I still get a couple emails like this each week in response to the painkiller series I wrote for Huffington Post back in March.

My husband died 4 years ago from a massive cerebral hemorrhage. He had multiple health problems but the worst one was a severely degenerative disc disease. Because he was on Plavix he was not a candidate for surgery. He took 80 Oxycontin daily for 3 years and 9 months prior to his death. But then the  doctor at the pain management clinic he went to regularly informed him that the clinic was quitting prescribing oxycontin. In those last three months of his life he was . . .  in agony. All he wanted to do was be able to walk across the living room to get to his potty chair without pain. He wanted to sleep but couldn’t because of the pain. He was incapacitated by the pain, and not because of drug abuse, but because the doctors at the clinic were afraid of losing their licenses. If I had known he was going to die, I would have found some way to get the Oxycontin for him. He was never high or stoned. He just wanted to be free of pain. As much as I miss Roger, I am glad he is now pain free.

But remember, this federal campaign against opiods is not a war on pain patients.

I know because the drug czar himself has assured me that patients like Roger have never had any problem getting the medication they need.

The Boston Globe today editorializes against medical marijuana and physician-assisted suicide today, both of which are on the ballot in Massachusetts. Why? Because neither ballot measure gives state bureaucrats sufficient control over over the lives of people who live in Massachusetts.

From the marijuana editorial:

With any other legal drug, patients would expect straight answers — they’d assume, almost unconsciously, that the FDA was protecting them. There’s no such backstop for medical marijuana. Even the wisest physicians wouldn’t have enough data to make definitive judgments . . .

Certainly, any regimen for medical marijuana that’s finally adopted should ensure that only those who demonstrably need the pain relief are getting it.

But in the end, Question 3 isn’t the right answer to a complicated policy issue. There are simply too many inherent problems in asking state officials to oversee a legalized system of growing and distributing a drug that hasn’t been subjected to the federal approval process.

Question 3’s heart is in the right place, and its architects have made a solid effort to learn from the mistakes of California and Colorado. But ultimately, the only truly safe way to legalize marijuana will be through the FDA, with doctors providing prescriptions and licensed pharmacists dispensing the medication.

In the meantime, let the patients suffer, the black markets prosper, and the raids continue. I mean, God forbid we pass a law that gives your average rube the tiniest bit more power to make his own decisions about what he puts into this own body. I mean, what if this law were responsible for someone using marijuana to get high?

And from the physician-assisted suicide editorial:

Reasonable people can disagree passionately about Question 2, but a yes vote would not serve the larger interests of the state. Rather than bring Massachusetts closer to an agreed-upon set of procedures for approaching the end of life, it would be a flashpoint and distraction — the maximum amount of moral conflict for a very modest gain . . .

Instead, Massachusetts should commit itself to a rigorous exploration of end-of-life issues, with the goal of bringing the medical community, insurers, religious groups, and state policy makers into agreement on how best to help individuals handle terminal illnesses and die on their own terms . . .

Physician-assisted suicide should be the last option on the table, to be explored in a thorough legislative process only after the state guarantees that all its patients have access to all the alternatives, including palliative care.

” . . . would not serve the larger interests of the state.” Doesn’t get much clearer than that, does it?

That last bit of emphasis is mine. Interesting what happens when you take these two editorials together. We can’t trust doctors and terminally ill patients to come to a decision about allowing a patient to peacefully, painlessly end his own life, because all of the experts, politicians, and elites haven’t yet decided what’s best for the patient. And we can’t let that same patient relieve his pain with marijuana, because the experts aren’t yet in agreement about the benefits of the drug (in part because the same bureaucratic structure refuses to allow the drug to be used for medical research), and in any case, because the proposed law doesn’t give nearly enough power to government to keep the drug away from people. (The Globe also endorses restricting access to prescription painkillers, by the way.)

The message the Globe editorial board is sending to people with chronic pain and terminal illness is pretty clear: Government power is far more important than your pain. So just fucking suffer.

