DEA Spots Fly, Wields Sledgehammer

Wednesday, February 8th, 2012

Just how much the federal government prioritize drug control over patient care? This much:

Federal authorities have expanded their crackdown on painkiller abuse, charging a major health care company and two CVS pharmacies in Florida with violating their licenses to sell powerful pain pills and other drugs.

The Drug Enforcement Administration linked Cardinal Health to unusually high shipments of the controlled drugs to four pharmacies.

On Friday, the DEA suspended Cardinal’s controlled substances license at its Lakeland, Fla., distribution center, which services 2,500 pharmacies in Florida, Georgia and South Carolina . . .

In its suspension order, the DEA alleges that Cardinal knew or should have known that the four retail pharmacies had purchased far more drugs than it needed to fulfill legitimate prescriptions.

The company called the DEA action a “drastic overreaction” that would disrupt delivery of critical medications to hospitals and pharmacies.

A judge has since temporarily stopped the suspension, pending a hearing.

But think about what the DEA is trying to do, here. They’re attempting to interrupt the treatment of thousands of patients served by 2,500 pharmacies because the wholesaler that supplies controlled drugs to those pharmacies is accused of inadequately policing the actions of four of those pharmacies. And the patients that would have been affected here aren’t just pain patients.

But the effect of actions like this going forward may be worse than the actions themselves. The DEA has forcibly deputized every actor in the manufacture and distribution of these drugs to police everyone else. And they risk severe civil, even criminal, repercussions if the agency determines they’ve done so with insufficient vigor. If you want to survive, you always err on the side of control.

So if you’re a wholesaler, and you have the tiniest of suspicions that a pharmacy is dispensing more of a controlled drug than the DEA thinks it should, you cut off supply, or you risk losing your license. If you’re a pharmacy, and you have the faintest hunch that a patient may not be legitimately in pain, or is getting more pain medication than he needs, or that a particular doctor is writing more prescriptions for a controlled drug than the DEA thinks he ought to, you refuse to fill the prescriptions, at risk of both losing your livelihood as a pharmacist, but also possibly your freedom. If you own a pharmacy, and you suspect one of your pharmacists is insufficiently suspicious of pain patients and pain prescriptions, you fire him, or you risk losing your business. And finally, if you’re a doctor, and you suspect any of your patients have a substance abuse problem, or that they aren’t in as much pain as they claim, you turn them down. Actually, it’s worse than that. It doesn’t really matter what you think as a doctor. What matters is what the DEA thinks of the decisions you make. So your job is not to administer the treatment you believe is appropriate, your job is to anticipate what treatment the DEA will think is appropriate, and deviate from that treatment at your peril.

At each step in the process, the incentives are structured to induce fear, suspicion, and mistrust of the other players in this mess. The interests of patients are way, way down in the ordering of priorities.

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33 Responses to “DEA Spots Fly, Wields Sledgehammer”

  1. #1 |  KBCraig | 

    As more and more pharmacies and doctors are forced out of the field, those remaining will become “suspiciously high volume providers”, justifying even more sledgehammers.

  2. #2 |  Ben | 

    As an ashamed Obama 2008 voter, stuff like this makes me want to scream at those who make excuses for him and say he deserves a 2nd term.

    Either Obama is an over-the-top nutso drug warrior who fervently believes that this is the right thing to do… Or Obama, afraid of paying a political price for stopping this massive injustice, cares more about his re-election than the good of the nation.

    This is the EXECUTIVE BRANCH that’s running rampant. Obama could stop all this with a single phone call.

  3. #3 |  treed | 

    Why would any person be surprised by this? Gov’t is nationalizing your body. And why not? Gov’t nationalizes your property rights and labor. This is a logical step.

  4. #4 |  PermaLurker | 

    If the DEA is going to mess with you no matter what, at what point does it just become easier and more reliable to go for black market pain meds?

  5. #5 |  Whim | 

    Question regarding the DEA:

    If all drug usage was legalized, would the mandate of the DEA then cease and the Federal agency then be abolished?

    Sounds like a Win-Win solution.

