Punishing Pain Doctors
- posted by Jim Leitzel @ 7:26 PM

From Radley at The Agitator, we learn of this New York Times editorial recounting the difficult path that US pain patients will be facing thanks -- again -- to the Drug Enforcement Agency's playing doctor.

The Pain Relief Network offers a perspective that differs, to say the least, from that reflected in DEA practices. (Other painful Vice Squad posts include this one from more than a year ago and this one from June, 2004.)

Labels: drugs, pain

 
Lazy Link-Based Post
- posted by Jim Leitzel @ 2:59 PM

(1) Ken Lammers at Crim Law doesn't think that the Supreme Court will recognize dog sniffs as a "search". He also manages to use the word "thaumaturgic," which I had to look up. Pete at Drug WarRant is pessimistic about the outcome of the sniff case, too.

(2) Via The Agitator, we learn of Jacob Sullum's piece at Hit and Run exposing the DEA's backtracking from its own advice to doctors about pain treatment. Seems like following their old advice might have left docs open to, oh, DEA prosecutions and long jail sentences. This whole DEA idea is working out so well that I think we ought to extend it to other commodities. How about a Cabbage Enforcement Administration?

(3) Libby at Last One Speaks has the word on an extremely dangerous vice criminal, thankfully to be held in custody more-or-less permanently. Pete at Drug WarRant notes that case, too, as well as that of another vicious miscreant held only for a couple of years, alas, though some extra-judicial abuse also was inflicted. This leniency is sure to lead to a crime wave.

(4) It looks like crack cocaine is losing out to heroin as the analogy used to demonize somethin' you're agin', as Radley at The Agitator demonstrates here and here.

Labels: cocaine, dogs, pain, search, Supreme Court

 
Lazy Link-Based Post
- posted by Jim Leitzel @ 7:21 PM

(1) Baylen Linnekin at D'Alliance provides an update on the suggestion from a police sergeant that Chicago decriminalize possession of small quantities of pot. Seems that Mayor Daley supports the notion, arguing (as did the police officer) that the courts have effectively decriminalized anyway. But as all Chicagoans know, Mayor Daley's is just one voice in this debate, and he rarely is in a position to influence policy. Baylen also took kind notice of Vice Squad's b-day.

(2) Walter Olson at Overlawyered notes today's beginning of the federal trial seeking, oh, $280 billion from Big Tobacco. Walter and his co-blogger Ted Frank were inexplicably left out of Vice Squad's (admittedly partial) anniversary list of blogger buddies, but that oversight has been corrected.

(3) Radley Balko at The Agitator is on a vice policy roll. Here's Radley's synopsis of the remarks of one speaker at last week's pain treatment forum. (The comments section includes an offering from Drug WarRant's impresario Pete Guither.)

Labels: Chicago, Drug WarRant, litigation, marijuana, pain, tobacco

 
OxyContin Developments
- posted by Jim Leitzel @ 4:48 PM

Purdue Pharma LP sold almost $2 billion worth of the popular painkiller OxyContin last year. OxyContin (with active ingredient oxycodone) was designed to be a time-released opioid that provides 12 hours of pain relief from a single tablet. Crushing the tablet prior to injesting, however, undoes the time release chemistry, and the crushed powder can be chewed, snorted, drunk in an alcohol or water cocktail, or further prepared and injected for an intense high. This discovery has led to lots of problems and even death for some OxyContin addicts and experimenters.

The Wall Street Journal reports today (page D3) that a reformulated version of OxyContin (which is no longer under patent protection) developed by Pain Therapeutics, Inc., may make it harder to undermine the time-release mechanism. From the WSJ article:

The company mixes oxycodone with three other substances it declines to identify, yielding a viscous fluid that Pain Therapeutics says won't release the oxycodone when crushed or dissolved in water or alcohol. Taken normally, the company says, the drug is still slowly released in a 12-hour period through the stomach and intestinal lining.

Pain Therapeutics issued this press release today.

Pressure has been growing on Purdue Pharma to do more to prevent OxyContin abuse. Last week, one of the manufacturing subsidiaries of Purdue paid $2 million to settle a case brought by the DEA alleging insufficient record-keeping. In December, the Government Accounting Office released a report (63-page pdf available here) concerning the abuse and diversion of OxyContin. Among the factors that the GAO identified as contributing to abuse was the original warning label, which advised against crushing the pill as that would lead to rapid release of the oxycodone. Purdue also has taken to training doctors, nurses, pharmacists, and law enforcement officers on how to detect potential abuses:

Two years after beginning their law enforcement training efforts, the three trained directors are in big demand, booking nearly six months in advance. Ritch Wagner was a former Nebraska Drug Enforcement Officer, and is now director of the Purdue Pharma program. Wagner says his team is training law enforcement and health care professionals about what to look for and what steps they can take to minimize prescription drug abuse.

