PAIN IN AMERICA

INTRODUCTION

There are 75 million patients across America suffering from terrible pain that never leaves them, not even when they sleep, and it has shattered the normal lives they once enjoyed with their families at home, and their colleagues at work.

Worse, there is a wave of baby boomers awakening to the challenges that age presents including chronic pain.

You might presume that the government was doing all that it could to redress this pandemic of pain.

Instead our government is daily making it worses, creating a public health crisis when it should be easing our pain.

The source of this pain should be well known as, with greater frequency, our friends, and family members suffer from this chronic, non-malignant pain.

Unsurprisingly, given this direction by the peers in their own medical profession, physicians are refusing to treat-lest they be jailed.

With fewer physicians prescribing controlled substances, chronic pain patients daily consider the dilemma of choosing endless days of extraordinary pain without surcease or surrendering to suicide.

The rationale for the federal government's wrong-headed campaign is a combination of ignorance, junk science, mis-placed religious zeal, misdirected social policy, and plain, old arrogance.

However you select or synthesize these various factors, what you get is a zero tolerance policy by our government for prescribing opioids.

The government may say that they are only "after the bad doctors". But consider the physicians that they've prosecuted, the "evidence" that the government relies on at trial, and how these much these criminal cases are much more like a medical malpractice case. ("Did the doctor run this test?" or "Keep this record?"), rather than a drug prosecution ("Was the doctor dealing in drugs"?

Left behind in the wake of the government' wrong-headed prosecutions are suffering patients trying to find another physician who might treat their pain.

We know that the government is no stranger to interfering in medical matters property reserved to the several states, to medical experts, who know the science, and to patient and family members who have a right to be "let alone" by the government.

We are all too familiar with the government's interference in matters that are none of its business.

The federal government interfered in the end-of-life decision of Terri Schiavo, who suffered irreversible brain damage, and had been uncounscious for years with no hope of recovery when her husband sought to remove her feeding tube.

Congress issued a subpoena for Ms. Schiavo to testify when they knew full well that she could never appear or testify.

Senate Majority Leader Bill Frist, a cardiac physician, told the media he knew that Ms. Schiavo was not brain-dead because he'd seen a videotape with her eyes moving in the same direction as in inflated balloon.

In the end, Congress conferred authority on the courts to rei-insert the feeding tube.

The courts, however, would have nothing to do with it-as the legislation was unconstitutional. Another example is how our federal government repeatedly resists efforts to expand embryonic stem cell research that may cure damage to the brain, spinal cord, skeletal muscles, and the heart, because, to some conservative fundalmentalists, the destruction of an embryo, though slated for destruction anyhow, is tantamount to murder.

Our federal government has interfered with those states that authorized medical marijuana. Since the mid-1970s, states have passed medical marijuana laws to treat cancer, glaucomea, pain, and HIV/AIDS. In Augusts 2006, the Scripps Research Institute found that an active ingredient in marijuana, THC, inhibits the formation of amyloid plaque, the primary pathological marker for Alzheimer's Disease. Despite this research, and the array of legislative findings suggesting the medical uses of marijuana, Congress lists marijuana as a Schedule I substance. which, by definition, means it has absolutely no medicinal value. Angel Raich, a medical marijuana patient, tried to stop federal raids against patients in California where medical marijuana is legal, but the Supreme Court refused his request for relief because, according to Congress, marijuana has no medicinal use.

The Justice Department also interfered with Oregon's assisted-suicide act but the Supreme Court of the United States in Gonsalez v. Oregon, _U.S._126 S.Ct.904, at 922 Jan. 17, 2006), put an end to that interference, saying the Attorney General has no medical expertise, no business substituing his judgment for a physicians's judgement, and no right to usurp a state legislature's finding.

The federal government nevertheless continues apace to interfere in matters medical wherever it can and that includes our main concern in this volume-chronic pain patients.

The Attorney General presumes to know what's "medically necessary" for a pain patient, notwithstanding the Supreme Court's ruling in Gonsalez that the Attorney General has no such expertise or authority.

The cost to our national health for this wrong-headed "drug" policy is incalculable.