    Exactly WHY is it the government’s job to prevent consenting adults from escaping REALITY through drug or alcohol usage?

    I can understand why drunk or impaired driving is prohibited due to safety issues, but so is Distracted Driving which is commensurately unsafe driving practice,and much more frequent.

    And, why mass transit operators like railroad engineers should not be impaired while working, but what earthly difference does it make if someone uses prohibited substances in their own home?

    There might also be a legal case to be made if someone is a serious methamphetamine, cocaine or heroin addict, and actually neglects their children, but then again Child Neglect for ANY reason is already illegal.

    The whole War on Drugs is just overkill to the Nth degree.

  6. #6 |  tarran | 

    This is a big reason why I am looking forward to the now inevitable collapse of the Federal Government. When people stop lending the govt money, and inflating the currency doesn’t work anymore, all their fat pensions will go poof, and these dirtbags will be on the street begging for change. And that will be a good thing.

  7. #7 |  Randy | 

    DEA = Terrorists.

    That is all.

  8. #8 |  tarran | 

    Exactly WHY is it the government’s job to prevent consenting adults from escaping REALITY through drug or alcohol usage?

    The 19th century evangelical movement and the progressive movement it morphed into into @ the turn of the 20th century was worried about keeping the people from feeding their degenerate appetites for mind altering substances, particularly the stuff that non WASP ethnic groups liked. Opium was the stuff of the degenerate Chinese. Marijuana was the drug of savage Negros and Hispanics. Alcohol was the province of the Irish and Eastern Europeans. these mind altering substances interfered with a healthy protestant work-ethic and needed to be stamped out so that men could be perfected.

    To this day, all the arguments buttressing drug prohibition argue that in the absence of prohibition, people would degrade themselves. OF course the guy who is making the argument can control himself and drink/toke responsibly. It’s the lower classes that need controlling and saving.

  9. #9 |  James J.B. | 

    It is almost like they want pain patients to opt for illegal drugs.

    Remember, if we check out with drugs – our masters have no workers – no tax dollars for the aristocracy. Same reason we bailed out the banks rather than pay off mortgages- if you have a mortgage you have to work – if not you get ideas about having fun – so no tribute for our lords.

  10. #10 |  The Mossy Spaniard | 

    Occupy Quantico.

  11. #11 |  Bob | 

    Shit like this is why we can’t have nice things.

    I always laugh at sci-fi stories where in the future, “cash money” doesn’t exist and all transactions are done through electronic point of sale devices of some kind.

    Can you even begin to imagine the totalitarian shit the government would do with that?

  12. #12 |  Brandon | 

    Whim, you’ve just hit on why the DEA does shit like this. Their #1 job is to justify their bullshit jobs, so they have to keep on creating boogeymen that they can slay, regardless of the collateral damage and lives ruined, as long as those lives aren’t of DEA agents. That is the nature of bureaucracy.

  13. #13 |  Dante | 

    #12 Brandon:
    “Their #1 job is to justify their bullshit jobs, so they have to keep on creating boogeymen that they can slay, regardless of the collateral damage and lives ruined, as long as those lives aren’t of DEA agents. ”

    It’s not just the DEA. It’s the whole Federal Government.

    Protect & Serve (Themselves!)

    It’s not just bad cops any more. It’s all of them. We are their prey.

  14. #14 |  Dave Krueger | 

    You people are over reacting. I’m sure this whole thing is being exaggerated. And why should the 75% of people who don’t use pain killers even care about this? That’s the problem with you libertarians. You only see the bad side of things. Most of the people using pain medication are probably faking it anyway, just like those people who claim to have colds so they can get pseudoephedrine to make meth. There should be a law against spreading your kind of doom and gloom. Wake me up when you have some evidence that we’re really losing our freedoms. I mean something significant like box cars being loaded with people for transport to death camps. Until then, don’t bother me with your whiny-ass stories of how government doesn’t let you get away with anything you want. Life isn’t one long pill-popping, glue-sniffing, orgy of reckless decadence. The DEA’s mission is to keep our citizens clean and sober for America’s mission to tame the world and if you’re not in tune with that mission, then you’re part of the problem instead of the solution.

