Saturday, September 30, 2006

The war on pain management

I almost missed this one, DEA Revises Rule on Prescribing Painkillers.
DEA Administrator Karen Tandy said the agency had been wrong in limiting the multiple prescriptions and had made the tough decision to reverse course. She said the DEA received more than 600 comments from doctors, patients and others about its policies on narcotic painkillers, many of them strongly opposed to the agency's position on limiting refills.

"Think about how hard it is for anybody to go out publicly and say, 'We think this is probably prohibited by law,' " she said, referring to the earlier decision to prohibit multiple refills. "And then you listen to people and then you say, 'You know what? You're right,' and we're going to propose a rule that interprets this correctly. And that's what we've done."
While admission that they were wrong is a major switch for the DEA, not everyone agrees this is a big change. Siobhan Reynolds, who created the Pain Relief Network several years ago to help defend pain doctors has this to say.
"Ms. Tandy states here, as she has on many occasions, that doctors need not fear criminal prosecution as long as they practice medicine in conformity with what these drug cops think is 'appropriate,' " Reynolds said. "If that isn't a threat, it will certainly pass for one within the thoroughly intimidated medical community."
She's right. As the DEA thinks it has the right to dictate best medical practices, nothing has really changed at all and this is all smoke and mirrors to make the DEA look human.

The definitive quote comes from Howard Heit, who's a doctor himself and also a pain patient after suffering severe injuries in an auto accident. (I can't give you the link because it comes from a paper that requires a subscription)
'Our government is letting the misbehavior of a relatively small number of people too often trump the needs of many, many good people with complex medical problems and lots of pain,' he said recently, seating behind his office desk where a chart of pain levels is prominently displayed. (1-2 is mild pain, 5-6 is distressing pain, 9-10 is excruciating pain.) 'Many doctors won't prescribe for pain now. And believe me, that's not where we as a society want to be.'
So true. No civilized society should be willing to allow its citizens to live with unbearable pain when treatments to alleviate it exist.


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