• Interesting article on Wikipedia’s reluctance to let go of accepted but false historical narratives.
• Police raid on child porn suspect ends in gunfire, wounded suspect, and wounded officer. Use of the word “stormed” makes me suspect they didn’t announce themselves. You don’t have to sympathize with the suspect (if the charges are true, I certainly don’t) to understand why this is such a dumb tactic. For example, look at the interrior wallof a Redditor who (claims he) lives next to the suspect. 
• Schrödinger’s cat’s lives.
• Mother Jones tries to link an alleged rise in mass shootings to increased gun ownership. Michael Siegel lets all the air out of that claim here. It’s also worth pointing out that Mother Jones is wrong not just on the analysis, but on the facts. Gun ownership is actually down. As is the overall crime rate. As is support for gun control. Which is to say I doubt there’s a link between guns and crime at all—positive or negative.
• Suspect that Baltimore police claim died from choking on drugs while in custody actually died of blunt force trauma.
• Fun gallery of hyperphotos from Slate.
• Another isolated incident.
• Probably the most outrageous thing you’ll read today: Sarasota, Florida sheriff tries to trick pain patients into signing away their Fourth Amendment rights.
• Some judges are finally started to question police officer claims of superhuman ability to sniff out marijuana.

• This week in Islam-related hoaxes.  In the interest of fairness, here’s a non-Islam related one via Radley, who also pointed me to the next item and to this horrifying picture of a wet koala.
• CNN:  “Iran already has a missile that could reach the US!”  Sort of.
• This coming Sunday is a red-letter day in alternate history.  (Via Jesse Walker)
• The Law of Unintended Consequences strikes again. (Via my friend Grace)
• Human evolution:  what we can learn from stone tools and petrified stools, and a scientist discusses why men love tits.
• Alaska town has had a cat as mayor for the last 15 years.
• Florida judges say, “Mens rea?  What’s that?”
• Dr. Marty Klein debunks the myth of “sex addiction”; I’ve done the same twice on my own site, but his is a lot more thorough and a lot less bitchy.

For the second time in as many months, Reuters has produced a refreshingly balanced, well-reported article on a hot issue that has sent many of its competitors into hysterics. This time, it’s the prescription painkiller panic.

The long article lays out the usual figures about painkiller addiction and overdose deaths, but then delves into the effects the resulting DEA crackdowns are having on doctors, patients, and pharmacists.

Pamela Storozuk, a petite 59-year-old, spent most of her career as a sales representative, dragging heavy suitcases filled with presentation materials. When her husband developed prostate cancer, she cared for him, often helping to lift him out of the bath or into bed.

Eventually, the strain on her back caught up with her. Today she has five herniated discs and relies on painkillers to function.

Over the past six months, however, the Fort Lauderdale, Florida, resident has found it increasingly difficult to get her medications. Her regular pharmacy is often out of stock, and others refuse to dispense painkillers to new patients.

“They look at you like you’re an addict, a lowlife,” she said.

Storozuk is one of thousands of Americans caught up in the government’s latest front in the war on drugs: prescription painkillers. From 1999 to 2009, the number of deaths from narcotic pain pills nearly quadrupled to 15,597, more than those from heroin and cocaine combined, according to the latest figures from the U.S. Centers for Disease Control and Prevention.

In response, the U.S. Drug Enforcement Administration has beefed up its efforts to block the diversion of prescription drugs to the black market, using many of the techniques it employs to combat illegal drug use: wire taps, undercover operations and informants.

Such efforts have helped it dismantle hundreds of “pill mills” – sham pain clinics that write thousands of prescriptions with few questions asked – as well as dozens of rogue Internet pharmacies.

Now the agency is using the same tactics to prosecute the legitimate pharmaceutical supply chain, which is required to maintain certain record-keeping and security protocols to prevent drug diversion.

Which is another way of saying that pharmacists can be held civilly and criminally liable if they don’t adequate police their own customers. They’ve basically been both deputized and told they can go to prison if they’re insufficiently skeptical about the people they’re supposed to be serving. (The article also points out that, as it’s been doing for 10 years, the DEA refuses to provide any clear-cut guidelines for any of the professionals involved in painkiller distribution. The fuzziness of course takes away the potential defense that the doctor or pharmacist followed DEA guidelines.)

“The techniques that law enforcement uses to combat drug traffickers, whether they’re Colombian organizations or Mexican cartels or Afghan drug lords, those techniques are very, very essential in combating prescription drug abuse,” DEA Administrator Michele Leonhart said in an interview.