  15. #15 |  Dave | 

    Wait, if a pharmacist diagnoses someone as not suffering enough and withholds their legit prescription, isn’t that basically practicing medicine without a license? Kind of puts them in a damned if you do and damned if you don’t situation?

    But of course the DEA bureaucrats hiding behind sovereign immunity can practice without a license all they want. Part of me hopes the people behind this policy come down with some nice slow bone cancer and spend the next few decades searching desperately for a doctor and pharmacy willing to give them effective pain treatment…

  16. #16 |  Sean L. | 

    Wow, Dave, you win the “Turing NeoCon Challenge” — The best imitation of a NeoCon by someone who actually believes the exact opposite.

  17. #17 |  Andrew S. | 

    And this is why my mom, who has MS and Fibromyalgia, can’t get adequate pain relief. It’s incredulous how little the DEA cares about actual pain patients.

    (unfortunately, my mom, despite all that, is still likely going to vote for Obama in November. I’ll have to work on that.)

  18. #18 |  a_random_guy | 

    Question: Exactly WHY is it the government’s job to prevent consenting adults from escaping REALITY through drug or alcohol usage?

    Answer: “Puritanism: The haunting fear that someone, somewhere, is having fun.”

    Of course, I assume your question was rhetorical…

  19. #19 |  C. S. P. Schofield | 

    It is no longer enough to disband the DEA. The people responsible for setting policy should be shipped to coldest Whatthef*ckistan, and left there in the shorts.

    And, yes, I’m looking at you Obama.

  20. #20 |  C. S. P. Schofield | 

    “their shorts” not “the shorts”

    *sigh*

    Outrage and typing don’t go together.

  21. #21 |  Nancy Lebovitz | 

    This is another case of “you should have known better than to trust your customers” enforcement. It exists in banking (money laundering) and gun sales.

    Anyone know of a history of that sort of law? I think it’s relatively recent. Or a discussion of what’s wrong with it? Obviously, there’s a problem of how much evidence is enough, but there’s probably more angles that I’m not seeing.

  22. #22 |  albatross | 

    The DEA is powerful enough that they can wreck things they don’t understand (or care about), and they don’t have to listen to complaints about it. The best analogy I can think of, really not trying to Godwinize the discussion, is the SS toward the end of WW2–they were often prioritizing the mass murder of Jews ahead of winning the war Germany was in. I think this worked largely because they were too powerful to cross, so they got their way.

    Many organizations and groups in our society now have huge amounts of power relative to their understanding of what they’re wrecking–the intelligence agencies, homeland security, the drug warriors, Hollywood/music studios, the folks at the top of the financial industry, the folks at the top of the media, etc. They routinely wreck delicate, valuable things to get or keep a small benefit for themselves–to protect their existing perqs, to expand their budget, etc.

  23. #23 |  albatross | 

    Ben #2:

    Whatever Obama believes, he is a career politician living in an ocean full of other career politicians. He is far more likely to behave according to his perceived interests, partly derived from the perceived interests of the people he has to deal with day to day, than to act according to whatever beliefs he has.

    Obama, like a great many other powerful people (Clinton, Gore, Bush, Gingrich), has used drugs from time to time. And, like most other powerful people who have done that, he supports laws that, had they been applied to him, would have wrecked his life. Presumably, that’s because his current political calculation is that not supporting them would cost him something.

  24. #24 |  el coronado | 

    Ohhh, they’re just getting warmed up. 30 years ago, the DEA was pretty much limited to ‘Just say No’ PSA’s and spraying fields in Peru & Columbia.

    Well, *THAT* didn’t work out so great, but never mind! On to bigger and better and more expensive & intrusive things! Why? Because Coronado’s Law states that “the Prime Directive of any and all taxpayer-funded agencies, bureaus, committees, etc., is ‘Maintenance and Expansion of their particular bureaucratic fiefdoms.’ In government, you see, if you’re budget’s not growing, you’re a loser. And nobody wants to be a loser!