Vice control has a way of enlisting "civilians" as informants. Meanwhile, the feds continue their dreadful, over-the-top campaign against pain-treatment doctors and their patients -- a campaign mentioned previously by Vice Squad in December and in February.

Labels: informants, pain, prescription drugs

 
(Warning: Lazy Blogger Post) Around the Blogosphere
- posted by Jim Leitzel @ 2:55 PM

(1) Mark Kleiman has prepared a study (24-page pdf here) on the links between illicit drugs and terrorism. He talks about it here, and includes a topic not in the report, the question of whether the terror links might suggest legalizing cocaine and regulating it a' la alcohol. Mark offers a tentative "no" to that question, but Drug WarRant begs to differ, while suggesting that a legal regime for cocaine more strict than that generally applied to alcohol in the US might be a possibility, too.

(2) Last One Speaks provides the latest on the DEA's war on pain treatment: a mandatory 25-year prison sentence facing a wheelchair-bound Florida man self-medicating with painkillers acquired through forged prescriptions. Another level of cascade: once you declare a substance to be evil when not used in the precise, officially approved manner, you become willing to put multiple sclerosis sufferers, 45-year old fathers of three, in prison for a loooong time if they ignore your strictures. And to think, there are Americans alive today who were also alive when there was no prescription system at all, not even for narcotics. What progress we have made in the span of one lifetime! (Mark Kleiman also notes the Florida story. Most recent related Vice Squad post is here. Home page of the Pain Relief Network here. I can't seem to find out what has happened to the March on Washington on behalf of pain treatment that had been planned for next week.)

(3) Reason online offers a fine article on the current federal crackdown on obscenity, with a good deal of attention paid to the prosecution of Extreme Associates. [Most recent related Vice Squad post here. Update: BuzzMachine and Mark Kleiman, and Volokh have more.]

Labels: cocaine, Drug WarRant, Kleiman, litigation, obscenity, pain

 
DEA Plays Doctor Again
- posted by Jim Leitzel @ 10:00 AM

I think that access to some potentially addictive drugs should be strictly controlled --though the drugs should remain legally available, and without a prescription, to adults. An article in today's Chicago Tribune (via the Washington Post; registration required) reports on the DEA’s intention to reschedule the painkiller hydrocodone as a Schedule II drug. This rescheduling will severely tighten the conditions under which hydrocodone is available via prescription. Hydrocodone use can easily become a problem for people, as it did for Rush Limbaugh. But tightening the prescription regime, I think, is an inappropriate response (even ignoring my general unease with making a drug legally available only by prescription.) The article notes that hydrocodone was prescribed 100 million times last year, and no one suggests that more than a tiny minority of these prescriptions were "abusive." Hydrocodone is obviously a painkiller that millions of patients and their doctors think is quite valuable for them. To make hydrocodone harder to get – for instance, the rescheduling would mean that prescriptions could not be refilled without another visit to the doctor – ensures that these people will receive a lower level of care.

The DEA, it seems, wants to ensure that Americans must live with more pain than is necessary. (Here’s a previous Vice Squad post on the DEA’s campaign against pain treatment, and here is the main webpage of the Pain Relief Network; a march on Washington on behalf of patients in pain is slated for April 18-20, 2004.) It’s not pure sadism, oh no, the DEA has a "noble" purpose. What is that noble purpose? To try to make it a little harder for other Americans to consume a drug that they want to consume.

Labels: pain, policing, prescription drugs

 
Pain Accentuation
- posted by Jim Leitzel @ 5:09 PM

The Drug Enforcement Agency knows better than medical boards and
individual physicians about how best to treat patients with chronic
pain. They are so certain of their superior knowledge that they are
happy to use our tax money to bring criminal cases against physicians
whose treatment of pain doesn't meet DEA standards.

No doubt there are some unscrupulous physicians who knowingly over-
prescribe narcotics. But remember, it was once legal in the US to
prescribe large amounts of narcotics to addicts, and is an accepted
medical procedure in other countries today. There are medical boards
that exist to control bad doctoring -- why is the DEA even necessary
for this purpose? The result is that few promising young physicians
will choose pain relief as a specialty and all of us will risk being under-
treated for pain.

Here's a Washington Post report (registration required) on the
DEA's activities; thanks to DRCNet for the pointer.

Labels: pain, policing, prescription drugs