But critics say applying the same strategy to the legitimate supply chain as to Colombian drug lords is ineffective and is also causing supply shortages that hurt pain patients.

“Going after a pharmaceutical manufacturer is not like going after the Medellin cartel,” said Adam Fein, president of Pembroke Consulting, which advises pharmaceutical manufacturers. “I don’t believe it is appropriate for the DEA to shrink the supply of prescription drugs, because it has unanticipated effects that have nothing to do with the problem.”

Effects like making life a living hell for pain patients—and effects that are entirely predictable, no matter what the drug czar says. The DEA is now quite literally treating doctors and pharmacists like potential drug dealers.

The agency has expanded its use of tactical diversion squads, which combine special agents, diversion investigators and local law enforcement officers to track down and prosecute prescription drug dealers.

Forcing the two sides to come together was not easy at first, Leonhart said, since special agents initially were reluctant to work on “pill cases.”

But the effort has shown some results. Asset seizures on the diversion side rose to $118 million in 2011 from about $82 million in 2009, Leonhart said.

That’s a telling metric, isn’t it?  The same drug warriors who tell us prescription overdoses are skyrocketing claim, at the same time, that their decade-long anti-diversion efforts are working because . . . the government has been more successful at taking money and property away from people. Let’s not forget that in a civil asset forfeiture case, the government needn’t even charge you to take your stuff, much less convict you.

What’s really remarkable is that the DEA is admitting that it’s putting a squeeze on the overall availability of prescription painkillers, which of course will affect legitimate patients as much as recreational users. Meanwhile, the drug czar is giving us the old “Nothing to see here,”  brushing off the notion that real pain patients are having difficulty filling their prescriptions. (The 400 or so desperate pain patients who have emailed me over the last few months would disagree.)

Still, sending in tactical diversion squads to break up pill mills does not address the leaks occurring from medicine cabinets at home or the drugs passed along from friends and family. That is one reason the DEA is attempting to squeeze supplies at the wholesale level.

“Going after Cardinal has sent shivers up the distributor grapevine,” said John Coleman, a former DEA chief of operations. “Close a CVS pharmacy in Florida, and I guarantee every pharmacy within 500 miles will be checking their records.

“You don’t have to hit a horse with a whip,” he said. “You just have to show it to them once in a while.”

Charming. Czar Kerlikowske has also assured us that legitimate doctors and pharmacists aren’t worried. Again, this is bullshit.

Pharmacists confirm that they are indeed fearful. Some are reluctant to take new painkiller customers. Others will only accept patients within a certain geographic area or refuse to accept cash.

“We turn away five or six people a day,” said Steven Nelson, owner of the Okeechobee Discount Drugs store in Okeechobee, Florida, and chairman of governmental affairs for the Florida Pharmacy Association.

Even large chains are leery. Walgreen spokesman Michael Polzin said that after looking into everything going on in Florida, “we’ve decided not to comment on our operations there at this time.” . . .

Physicians are equally nervous. Many have stepped up patient monitoring, according to Storozuk’s physician, Dr. Martin Hale. That means more urine tests, more documentation, and more frequent “pill count” checks, where patients must go to the doctor’s office with their pill bottle to prove they have not sold or misused their medication.

“Every hour of the day I have concerns I’ll be audited, that my ability to take care of my patients and my family can be taken away, and I’m as legitimate as you can get,” said Hale, who has a private orthopedic practice a few miles from Fort Lauderdale and is an assistant professor at Nova Southeastern University. “You’re constantly watching over your shoulder, and it takes a toll.” . . .

John Burke, president of the nonprofit National Association of Drug Diversion Investigators, says the DEA behaves as though those it monitors are the enemy.

“The mindset is, these are folks we have to keep at arm’s length,” said Burke, whose organization tries to foster communication between law enforcement, regulators and industry.

As long as you have a law enforcement agency bringing a law enforcement mindset to what ought to be a medical issue, they’re going to look at every doctor, pharmacist, wholesaler, and patient as a potential criminal. That’s what law enforcement officials do. They look for criminals.

And so in its ongoing effort to stop people from getting high, the government has once again created an atmosphere of fear, distrust, and paranoia. This time, sick people are suffering because of it.

