Monday, October 20, 2003

WAITING FOR THE SUN

It appears that I have new neighbors moving in even as I begin to write this evening. I didn't get a look at them yet but they sound somewhat young and jolly. Of course they usually do. I'm going to have to get used to people being around again. That apartment has been empty for months.

Hard time to be moving. It's freezing here today but the good news is, the hotel clerk tells me that it's 86 degrees in Florida. I opted out for the funky motel with internet access at Lauderdale-by-the-Sea. In the end I couldn't resist the name of the beach and besides the hotel is pink. To quote my dear friend Karen - one more day to crawl through....... I can't wait to be warm.

Noho has been pretty subdued by the chill winds, but I have one piece of hot gossip. Straight from Timmy Driscoll's mouth, he really is selling City Cafe to Harry's son Tully and his partner John Reilly, the guy I don't really know from Fitzwillys. I've been watching Tim wandering around silently saying farewell to the bar for a while, but I can also envision how happy he and his lovely wife Louise will be when they buy that condo and start living in the Carribean.

Me, I just hope the new guys don't change it too much. It's the last original refuge left in this town.




PAIN RELIEF

I have always thought the absence of pain feels better than never having been hurt at all. For those of you who have ever suffered a great injury, then you understand the miraculous nature of a remedy.

This article about the prosecution of Dr. William E. Hurwitz, a 57-year-old Virginia pain treatment specialist will resound with those of you who have suffered through some mind numbing, skull bashing pain and had a doctor refuse to prescribe for it.

Now Will is an unlikely poster boy for the issue of pain management, he's had some other legal trouble along the way, but his peers are rallying around him as a medical practitioner courageous enough to continue to prescribe adequate dosages of legal opiods in spite of the current intimidation tactics by the DEA.

I know you're bored senseless with Rush analogies but here is another classic illustration of how the prohibitionists punish innocent citizens who have a real need for these medications while sheltering those within their own ranks from these consequences inflicted on 'the people'.

Honest doctors are afraid to prescribe adequate dosages for fear of incurring the notice of the DEA's unsleeping eye. Meanwhile the monied right, people like Rush, pressure their housekeepers into finding an illegal source. Rush is more responsible for the black market than she is.

She could never afford that many pills, (what was it 40,000?), on the salary he was paying her. I read story today from a reporter who bought 20 or so Oxycotin at $3 a piece. So even assuming Rush got the big volume discount, at a dollar a piece say, it's still more than a year's salary for her. Think about it - without his money, it wouldn't have happened. He effectively financed the activities of some small mid-level network of dealers.

Rush's apologists spin this ad naseum as a medical problem, covertly blaming the doctor and the very practice of medicine for causing his addiction. They try to draw some distinction between his addiction and those of the 'street people'. That he was somehow inadvertently drawn into addiction because of the initial medically sound treatment plan. I don't like to be profane, but bullshit.

Rush is just another injured soul who self medicated in an attempt to cure his pain, just the same as the guy in the gutter begging or stealing for some dimes of heroin. The only difference is what quality of self-prescribed medicine they can afford.

And there's a far more evil element to this than just the obvious interference by the DEA in what should be purely medical decisions. Not only have these prosecutions made doctor's reluctant to prescibe adequate levels of these drugs, which are not actually addictive, they're habit-forming, there's a difference; they have also doubled the fees for the license to prescribe them.

The DEA made 60 million on this little rate hike which they intend to use for further prosecutions of this sort. DEA spokesperson, Pat Good said the funds will provide for a modest increase in DEA enforcement efforts. Well that's true at least, 60 mil is a drop in the 20 billion dollar budget bucket for them. Still it sounds kinds of like organized crime protection money to me.

It's a long article, so for my readers who don't read the links, a few excerpts to tempt you into clicking.

Hurwitz is regarded as a pioneer in pain treatment by many doctors, academicians and medical groups, who have decried his prosecution. The case, along with other prominent criminal prosecutions, is putting a chill on legitimate pain treatment by doctors who fear prosecution, they say.


The Hurwitz case has exposed a deepening rift between law enforcement and the medical community over the use of opioids in modern pain treatment.


What happens typically is that 99% of the physicians, who are good, decent people, can become paranoid," said John Burke, head of a drug enforcement task force in Ohio and vice president of the National Assn. of Drug Diversion Investigators. "This is a very touchy issue. We do not want to impact legitimate pain patients or their physicians."


Even doctors who adhere carefully to rules can run afoul of law enforcement agencies, according to David Brushwood, an expert on opioid legal issues and a professor of pharmacology at the University of Florida.

"Something is terribly wrong with the way some criminal justice authorities have begun to enforce the law against physicians and pharmacists who prescribe and dispense high-dose opioids to treat chronic pain," he said. "The necessary balance ... has tipped drastically in the direction of ruthless drug control."


There isn't any doubt that these prosecutions are increasing under the Bush administration," Hallinan said. "It is like busting a car dealer because somebody runs off the road and kills somebody."


"It seems to us that the DEA has shifted its focus from street thugs to doctors, because doctors are easier targets," said Kathryn Serkes, a policy executive at the association of physicians and surgeons. The group now flatly advises its doctors not to prescribe opioids.

The American Medical Assn. has not weighed in on the Hurwitz case, but last July fired a warning shot by posting on its Web site a statement that it "wants no doctor harassment over pain medication" and pledging to take the case to President Bush and Atty. Gen. John Ashcroft.


I'm glad to see the AMA concerned enough to make a statement on this issue and right on. The DEA has no business interfering with the practice of medicine.




ONE WORLD

Well, we're already running long here and I know I've already lost Michael on this post so I leave with with the words of Leonida ZuritaVargas, a cocalera and the secretary general of Bartolina Sisa, an association of peasant women in Bolivia who issued this eloquent plea to end the war against Bolivian farmers.

Al Giordano remarks at BigLeftOutside that newly installed president Mesa will have to address the proposal by coca growers that families be allowed to grow one "cato" (a 40-by-40 meter plot) of coca without being persecuted by police or invaded by the military. The US Embassy, always preferring to go after poor farmers while allowing narco-bankers off scot free, violently opposed this proposal.


Leonida can tell you more.

My tribe, the Quechua, comes from the jungles of the Chapare. We are used to chewing coca leaves every day, much as Americans drink coffee. We sustained ourselves by growing coca for chewing and for products like shampoo, medicinal teas and toothpaste.

We did not turn coca into cocaine; the chemicals needed for that are made in countries like the United States. Bolivia now allows us to grow a very small amount of coca, but it is not enough.

I am a cocalera. I owe my life to coca. My father died when I was 2 and my mother raised six children by growing coca. I was a farmer myself, growing coca for traditional purposes.

The war on the cocaleros has brought nothing but poverty and death.


Her story makes me want to apologize for being a US citizen.


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