I’m saddened to learn this morning that Siobhan Reynolds was killed over the weekend in a plane crash.
I met Reynolds several years ago when I attended a forum on Capitol Hill on the under-treatment of pain. Her story about her husband’s chronic pain was so heartbreaking it moved me to take an interest in the issue. I eventually commissioned and edited a paper on the DEA and pain treatment while I was working for Cato.
Reynolds was tireless and fierce. She ran her advocacy group the Pain Relief Network on a thin budget. She often used her own money to travel to towns and cities where she felt prosecutors were unfairly targeting a doctor. Then she’d fight back. And sometimes she’d win. The DEA and federal prosecutors she fought weren’t really accustomed to that. They were accustomed to holding self-promoting press conferences where they’d hold up big bags of pills, thus winning glowing write-ups from doting, unskeptical journalists. Reynolds put those bags of pills into context. She talked about the lives made livable with opiate therapy. She encouraged pain patients whose lives these doctors saved to speak up and speak out. And she educated journalists.
There aren’t very many people who can claim that they’ve personally changed the public debate about an issue. Reynolds could. Before her crusade, no one was really talking about the under-treatment of pain. The media was still wrapped up in scare stories about “accidental addiction” to prescription painkillers and telling dramatic (and often false) tales about patients whose lazy doctors got them hooked on Oxycontin. Reynolds toured the country to point out that, in fact, the real problem is that pain patients are suffering, particularly patients with long-term chronic pain. And because of the government’s harassment, there are increasingly fewer doctors willing to treat them. Thanks to Reynolds, the major newsweeklies, the New York Times, and a number of other national media outlets began asking if the DEA’s war on pain doctors had gone too far.
Reynolds’ passion stemmed from watching her ex-husband agonize from his pain, and later her belief that his death was due to his inability to get treatment. She was haunted by the prospect that her son could inherit the same condition and face the same obstacles. What infuriated her most was that this was never a problem of not knowing what relieves chronic pain. This wasn’t about the need for more research. Her husband had found relief in high-dose opioid therapy. The problem was that in its ceaseless efforts to stop people from getting high, the government had blocked that relief, imprisoned the doctor who administered it, and thus condemned her husband to suffer. (Watch The Chilling Effect, the movie Reynolds produced about her ex-husband’s fight here.)
Reynolds was admirably persistent. I often thought she was often a bit too idealistic, or at least that she set her goals too high. She told me once that she wouldn’t consider her work done until the Supreme Court declared the Controlled Substances Act unconstitutional. That’s an admirable goal, but not a particularly practical one. She often frustrated efforts to build a coalition on the issue because she’d grown weary of medical organizations and academics who, while concerned about the issue, she thought were too cowardly to take a more aggressive stand.
But Reynolds did begin to win her battles. She deserves a good deal of the credit for getting Richard Paey out of prison. She got some sentences overturned, and connected accused doctors to attorneys who know the proper way to fight for them in court. That led to some acquittals.
Of course, the government doesn’t like a rabble-rouser. It’s especially wary of rabble-rousers who start to accumulate victories. And so as Reynolds’ advocacy began to move the ball and get real results, the government hit back. When Reynolds began a campaign on behalf of Kansas physician Stephen Schneider, who had been indicted for over-prescribing painkillers, Assistant U.S. Attorney Tanya Treadway launched a blatantly vindictive attack on Reynolds’ right to free speech. Treadway opened a criminal investigation into Reynolds and her organization, attempting to paint Reynolds’ advocacy as obstruction of justice. Treadway then issued a sweeping subpoena for all email correspondence, phone records, and other documents that, had Reynolds complied, would have meant the end of her organization. Treadway wanted records of Reynolds’ private conversations with attorneys, doctors, and pain patients and their families. It was unconscionable. The government was demanding that she turn over all records of her conversations with suffering patients. (Some of whom undoubtedly sought out extra-legal ways to relieve their pain, since the government had made it impossible for them to find legal relief.)
So Reynolds fought the subpoena, all the way to the U.S. Supreme Court. And she lost. Not only did she lose, but the government, with compliance from the federal courts, was able to keep the entire fight sealed. The briefs for the case are secret. The judges’ rulings are secret. Reynolds was barred from sharing her own briefs with the press. Perversely, Treadway had used the very grand jury secrecy intended to protect Reynolds as a gag to censor her. The case was a startling example not only of how far a prosecutor will go to tear down a critic, but of how much power they have to do so.
The sad thing is that it worked. The Pain Relief Network went under. Reynolds also lost a good deal of her own money. She was never charged with any crime. But that was never the point. It was a transparent and malicious effort to neutralize a pestering critic. And it was successful. (I wrote a piece for Slate on Treadway’s vendetta against Reynolds.) Despite all that, the last time I spoke with Reynolds she working on plans to start a new advocacy group for pain patients.
Reynolds was an unwearying, unwavering activist for personal freedom. She not only became a martyr for the rights of pain patients, but also for free expression and political dissent.
And she died fighting.
Rest in peace.
You have had no way to have known, but you have been one of my heroes (and I have very few) ever since I learned, more or less by chance, about your efforts on behalf of people denied pain relief by the whole congeries of sadistic government laws, functionaries, and activities aimed at keeping them in pain. I have the greatest respect for you and the few others who have the courage to do something concrete to fight the power.
Please accept my very best wishes for a happy Christmas and for better days to come. And please know, too, of the great esteem in which I hold you.
UPDATE II: Richard Paey’s wife Linda left this in the comments:
Siobhan, an amazing force focused on defending the rights of people in pain and their doctors, she was relentless in this pursuit. My husband and I owe her a debt of gratitude, one that we could never repay. Siobhan was responsible for moving the nation to support the release of my husband, Richard Paey from a Florida prison. Her impact on pain patients and the issue of undertreatment of pain is her legacy. We will all miss her loud and strong voice. My heart and my prayers goes out to her son.