• Witnesses shocked after Vista, California deputy shoots broomstick-wielding man.
• New New Jersey law will fine motorists for not putting seat belts on cats and dogs.
• Headline of the day. 
• Daytona’s police chief is outraged that Judge Joseph Will dared to call his lying police officers liars.
• Things cats won’t do.
• Bloomberg’s defenders speak out: “But might there come a day when the New York City Department of Health mandates that burgers be limited to, say, four ounces? Indeed there might. And why not? Eight- and ten-ounce burgers are sick things.”
• Alternate headline: “Drug warriors to chronic pain patients: GFY.”
• Oh. Hi. So you’re home.
• Man arrested for spitting on the sidewalk.
• RIP, Richard Dawson. The only man who ever pulled off the pinky ring.

In the name of preventing the diversion of prescription painkillers, the DEA is causing unneeded suffering in America’s nursing homes.

Meanwhile, here’s an email I received today from a pain patient in Tennessee.

Hi Mr. Balko. First, thank you so very, very,  much for being the “voice” for all of us chronic pain disease people. I have a rare disease called RSD/CRPS. It is rated the highest of all pain diseases on the Mcgill Pain Scale. It is rated higher in pain than child birth or the loss of a digit. I am on a fentanyl patch and other meds as well. I have recently been informed that the pharmacies near me will no longer fill opiate pain meds! My husband has to drive all over the state to find a place that will fill my medicine. I would be willing to talk to you if it will help me and others with the nightmare we are living. Again, thank you for what you are trying to do. We need you.

After my Huffington Post series on chronic pain, I created a file for emails from pain patients who can’t find treatment. It’s up to 300 messages.

But they must all be lying. Because the drug czar assures me such people don’t exist.

Doctors prescribed a Texas woman a strong narcotic after she shattered her knee in Haiti.  And then . . .

“They gave me a pretty high, heavy duty narcotic, Norco, as a painkiller going forward and I had used that up. It had been a month and I had called for my refill,” Lenhart said.

The pharmacy called Lenhart to ask her exactly what time she would be in pick up her prescription. She thought it was odd, but told the pharmacy what time she would be there.

Still on crutches and unable to drive, a friend of Lenhart’s, drove her to a CVS Pharmacy in Oak Cliff.

She wasn’t able to pick up her prescription because a police officer arrived to pick her up.

“He was like ‘we need to go outside,’” she said. “I was on crutches and I had a permanent IV line in my arm. I had a big leg brace. I asked him if it was necessary and he said yes and he rather policingly escorted me out the front door and into the back of a waiting patrol car.”

Lenhart was so stunned, she didn’t think to ask the officer questions. The officer explained to her what was going on.

“He said, ‘Well we believe that you have forged your pain pill prescription and we are calling your doctor now. But I’ve worked with this pharmacist a number of times and he’s never made a mistake,” Lenhart said.

The officer then took her the Dallas County jail, where she remained overnight.  After she was released on bond, she was charged with obtaining a controlled substance by fraud, a felony.

“I couldn’t go back to work until HR had received the paperwork that this was a mistake from my attorney,” she said.

Dallas police later dropped the charges after speaking with Lenhart’s doctor.

These idiots couldn’t even bother to call the woman’s doctor before tossing her in a jail cell.

Lenhart’s story has been making its way around the web the past few days, and has been generating the appropriate outrage. But it shouldn’t be all that surprising. This is the perfectly predictable outcome of all this painkiller hysteria of late. It’s bad enough coming from the usual drug warriors. But because there’s a big evil pharmaceutical corporation to play the villain, we now get progressive outlets like ProPublica, and Alternet and Salon spitting out the government’s hype without the least bit of skepticism—or concern for pain patients.

You can’t really blame the pharmacist, here. She risks arrest and criminal prosecution if some overeager prosecutor looking to make a name for himself decides she hasn’t been sufficiently suspicious of her customers. Think about that. The government will now throw you in jail for failing to be suspicious enough of your fellow citizens. (And not just with painkillers — remember this monstrous injustice?)

Don’t blame her employer, either. The DEA recently shut down two CVS stores in Florida because federal drug cops thought the stores should have been turning away more people who came to fill pain medication prescriptions. Not only that, the agencies also attempted to shut down the wholesaler who supplies those stores for not being sufficiently suspicious of them, a move that would have left thousands of patients in several states without access to the medication they need.

