Treating Doctors as Drug Dealers: The DEA’s War on Opioids

Treating Doctors as Drug Dealers: The DEA’s War on Prescription Painkillers – by Ronald T. Libby – from the Cato Institute’s publication: Policy Analysis – June 2005

Executive Summary:

 It was only in the late 1980s that leading physicians trained in treating the chronic pain of terminally ill cancer patients began to recommend that the “opioid therapy” (treatment involving narcotics related to opium) used on their patients also be used for patients suffering from nonterminal conditions.

The new therapies proved successful, and prescription pain medications saw a huge leap in sales throughout the 1990s.   

But opioid therapy has always been controversial.

The habit-forming nature of some prescription pain medications made many physicians, medical boards, and law enforcement officials wary of their use in treating acute pain in nonterminal patients.

Consequently, many physicians and pain specialists have shied away from opioid treatment, causing millions of Americans to suffer from chronic pain even as therapies were available to treat it.

This is the big ethical problem:

Is it ethical to witness someone suffering in pain and allow this continue despite having the means to relieve it?

Or is the withholding of pain relief analogous with torture?

Those of us who have chronic pain feel like we’re being tortured when our pain could be relieved but is not.

The problem was exacerbated when the media began reporting that the popular narcotic pain medication OxyContin was finding its way to the black market for illicit drugs, resulting in an outbreak of related crime, overdoses, and deaths.

Though many of those reports proved to be exaggerated or unfounded, critics in Congress and the Department of Justice scolded the U.S. Drug Enforcement Administration for the alleged pervasiveness of OxyContin abuse.

The DEA responded with an aggressive plan to eradicate the illegal use or “diversion” of OxyContin.

The plan uses familiar law enforcement methods from the War on Drugs, such as aggressive undercover investigation, asset forfeiture, and informers.

The DEA’s painkiller campaign has cast a chill over the doctor-patient candor necessary for successful treatment.

It has resulted in the pursuit and prosecution of well-meaning doctors.

It has also scared many doctors out of pain management altogether, and likely persuaded others not to enter it, thus worsening the already widespread problem of undertreated or untreated chronic pain.

In today’s crazed rush to restrict opioids, it seems like the “widespread problem of undertreated or untreated chronic pain” emphasized in 2005 has disappeared completely,

Of course, this is not because pain is now being properly treated but because it has become an inconvenient truth.

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