Kerlikowske Responds

Thursday, March 22nd, 2012

The drug czar himself has written a response to my HuffPost series on prescription painkillers.

Give him some credit here, for at least engaging a critic. His predecessor’s approach was to pretend his critics didn’t exist.

I’ll have a response to Kerlikowske’s response in a few days.

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25 Responses to “Kerlikowske Responds”

  1. #1 |  Kevin O'Reilly | 

    You should correct this: It’s Kerlikowski.

  2. #2 |  David | 

    Upon reading Mr. Kerlikowski’s response, including the note that the federal government abandoned the “war on drugs” approach in 2009, I would very much like to travel to the alternate universe he inhabits.

  3. #3 |  Aresen | 

    From the article:

    “The top three barriers to receiving adequate patient care were 1) workforce issues with lack of competent pain providers, 2) lack of knowledge by peers and/or patients regarding the field of pain medicine and 3) lack of public knowledge regarding pain issues.”

    And, Mr Drug Czar, just how much has government contributed to all three of these barriers, with the constant barrage of misinformation and willingness to attack anyone they percieve to be out of line.

    He also says that prosecutions of physicians is ‘rare’. Is that because physicians are to terrified to give the level of care that is needed because they are afraid they will become the targets of prosecution?

  4. #4 |  Mario | 

    A 2006 study published in the journal Pain Medicine found that when adequate documentation exists in the medical record, the risk of civil, criminal or administrative action being taken by the DEA against a physician for prescribing opioids for a chronic pain patient is small.

    My guess is the sticking point is “adequate documentation.” It sounds like this process is likely itself a disincentive to prescribing pain medication, since a doctor’s judgement must now take a backseat conforming to cookie-cutter, bureaucratic dictates.

  5. #5 |  Yizmo Gizmo | 

    “My first act upon being appointed President Obama’s drug policy advisor in 2009 was to discard the “war on drugs” approach to formulating drug policy. Approaching our drug problem through the frame of a “war on drugs” is overly simplistic and does not adequately address what is, in reality, a very complicated public health and public safety problem…”

    Wait, hold on, a gov’t talking head who is thoughtful and sensible, and avoids cliche gov’t talking points and dogma?
    Isn’t March 22 a little early for an April Fool’s Joke?

  6. #6 |  dave smith | 

    This guy ending the “war” approach to drug policy in the US is an empirically testable statement. Do we have fewer arrests? What drug laws have been repealed? Are prisons slowly becoming less crowded?

  7. #7 |  Aresen | 

    @ Yizmo Gizmo | March 22nd, 2012 at 11:52 am

    I would be puzzled by how he thought he could get away with such a bald-faced lie were it not for the numerous Team Blue partisans who insist that the BHO administration is doing just that.

  8. #8 |  el coronado | 

    Couldn’t help but notice that nowhere in Kerlikowski’s little ‘rationalization for my job & solid-gold pension’ screed are the 6 little facts that Libertarians have been harping on for decades:
    1) Narcotics started being made illegal back in 1914, IIRC. That means this shit’s been going on for almost 100 years now.
    2) And failing miserably, no matter how ever-more draconian the laws & punishments get. A *hundred year* record of miserable, pathetic, laughable FAILURE….and they want more. Government in a nutshell, right there.
    3) Proof of this failure can be seen by this: Just as it was a million years ago when I were in high skuel, any HS kid in America with the cash and cursory vetting can get his hands on any ‘illegal’ drug he wants in 48 hours or less. EVERYBODY knows a guy who knows a guy.
    4) In the meantime, the fedgov reaction to this century-long gross failure is, of course, to limit ever-more of our freedoms. It’s pretty obvious we live in a police state. If you doubt it, don’t obey a cop’s “order” and see how fast you get tazed/shot. Carry $10 grand in cash into an airport and see if they let you leave with it.
    5) The net result of the fedguv war on RX drugs is, first & foremost, that sick people in serious pain will suffer. The fedguv’s response to this seems to be, “Better they suffer than others get high.” Gotta break a few eggs to make an omelette.
    6) We already HAVE a successful template on how to decrease usage of substances Big Brother wishes us not to partake of: witness the ‘social engineering’ campaign against booze & ciggies, which has brought about a large decrease in the use of those substances….all without SWAT raids or shot poodles.

