Ian

Now the local VISN20, the guy in charge of 5 states of VA hospitals, has decided that no pain patient may have more than 160 mg of morphine equivalent (and those “equivalencies” are valueless when applied to different people, and meaningless in chronic pain anyway) per day. That is going to cripple the majority of the pain patients they’re treating. Even the W.H.O. says, “The correct dose is the one that works.” And the VA’s former Directive on CP treatment agreed with current science: opiates have no severe upper limit. You titrate to pain and function. Sheer numbers of pills or milligrams per dose mean nothing except in terms of the patient function and quality of life.

I can guarantee you there will be more suicides because of this. And something else you never hear: there are an estimated 75 MILLION CPPs in the US who are under-treated or entirely UN-treated. As pain treatment gets worse, as Baby Boomers age, as more vets come home and THEIR pain goes untreated, that number will skyrocket, and the shortage of doctors will become impossible. Most of us are, as Dr. Fisher said, “Medical train wrecks.” We have conditions secondary to the pain, which is now classed as a disease process in and of itself. In short, we’re dying out here, slowly, in poverty and agony. A woman I know has been sentenced to death by her insurance company which no longer chooses to pay for her pain meds. She has a disease the destroys cartilage, and if her pain runs out of control, her BP shoots up and she’s vulnerable to tracheal collapse, clots and so heart attacks, strokes and pulmonary embolism. Or she can bleed out through damaged vessel walls or have a stroke that way. (The disease is relapsing polychondritis). We’re profitable to the DEA and DOJ, you see, when we’re suffering. And the private prison industry. We’re great material for justifying the Drug War, and Drug War funding (60 billion per year and climbing), plus the DEA gets great media coverage, and they can keep funds from civil forfeitures. And we’re only a bunch druggie cripples just a breath away from being street people. Who cares?

Not Treadway; that’s for damned sure!

Ian MacLeod

We need to legalize these drugs, prohibition leads to gang violence and black markets. It gives the government more power and money, and we lose our civil liberties and freedoms more and more every day.

Below is a link for more on the abuse of physicians by government agents.

http://www.aapsonline.org/painman/pm-ppba.htm

This appears to be about her self image as a champion of justice. If decent people oppose her then she might not be what she sees herself as. And of course that is not possible, is it?

And it’s total BS this crap about people being prescribed “too much” pain medicine. Well, that’s the way it f***ing works…patients REQUIRE more and more medication because there’s this whole thing called TOLERANCE. With opiates, you build up a tolerance and need more and more to treat the pain effectively…there’s no such thing as “too much”, there’s only the “effective dose”, and it’s on a case by case basis. The dose that I was taking would kill anyone who was “opiate naive”, but for me, it was a safe effective dose. And yes, unlike the propaganda says, opiates are one of the safest medications around so long as they are taken correctly. But the gov’t won’t ever admit to the fact that opiates (even diacetylmorphine) is both SAFE and EFFECTIVE, probably THE MOST safe and effective medication in existence for treating pain. But the gov’t apparently wants to keep doctors from treating people EFFECTIVELY. They would rather have the patient take an ineffective dose that the DEA deems to be an “appropriate amount” and have the patient suffer in pain all day and night, rather than allow the patient to take an EFFECTIVE amount so that maybe they could have a chance at living a decent life. This is such BS what they do to these doctors and the thousands of patients that rely on them. I wish something could be done…but what? Bunch of monsters these drug prohibitionists are…and that’s really the root of all this: drug hysteria and prohibition.

Exactly. Why you chose to bring up the non-relevant point in the first place is something you need to deal with. The discussion is about physicians who prescribe legally approved pain medication to treat patients with chronic pain and prosecutors, with no medical training, interceding in this process with their own non-medical judgments.

Exactly why you chose to bring in the topic of schedule I drugs (that have no medical benefit) use in recreational activities has caused what it was intended to do. Get everyone off topic.

It is sophmoric to say that a person’s choice to get high doesn’t affect anyone else. It is also sophmoric to say that it will always 100% negatively affect others

Well, then, it’s a good thing I didn’t claim that it does. :)

For the last time, I didn’t come here to start an argument over whether marijuana or any other drug should be legal or not. I only mentioned my anti-legalization stance on recreational drugs as a way to emphasize the fact that I agree with Radley that prosecuting pain doctors in the absence of clear evidence of wrongdoing is reprehensible.

I’m not going to continue arguing with you, because it’s not achieving anything other than distracting attention from the issue we agree on.

Treadway’s actions look like those of someone whose inflated self-image has been challenged.

To me, it more dangerous and disturbing to undertreat pain than to overtreat it. I will provide my patients with the care that they need, according to sound medical judgment. This is more important to me than worrying about the vicious actions of some heartless bureaucrat.

Furthermore, the philosophy of criminalizing something that will, under some circumstances, be misused by someone resulting in injury to another person is a bottomless pit by which government can justify anything it wants. There is no “judgment call” that determines where the line is drawn. The line constantly moves and it moves only in the direction of increased government intrusion into people’s lives.

Finally, those injurious things that people do that affect other people, whether under the influence of drugs or not, are already covered by laws that come into play when an injury actually occurs.

Criminalizing an activity that causes no one harm simply because it puts a person in a position to cause someone harm serves no purpose other than to make criminals out of non-criminals and give legislators something to list on their resume during the next election.

And what I actually said was:
Under your formulation, self-medication is not a right. Neither is pleasure, even at the expense of no other person.

I never asserted recreational drug use “doesn’t affect anyone else.” That’s a red herring anyway. We’re talking about drug prohibition by government force, not metaphysical notions of interrelatedness.

Unless one chooses to live the rest of his life as a hermit in some unpopulated area, his use of mind-altering substances will have an effect on his family, his friends, and his community.

I don’t think the DEA allows any exceptions for hermits.

Again, I’m not here to argue whether or not recreational drugs should be legal, much less whether drug interdiction activities are just and rational (I think a lot of it is not). If you will recall, my original point was that even though I’m more in favor of drug prohibition than most of the readers of this blog, I completely agree that going after pain doctors without proof that they’re giving prescriptions to people who aren’t injured or sick is reprehensible.

How often do you think they give those special approvals?

Fairly often, actually. Just do a Google search on “clinical trials cannabis” and you’ll find a lot of results from trials which obviously must have been approved. In fact, the University of California has a Center for Medicinal Cannabis Research.

I concede that I haven’t done much of my own research into medical uses of marijuana. My expressed skepticism (not opposition) was based on the fact that virtually everything I hear from marijuana advocates is entirely anecdotal. Which makes a certain amount of sense, since most advocates aren’t really interested in making cannabis available as a prescription drug; they want to make marijuana legal for people to use however they see fit. But if cannabis were shown to be safer and/or more effective than currently-available pain treatments, I’d have no objection to its medical use whatsoever.

Your argument also ignores the “harmful externalities” created by a system of prohibition: black market violence, erosion of civil liberties, militarization of police, the list goes on and on. Not to mention the absurdity of “protecting” families by ripping them apart and sending a parent to prison.

On top of that, prohibition isn’t even successful at what it aims to do, so it isn’t really protecting anyone from “harmful externalities,” it’s just creating more.