…federal and state agencies are focusing on the wrong target – legitimate prescribing of opioids – and have insinuated themselves into the doctor-patient relationship as never before.
Our governments are taking prescription pads out of the hands of physicians and dictating which, and how much, prescription pain medication may be prescribed for patients. This is chilling and unprecedented.
And nationwide, millions of pain patients, even those who were functioning well with long-term opioid therapy, are being forcibly tapered or having their medicines stopped outright, regardless of their wishes or those of their physicians.
Legal “solutions” to medical issues are dubious, both scientifically and with respect to policy.
For example, consider surgical recovery. It is well known that not only does surgical pain vary from patient to patient, but so do patients’ responses to pain medications.
Therefore, a standardized, one-size-fits-all dose of a given drug cannot meet the needs of all post-surgery patients, and it will also fail those afflicted with other kinds of pain, both acute and chronic.
In a country so respectful of individuals’ rights, it is unimaginable that we would surrender the sanctity of the patient-physician relationship without a whimper.
This is even more strange considering what a powerful lobby the AMA used to be.
This is not likely to end with opioids. Since our government now intrudes into determining the use of pain drugs, why not do so with other potential drugs of abuse?
Indeed, these seeds are already being planted.
One of the so-called “addiction specialists” who played a significant role in the current opioid fiasco has now set her sights on benzodiazepine sedatives (which include Klonopin, Valium, Ativan, and Xanax) because of their addiction potential.
It is ironic that people who suffer from anxiety will have ample reason to worry even more — about the very real possibility of their medicines being taken away.
That has certainly been true for me. My genetic disorder, EDS, already primes me for anxiety and with my functional life under increasing threat, it’s difficult not to succumb to fear… even outright panic.
The rate of metabolism of opioids can vary as much as 30-fold from one individual to the next because of genetic differences in the liver enzymes responsible for the degradation of the drugs. This means that a given dose of an opioid could be dangerously high for one person while too low to be effective for another.
If this is so obvious and well-documented, then how can any doctor (even if they are writing the CDC guidelines) believe that standard dose limits are a good, or even valid, idea?
At the core of this disturbing trend is the myth that restriction of certain drugs will eliminate drug abuse. It doesn’t work. It just raises the street price of highly sought-after, abusable drugs.
The decades-long “War on Drugs,” which has never succeeded in controlling abuse or addiction, is now being waged in doctors’ offices, the last place we should want government intrusion. In the name of addressing a crisis, we are sacrificing freedoms in a new, frightening way. That’s a prescription for disaster.
If the science is bad, the legal precedent is worse.
In the mad rush to address a complex problem with simplistic thinking, there has been an insidious power shift – toward state governments and federal agencies, in effect, writing prescriptions.
This insidious trend has been ignored by the press, civil rights advocates, the public health community and the general public.
Author: Henry I. Miller, a physician and molecular biologist, is a Senior Fellow at the Pacific Research Institute. He was the founding director of the FDA’s Office of Biotechnology. Follow him on Twitter: @henryimiller