    Drugs are illegal because TPTB want them that way: almost certainly because the illegality guarantees huge margins & profits. Well, that and “fighting the eeeebil scourge” means fedguv gets a LOT more money and power, as well. It’s going to stay that way, no matter what common sense or we the proles want, and we all know it. We can’t tell women ‘No Abortion!’, because we have to keep our laws off their bodies. But we also can’t put what we want into OUR OWN bodies, because Fuck You, that’s why. Uh-huh. Fuck Kerlikowski, and all his stinking ilk, and all of their lies.

  9. #9 |  picachu | 

    dave smith “This guy ending the “war” approach to drug policy in the US is an empirically testable statement. Do we have fewer arrests? What drug laws have been repealed? Are prisons slowly becoming less crowded?”

    Bingo! Just not using the phrase “war on drugs” anymore doesn’t mean they’ve ended anything.

  10. #10 |  Lucy Steigerwald | 

    After watching the Google+/Brit drug war debate (very interesting) I noticed it’s not just professional Drug Czars who think that stressing that “the war on drugs” rhetoric is over is so important and meaningful. It’s the hot new prohibitionist rhetoric and it’s damned annoying. Kerlekowski is almost more annoying than the more blatantly evil folks who have had jus job…

  11. #11 |  Mario | 

    el coronado @ #8

    Narcotics started being made illegal back in 1914, IIRC.

    Ah, the Hundred Years War. Perhaps that will catch on.

  12. #12 |  Matt | 

    I think my blood pressure probably rose about 10 points after reading that article, but the most infuriating part had to be the “addiction is a DISEASE” discredited bullshit that attempts to assert that individuals have no control over their own life and actions.

    Its maddening thinking that so many people are telling addicts who are destroying their life due to poor choices that “you have no responsibility for your own choices”. What do they think the consequences of that thinking will be?

  13. #13 |  M | 

    How are the numbers he cited counted? Didn’t you post something saying that if somebody dies of natural causes with painkillers in their system it’s recorded as a drug death?

  14. #14 |  Christ on a Cracker | 

    A 2006 study published in the journal Pain Medicine found that when adequate documentation exists in the medical record, the risk of civil, criminal or administrative action being taken by the DEA against a physician for prescribing opioids for a chronic pain patient is small.

    The problem is “adequate” is defined by the DEA and changes frequently. A doctor one the wrong side of “adequate” is screwed. I wonder if he actually read the articles.

  15. #15 |  SJE | 

    I was immediately irritated by the headline: “setting the record straight” starts from premise that Radley’s article was lies or half truths. Sorry, drug czar, but treating those who disagree with you as liars, idiots or criminals is not the way you engage in public dialog.

  16. #16 |  SJE | 

    re: “war on drugs”
    I don’t care what you call it, I care what I see. You can call it “war” “police action” “counterinsurgency” or “rainbow unicorns,” but when you use machine guns, helicopters, tanks, and other advanced weaponry, spend billions of dollars in a coordinated action between multiple federal and state agencies, tens of thousands of people are dead, and the stability of regional governments is threatened, it LOOKS LIKE A WAR.

    Lets do a thought experiment: say that this were a political insurgency. How would the weapons, the tactics, the policies and the regional instability look different?

    If it looks like a duck, walks like a duck, and gets shot in a warrantless raid by the SWAT like a duck, then what do we call it?

  17. #17 |  elcid1390 | 

    Let’s try calling it a kinetic military action against drugs and see how that works…

  18. #18 |  Jerryskids | 

    science shows that drug addiction is a disease of the brain that can be prevented and treated

    @#12 Matt Its maddening thinking that so many people are telling addicts who are destroying their life due to poor choices that “you have no responsibility for your own choices”. What do they think the consequences of that thinking will be?

