testing… They are sneered at by pharmacists, called addicts by doctors, drug tested, called “frequent-flyers” and other derogatory names by emergency room nurses and doctors, denied reimbursement…

Update on the case of USA v Dr. Martinez in Washington state. Martinez has been acquitted of all drug crime charges. The fraud charges remaining after her 2007 fed trial have also been dismissed, but the govt can bring the fraud charges anew. Also examined is a recent Yakima Herald article announcing “new” charges that are not, in any reality-based sense, “new” at all.

Abstract of peer-reviewed article reporting multicenter outcomes for safety and analgesic efficacy of high-dose, transdermal buprenorphine in the treatment of chronic pain, and brief comments on same by Dr. Alex DeLuca, and with links to related discussions on the Pallimed blog.

Experts: Untreated pain as serious a problem drug abuse. By Tristan Scott of the Missoulian. With the specter of prescription drug abuse looming large, health care workers stressed Friday that untreated pain in Montana is a public health crisis commensurate to that of addiction.

The article well describes the public health chaos this is the predictable consequence of clinical and public health authorities abandoning their real mission to uphold the medical standard of care for their citizenry, and instead focusing exclusively on the policeman’s agenda which prioritizes ‘catching a few addicts’ over providing adequate pain management for legions of innocent patients.

It seems to me an uncivilized and insane notion that just because someone in current moderate to severe pain had a history of an alcohol or drug problem, or even a current substance abuse problem, that you would deny them opioid therapy if that was the best medication to relieve their suffering. But this seems to be a point of confusion that increasingly comes up from patients, doctors, and regulators alike. So, in this post, let me make the medical standard of care in this situation perfectly clear. [...]