The government has created a poisonous, paranoid atmosphere in which every player in the painkiller process from manufacturer to patient has been deputized to police every other player, to the point where anyone who doesn’t continually question the motives and actions of everyone else risks losing his livelihood, or even his freedom.

But Drug Czar Gil Kerlikowske personally assures me that none of this hysteria is affecting patients. People suffering from pain and conscientious doctors have nothing to worry about, Kerlikowski promises. Just trust him on this one.

Yeah, so tell that to Anne Lenhart. Or to the desperate pain patients who have been emailing me since the most recent doctor went down.

You are sorely missed, Siobhan Reynolds.

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.

The third part of my three-part series on the painkiller debate is now up at Huffington Post.

Check the comments for more stories from pain patients who have been unable to find treatment.

• The latest edition of Cato Unbound looks to be pretty interesting. It’s on DNA testing and the death penalty.
• Interesting look at the lobbyists who are paid to keep marijuana illegal.
• Bunk opens a grocery.
• So this is absurd. Let’s hope Texas doesn’t hear about it.
• Doctor faces murder charges for prescriptions she wrote for painkillers. Note that the investigation began in 2008, the deaths she’s charged with causing occurred until December 2009, and she had her license and was still prescribing until at least the end of 2010. This is consistent with the criticism that law enforcement agents are more interested in bagging scalps and seizing assets than protecting patients.
• Remember when media consolidation was the big fear? Now, it’s too much media. Where are you when we need you, Rupert Murdoch!?!
• Recently laid-off manual laborer leaves a generous tip.

• British government, public health activists say alcoholism running rampant even though per capita consumption is down.
• States looking to pass yet more policies to curb access to prescription drugs. Note that one politician quoted refers to “patients” trying to manipulate the system, not “addicts” or “dealers.” A patient trying to manipulate the system is a patient who can’t get the drugs he needs, because of the system.
• I feel another law named after a dead person coming on.
• Oakland cops were given body-mounted cameras to improve relations with the public. But they aren’t turning them on when they’re policing protests.
• The best outcome to the birth control debate: Make the pill available over the counter. I have a feeling neither side would approve.
• Philly cops say they aren’t required to observe bike lanes.
• Middle-aged American Family Association columnist calls high school junior a “small-minded and vengeful brat.” He also calls her “mean.”

Part two of my three-part series for Huffington Post is now online.

It takes a skeptical look at the new overdose/abuse figures the federal government is touting, and points out that the problems we’re seeing today with pill mills and strip-mall clinics are the result of overly protective drug control policies. And they’re the same sorts of policies opioid critics are now saying need to be expanded and strengthened in response to the latest panic.

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.

This week at Huffington Post, I’ll be posting a three-part series on the latest outbreak of prescription painkiller panic.

The first part is up today.

I’m currently working on a piece for Huffington Post on the latest prescription painkiller hysteria. In researching the piece, I found this 2010 Time piece by Maia Szalavitz on how post-mortem overdose diagnoses may be overstated.

The problem is that it’s difficult to isolated a particular drug as cause of death. So the rise in opioid-related overdose deaths that the CDC and numerous media outlets have been screaming about for the last few months could be the result of lots of people ODing on painkillers, or it could merely be that because more people are taking painkillers, more people are likely to have painkillers in their systems when they die. Hence, the use of the term “opioid-related” to describe these deaths. That allows panic-sowing without the need to establish any causal connection. (It’s similar to the way the government calculates “marijuana-related emergency room incidents.)

But the problem gets more urgent when we start using these diagnoses in court, as the government has done in the trials of doctors accused of contributing to a patient’s overdose death.

It’s here that the opinions of one of  Szalavitz’s sources seem particularly troubling.

Given the state of the science, then, should it be used in court? Ed Cheng, a professor of law at Brooklyn Law School and expert on scientific testimony, says, yes, noting that more research is still needed. “If we were to require studies and statistical assessment on every assertion, almost nothing would be able to be used in court. My view on this is that the question here is not throwing the baby out with the bathwater,” says Cheng. “It’s clear that the forensic sciences do not have as much of an empirical basis as we would like them to have. The question becomes how do we motivate them sufficiently to come up with the empirical basis that we want?”