If the federal government was truly concerned about the diversion of prescription drugs, then the government would investigate and prosecute the thefts of controlled substances transported to or stored at the pharmacies.

Willy Sutton said he held up banks because that was where the money was. Similarly, the serious drug dealers hold up pharmacies, or seize delivery trucks in transit; they don't spend their time stealing prescription pads and forging scripts.

You may fairly ask why you haven't heard of this problem before? The answer is you have but it wasn't couched in the language you find here.

The federal government has wrongly and artfully cast the prosecutions of physicians as if it were part of this nation's never-ending "war on drugs".

We say "never ending" because "the war on drugs" was declared before many of us were born. It is a "war" that we cannot seem to in for, if you've noticed, it has been repeatedly declared anew, again and again, usually during an election year, and a fair review of the results of this war are always the same, ineffective deterence and collateral damage that obliterates notions of fair play and individual rights.

The government has successfully made the nation believe that this never-ending drug was has moved on to a new "theater that justifies the denial of medical treatment of chronic pain patients with opioids. In this new 'theater" of the never-ending war, the government invokes its inept drug speak, to mis-characterize physicians as "drug dealers", medicines as "drugs" and patients as "users" or "addicts".

Our critical faculties have failed to question the language we've grown accutomed to accepting when discussing abuse of heroin or methamphetamine. We have assumed a habit of acceptance. Thorsten Veblen called this the "bias of settled habit".

We must, however, resolve to re-consider this "war" on physicians and patients more carefully because the extension from the street and street drugs to professional medical offices and prescriptions is a quantum leap that has not only adversely affected our national health but also had a ruinous effect on our constitutional rights.

The "war" is encroaching on our constitutional right to be "let alone" by the government. This right to be "let alone" is what we otherwise know as the "right of privacy" and was described by Justice William Douglas as the penumbral emanations of those rights enumerated in our Constitution.

We must resist any government that would muzzle a physician's unquestioned right to advise his patient confidentially or to write prescriptions or to associate with other physicians who seek to treat chronic pain patients for such conduct violates the constitutional right of free speech and freedom to associate and assemble guaranteed by the First Amendment.

We must resist the government's efforts to compromise a physician's livelihood, and thus "take" what is his property in violation of the constitutional guarantee that no "taking" by the government of a person's property shall occur without due process, meaning unless it is fundamentally fair.

We must object, and not suffer in silence, the government's policy abidging the health and well-being of patients, for what could be more clearly an infringement on the constitutional guarantee of their life and liberty.

The government has set apart chronic pain patients as different than other patients, denigrated them to in word and deed, stigmatized them as addicts when they should be healed, and thus does our government deny patients another constitutional right, the equal protection of our laws guaranteed by the Fifth and Fourteenth Amendments to the US Constitution.

The government actually punishes patients, it doesn't just compromise their access to medicine, it imprisons them for being ill and this violates the constitutional prohibition agains cruel and unusual punishment.

You may be tempted to think that this discussion about chronic pain does not concern you. But here's the rub. The difference between being pain-free today, and a chronic pain patient tomorrow may be a rush-hour rear-end collision at a congested intersection. If you wait until this problem is about you alone, it may be too late to save you. If you do not help those who have the problem today, there may be no one to help you when the government turns its attention on you.

This book therefore seeks to show how our nation's public health is at risk, to let you see through the eyes of a chronic pain patient his fear that the government will cut off his medical treatment, and consign him to the abyss of pain he's spent so long trying to excape, to let you visit with a patient and two physician who were caught in the prosecutorial cross-hairs, and to understand the nightmare of their lives, to consider how the government actually manufactures crime, having agents pose as chronically ill patients, to let you look over the shoulder of a government prosecutor arguing why these prosecutions make sense to him, to see how the courts are confined by their own "bias of settle habit" not to resolve this problem, to offer some suggestions on what a patient or a physician should consider doing to defend himself from his government, and to discuss the individual's right to be let alone that our unjust government daily violates in chronic pain cases.

We begin with a look at this national tragedy through the eyes of a chronic pain patient who fears that he may be denied treatment and lose his physician because of the governments campaign against treatment. (see a "60 Minute" video about this case)

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