    So now it’s 2012 and the drug warriors are busting people carrying cold medicine across state lines (“drug mules”) and fucking with people in serious pain. (“addicts”) (SOOO much easier than messing with the Cartel guys – those dudes are SCARY!!)

    What do you suppose they’ll be doing in 2020? 2030? Can you envision a DEA compliance officer stationed in every hospital pharmacy in the USA? (“I don’t see where that surgical patient should need morphine – morphine is a gateway drug. Give ‘em Tylenol instead. Not too much, mind….or I’ll have you arrested, Doctor.”) I can see that easily – and I’m not all that imaginative. Yeah, this’ll end well.

  25. #25 |  EH | 

    Pharma-Stasi

  26. #26 |  Personanongrata | 

    He has erected a multitude of New Offices, and sent hither swarms of Officers to harass our people and eat out their substance.

    The more things change the more they stay the same.

  27. #27 |  Charlie O | 

    Great news. I’m recovering from joint replacement surgery this past week. Now I’m afraid to take my meds for fear I can’t get more.

  28. #28 |  Robert | 

    If all drug usage was legalized, would the mandate of the DEA then cease and the Federal agency then be abolished?

    The drugs being referred to here ARE legal. If every drug in the universe were legal, we’d still have these lunatics kicking down doors because people use “too much” of a particular drug.

  29. #29 |  C. S. P. Schofield | 

    #28 Robert,

    Tell it, brother!

    Which is why we need to seize every Second Amendment victory we can get, and push to make police criminally liable for ‘mistakes’. Godsdamnit, it you kick the door of the wrong address in at three A.M. you are committing a godsdamned felony and should have to take your chances with the possibly armed householder, knowing that if YOU shoot HIM, you will be tried for murder. NO MORE EXCUSES!

  30. #30 |  Steve in Clearwater | 

    #4 – If the DEA is going to mess with you no matter what, at what point does it just become easier and more reliable to go for black market pain meds?


    Answer: Ummm….about 10 years ago and forward. Just one of many reasons to use the Miracle of the Interweb and make some friends in foreign countries where reasonable access to good quality pharms is in place. Travel there once a year and then FedEx your next year’s supply back home to yourself. Discreetly packaged within some overseas clothing purchases of course, of course

  31. #31 |  Don’t Rely on the Supreme Court to Protect You from ObamaCare: Practice Nullificaiton – It Is Your God-Given Right (and other news) » Scott Lazarowitz's Blog | 

    [...] Radley Balko: DEA Spots Fly, Wields Sledgehammer [...]

  32. #32 |  micki | 

    interesting topic as I am a chronic pain (back L3-5) in my medical group there is one doc who could do surgery he wont.. the closest hospital who may be able to help me is Stanford about two hours away but because they are not in my “group” they will not help me..that was two years ago…fast forward to present..after a steroid shot in December I decided to go down on my pain meds..I did fine on the stronger ones never refilled early etc..so now I am having a rough time..go into the docs (my doc is out of town) saw the PA and she maid me take a drug test. Now I dont drink, smoke pot and frankly I am trying to survive this injury (car hit me behind at 60 miles per hour while I was at a complete stop) and to have someone ask me to take a urine test.. well I was in tears..its disgusting how patients are treated for a chronic condition and I am appalled at the lack of compassion just so these people can cover their asses from the DEA scrutiny. I am thinking I am going to write Obama personally as I am a straight laced by the book kind of girl. What a crock of shit and I bet if I was dying as opposed to “chronic” my treatment would be quality… just my two cents

  33. #33 |  Random notes: July 13, 2012. « Whipped Cream Difficulties | 

    [...] Balko and Reason, among others, have been all over the painkiller issue. The government repeatedly and consistently has attempted to make criminals out of doctors who legitimately prescribe high doses of painkillers for patients suffering from intractable pain. Not just that; the government has stomped on the First Amendment by going after patient advocacy organizations, and has even threatened to shut down pharmacies for filling prescriptions. [...]

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