In the Schneider case, which entered jury deliberations on Wednesday, the defense team sought and failed to prevent the jury from hearing testimony that it believed did not have sufficient scientific foundations. But according to Cheng, it may be preferable to let the jury hear both sides of the scientific dispute and make up their own minds. “I myself have floated between the poles on this,” he says. “I’m currently more on the ‘Let the jury hear it’ side. I’m not convinced that good science and bad science is always cut and dried.”

“Let the jury hear it” sounds great on its face. But there’s more to it than that. If the science linking a particular drug to a particular overdose isn’t established–if the scientific community is split over whether you can make that connection–then the jury shouldn’t hear it. (If nothing else, that would seem to establish reasonable doubt.)

Yes, we do have an adversarial judicial system. But lay juries aren’t trained scientists. Most people don’t know what to look for  when evaluating the veracity of some science-based claim. Get two scientific-sounding witnesses pitching the jury competing or mutually-exclusive theories, and the winner will more often be not who advocated the best science, but who was a better expert witness. Or more bluntly, who was a better salesman.

We’ve seen this over and over again with bite mark testimony. Frauds like Michael West have sold crap science to juries for years, sometimes unopposed, but often opposed by more credible experts. Even now, with a solid consensus in the forensics community that you can’t “match” bite marks in skin to one person to the exclusion of everyone else, we still see appeals courts shoot down post-conviction petitions on the grounds that the defense already challenged the state’s expert at trial, and the jury found the prosecution’s witness more convincing. It doesn’t seem to matter that we now know the prosecution’s witness was spewing pseudo-science hokum.

I think you could make a strong case that West was able to persuade juries because he didn’t sound scientific. I’ve read more than a few trial transcripts where West and the prosecutor would actually use an opposing expert’s credentials against him, contrasting him as a fancy out-of-town hired gun with a bunch of letters after his name with West, the local dentist just trying to do the right thing, helping put bad guys away with intuition, common sense, and some self-taught expertise. The scary thing is that when you see West in action, he sounds convincing, even when you know he’s a fraud.

Of course, West is only one example (although he is one of the most egregious). I don’t know the best way to determine what science has reached enough of a consensus to be used in a courtroom, but leaving the decision to individual juries on a case-by-case basis seems like a bad idea. In the federal courts, and in much of the country, challenges to scientific evidence are currently resolved by the judge in what’s called a Daubert hearing. From my understanding, while those hearings have done a decent (but far from perfect) job keeping junk science out of civil cases, the process has been less successful at keeping it out of criminal cases.

Skeptical as I am of blue ribbon commissions, this may be one area where we’re best off having an established, accredited panel of specialists set policy.

• “Anything dealing with that kind of work, anything dealing with guns and taking down bad guys, I’m there. I love it.”
• Bakery creates TSA-compliant cupcake.
• The second-to-last paragraph of this piece is horrendous. There’s an ethos
• A pretty stunning series of portraits.
• Coddling Joe Arpaio.

• Indiana legislator wants to ban novelty lighters.
• Lost city emerges in East St. Louis.
• This is kind of badass.
• Paypal orders man to destroy expensive WWII violin.
• Exploiting tragedy to push an agenda: Apparently, when killers going on murder sprees, they stop to be sure they’re abiding with federal gun laws.
• Maia Szalavitz eulogizes Siobhan Reynolds over at Time.
• The guy who thinks “the pursuit of happiness” ruined the Declaration of Independence nearly won the Iowa Caucuses last night.

• Not The Onion: Californians will vote on whether porn stars should be required to wear condoms.
• It’s all just going to get dumber and dumber until November.
• Gene Healy: the five worst op-eds of 2011. His delightfully Friedmanesque closer: “And so, my friends, we roll up our sleeves and limp forward, hunkered down to face what 2012 holds, our boats borne back ceaselessly into the past, yet always, always, twirling toward freedom.”
• Alternet publishes article calling for government monitoring of doctors and their pain patients, a crackdown on prescription painkillers, and generally expanding the drug war, all because . . . corporations are evil. And Florida’s governor loves the Tea Party. Or something.
• A list of all the new reasons for which governments will send you to jail, starting on Sunday.
• Woman says she was arrested, had her phone confiscated after trying to record a police beating in North Carolina.

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.