    I suspect you mean to suggest that ending the “war on drugs” and making it “healthcare for drug addicts” is going to be one more example of nanny-statism, but I would disagree.

    Notice he said drug addiction is a mental illness that can be *prevented* and treated. Since we all know one beer or one toke can lead to addiction, I see a future of no more prisons for drug offenders but lots and lots and lots of involuntary commitments to psychiatric hospitals – you know, the kind with armed guards and razor wire and locked cells. It won’t be punishing them with prison, it will treating them for their own good.

    And think about our national salt addiction and sugar addiction and fat addiction and junk food addiction……….

  19. #19 |  Kevin Rulokowski | 

    Hey Gil,
    Did you find your gun, yet?

  20. #20 |  KPN3% | 

    Kevin @ # 19, hahahaha

    You beat me to it.
    wonder what ever happened to old Gil’s gun.

    Dumb-shit.

  21. #21 |  Alex | 

    > painkillers are essential for millions … thousands of victims

    Let’s expand the idea to the judicial system, shall we! Maybe we’ll put millions of innocents in jail, but at least we’ll catch the thousands of bad guys.

  22. #22 |  Cyto | 

    There’s more to that “adequate documentation” bit. The article found that given adequate documentation in the medical record, the risk of prosecution was small.

    Let that sink in.

    So, given that you have “adequate documentation” in all of your case files, you still might be prosecuted and face losing your entire life’s work, along with your freedom and any wealth and property you’ve accumulated.

    And that is supposed to be evidence of how wonderful and careful the system is. Yikes!

  23. #23 |  Ian MacLeod | 

    “# #13 Didn’t you post something saying that if somebody dies of natural causes with painkillers in their system it’s recorded as a drug death?”

    I did. It’s the D.A.W.N program: Drug Abuse Warning Network. Meant to help spot new drugs on the streets or new ones making a resurgence, it’s used for propaganda purposes more than anything. In the trial of the doctor, the jury is told that a patient of his died in a car wreck with a large dose of opiates that were prescribed by the doctor in his system. The problem: he was a passenger in the car and died from having his heart crushed and essentially removed from his chest. He wasn’t driving stoned and didn’t die because of that – but that’s what the jury is led to believe. It is listed as an opiate-related death” for the purpose of statistics.

    I say that people who declare war on a substance or tactic and DENY they’re fighting a war on people are a)delusional on the natch, or b)raiding the evidence/property room. Is that it? Is THAT where all those confiscated drugs going? How stupid does this guy think we are, anyway? If the Drug War is ended, why are all those people in prison? What are all those SWAT raids and dead “accused” druggies and their pets and families and neighbors all about? Is this another tactic in Agenda 21? Sorry Radley, but a mouthful of fertilizer is NOT a “response.”

    Ian

  24. #24 |  Ian MacLeod | 

    And I could have phrased that better – I refer to the ONDCP Drug Czar’s “response” to the article, not to anything you wrote.

    Ian

  25. #25 |  Ian MacLeod | 

    “My guess is the sticking point is “adequate documentation.” It sounds like this process is likely itself a disincentive to prescribing pain medication, since a doctor’s judgement must now take a backseat conforming to cookie-cutter, bureaucratic dictates.”

    It’s actually worse than that. They’d worked WITH – he thought – Dr. Bill Hurwitz, and he cooperated. He kept meticulous records, they encouraged him, and when they were ready they busted him and used those records as evidence against him – or their interpretation of those records. He was following the Medical Standard of Care, he broke no laws, and he actually had patients whose nerves were starting to heal! That would have reduced the number of potential added evidence, though. He was “treating too many patients, and using HUGE amounts of morphine” kind of thing. So when they busted him, one patient simply chose to die by his own hand. I think that was the former police officer.

    This is why doctors get scared. NOTHING matters to the DEA except another bust and how much money they can get out of it. suicides aer more evidence against the doc: “e turned this poor,sick guy into an addict on top of his other problems and he killed himself when he couldn’t get his fix anymore!” And juries buy it. Oh – the patients DON’T get to testify unless it’s for the prosecution.

    Ian

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