UPDATE: More tributes to Reynolds from Jacob Sullum, David Borden, and Robert Higgs. Higgs quotes from an email he sent to Reynolds two days before her death:

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.

• The Bernie Fine story keeps getting stranger. His wife apparently had an affair with one of his accusers. Another accuser’s father says he’s lying, and the accuser is himself facing sexual assault charges. Two of the accusers are also step-brothers. None of which means Fine is innocent. It just means we should probably wait a bit longer before assuming he’s guilty.
• Fed gave biggest banks billions in secret, low-interest loans.
• With the exception of the last one, I’m fairly sure every category of ads in this article has been run against a prominent male politician.
• Tennessee constables get kickbacks from the state for writing citations.
• Heard an ad for the site on Sirius the other day. Your thoughts? Disgusting, or just a more transparent way of dating? Both?
• Emma Sullivan, hero of the week.
• Washington State law to take effect next month is likely to make it yet more difficult for pain patients to find doctors who will treat them.

In this hysterical USA Today piece about infants born addicted to prescription painkillers, Florida Attorney General Pam Bondi says, “I’m scared to death this will become the crack-baby epidemic.”

I agree. I hope this doesn’t turn into an excuse to pass a bunch of dumb laws that will restrict personal freedom and impose draconian sentences on people who commit nonviolent offenses, all in response to a hyped-up, non-existent problem drummed up by the media and drug warriors. The “Oxy baby” narrative has the added potential to further chill the treatment of chronic pain.

It may well be that this is a huge and growing problem. But I don’t find the USA Today piece all that convincing. In 2009, the New York Times looked at recent studies of what has happened to “crack babies.” Turns out, the consensus seems to be that the biggest hurdle they’ve had to overcome is the fact that they’ve been called “crack babies” all their lives.

• “We received a report that you may have put a Kraft single on imported sopressata. Mind if we look around?”
• A heartwarming tale of jury nullification.
• Obama’s crackdown on pain patients.
• This one may be more difficult to disprove.
• “In Defense of Flogging.” BTW, Peter Moskos will  be one of your guest-bloggers while I’m on vacation, starting next week.
• “Make way, peasant!” I’ve written about some related issues.

• It’s still legal, for now, to grow your own tobacco in Brooklyn. What’s sad is that New York has imposed the phalanx of restrictions that make an article like this contemplatable. (Yes, I’m pretty sure I just made that word up.)
• Jury nullification advocate is indicted in federal court for jury tampering. I have a feeling we’re going to be hearing much, much more about this case in the coming years.
• Huge wave of pain clinic raids in Florida. Note that the USA Today couldn’t find room in a very long article to quote even one critic of these crackdowns.
• In Esquire, a long profile of exoneree Ray Towler.
• Why liberals should support eminent domain reform. This is a pretty important credibility issue for the left. We aren’t talking about public use, here. If you can’t bring yourself to support laws barring the government from taking land from poor people to give it to rich developers, it’s pretty darned clear that your priority isn’t protecting or advocating for the poor, it’s preserving government power. Or just opposing property rights because you don’t like the people who support them.

I don’t know any more than what was reported by the local paper. But this editorial sounds familiar:

[M]any of us know Kim Rotchford and his family. Rotchford is known as the physician who has taken into his care people with chronic pain or addictions for which others may have no good answer. He takes cases that others would choose not to take.

He is also the local physician who has put his time and his expertise into the service of our homeless and dispossessed through the founding and volunteer staffing of the JC MASH free medical clinic. Other docs help out, but everyone knows that clinic is the product of Rotchford’s calling to help the down and out.

We know that Rotchford and his family have been good citizens and good volunteers in this community for many years. Without pre-judging the investigative findings, we believe that Rotchford deserves the benefit of doubt from the justice system and from us as he proceeds into the legal ordeal ahead.

Unfortunately, taking cases that others choose not to take is often enough in itself to get yourself investigated. And of course all of Rotchford’s pain patients are now out of luck.

Those of you who think we need more government healthcare might keep in mind that when the feds can’t prove a case for drug distributionthey often fall back on Medicare fraud, which appears to be the impetus for this investigation. That is, they argue that billing Medicare for pain scripts DEA cops don’t think patients need becomes a criminal offense. That kind of intimidation will only get worse with more government oversight.