Tuesday, April 19, 2011

Feel the Pain

Elected officials across the political spectrum are in unanimous agreement.  We are in austerity mode, and the only cure is that we all share the sacrifice and feel the intense, unrelenting pain.  Otherwise, the spending will cause Armageddon and we will all be dead.  Even Standard & Poors, the credit rating agency that said subprime mortgage securities were AAA-OK, is warning of disaster unless we  raise the damn debt ceiling to avoid cracking open our fool skulls and making our national headache even worse.

 And when they say feel the pain, boy, do they ever mean it. Literally. The Obama Administration wants to clamp down hard on the inordinate amount of narcotics being prescribed to a nation of slobbering junkies. They want doctors to undergo special training in order to weed out the addicts from the bona fide legal sufferers. And guess who would provide this special training to the clueless doctors who have already gone through three years of medical school and another three to five years of internship, residency and postgraduate training?  Why, the drug companies, of course! The very pharmaceutical companies which manufacture the pills will be trusted to tell doctors how to prescribe less and vet their patients with a vengeance. They would also be forced to bear the costs of the pain meds classes.  I can just envision the outcome.  Profits are at stake here, people!  Watch out for a merry-go-round of lobbyists and sudden influxes of political contributions from drugmakers to the lawmakers in charge of this noble effort. Watch out, too, for a chilling effect on doctors trying to alleviate the pain of the suffering.  Big Brother DEA will be watching them more closely than ever and monitoring every controlled substances form in triplicate.  Watch out for people in pain being turned away, in droves.

Pain medication is actually being underprescribed by most American physicians, according to a slew of surveys.  Doctors are already afraid enough of being investigated by the DEA. (The only sure way to score a Vicodin prescription, according to one unnamed doctor I know, is to be a police officer with an on-the-job injury.  Then your health care provider is safe from scrutiny.)

Meanwhile, the Administration is "absolutely committed to legislation that will make prescriber education mandatory,” R. Gil Kerlikowske, the Obama Drug Czar, announced. He said the White House will push hard for the legislation, and that he has already approached members of congress to discuss and craft it. He wants it done by the end of the year.  Among the drugs to be more strictly monitored are  OxyContin (long-acting oxycodone), fentanyl and methadone.

 "They are considered critical to pain treatment. But they also have been associated in recent years with a national epidemic of prescription drug abuse and addiction, as well as thousands of overdose-related deaths," according to The New York Times. "The F.D.A. has long argued that only Congress has the authority to mandate physician training as a condition of prescribing narcotics, because the legal distribution of the drugs is regulated by the Controlled Substances Act of 1970 and the licensing of doctors to prescribe them is overseen by the D.E.A., not the F.D.A."

Kerlikowske, former Seattle Police Chief, is the same guy who got rid of the "War on Drugs" slogan, but he continues to do battle against marijuana legalization.  He's the same guy who threatened to sue the State of California if it legalized weed.  He loves Nancy Reagan's "Just Say NO" anti-drugs campaign, and thinks it worked.  He also has a pretty poor civil liberties reputation. In March 2007, the NAACP called for his resignation, stemming from his alleged cover-up of a police brutality incident against a drug dealer. The case was referred to the FBI and the Justice Department, which found no evidence of corruption against Kerlikowske or the Seattle P.D, despite video footage of the incident. Kerlikowske is  a graduate of the FBI Academy's executive program.

Kerlikowske, who also has a masters degree in criminal justice, thinks our doctors just didn't get enough training about addiction and pain management in medical school.  So, his solution is to legislate the drug companies -- the altruistic drug companies which have only the best interests of the populace at heart and work hard to keep the prices of its United States drugs the highest in the world, and blackmailed the President into backing off drug price negotiations in health insurance reform in exchange for their cooperation - into teaching doctors who already have more education than their overpaid CEOs could ever hope to attain.

Sure, there's a drug problem in this country.  People often self-medicate because they have no health insurance, they're miserable due to joblessness, or they are in psychic pain for any number of reasons.  And the way we have of dealing with it is ass backwards. We don't treat addicts -- we jail them. Only the rich and insured go to rehab. Insurance companies are stingy about covering it. The government's solution is to make both the addicts and the sick suffer needlessly and crack down on doctors instead of cracking down on illegal drug labs and internet sales and the constant barrage of TV commercials actually urging us to pop a pill for any condition, real or imagined. How sick is that?

Take Two Aspirin and Don't Call Me in the Morning


John in Louisiana said...

When is this nation going to finally give up on this ridiculous war on drugs? What makes anyone in government think they have the right to intrude upon the doctor - patient relationship?

ALL drugs should be legalized and the government needs to get out of the business of policing them. The only things our current system has done are:

1) keep people who need drugs and don't wish to break the law from getting them
2) make criminals of those who either wish to get a legal drug a doctor refuses to prescribe or want a drug that has no official sanction
3) enrich big pharma at the expense of the middle class
4) enable a huge criminal class which, in turn, undermines governments all over the world
5) keep the price of drugs - both legal and illegal - artificially high (no pun intended)

Valerie Long Tweedie said...

I don't know that I agree that all drugs should be legalized, John, but we certainly should decriminalize marijuana. It should be like alcohol, no one under 21 can buy it and if you get caught driving (or operating any motorized vehicle) under the influence, there is a penalty. Personally, I think the penalties should be a lot stiffer for DWIs, but alcohol and pot are basically the same thing. - Said by someone who doesn't smoke pot and drinks a glass of wine rarely.

What an insulting piece of legislation to throw at doctors! - and what a colossal joke that the drug companies should be in the position of educating physicians! As Karen said, doctors are already monitored in their prescribing medication. My cousin, with a brain tumour used to get crippling head-aches and doctors were scared to death to give her much pain relief. I can't believe that people addicted to these drugs are getting them from legitimate sources. More likely, the weakness in the system is from some aspect of the pharmaceutical distribution process. I smell a rat in all this.

Anonymous said...

What am I missing? The drug companies have highly paid reps whose job is to PUSH pills. Who thinks drug companies will be motivated to reduce the pain scripts?

Oh well. I guess it's not crazier than cutting taxes in order to raise revenue.

John in Louisiana said...

Valerie, when you say you can't believe that people getting addicted to drugs are getting them from legitimate sources you are making my point.

Keeping drugs illegal has done nothing to reduce either the demand for them or their availability. I've lived in Louisiana less than one year and know almost nobody here, but I'm sure I could walk out of my house right now and be back with any drug on earth within an hour.

Ask any high school kid why he smokes pot or does math instead of drinking and he'll tell you it's because the drugs are easier to get than the alcohol.

Make drugs legal and put them behind the counter in the pharmacy. If you want your insurance to pay for it, get a prescription. Then we'll eliminate all criminal activity surrounding the drug trade except for that of big pharma itself.

John in Louisiana said...

That's "meth" not "math." I only wish high school kids were doing math.

Karen Garcia said...

Since I posted this, the Times is running another article about an entire small town becoming victim to the oxycontin epidemic. I guess this sudden burst of publicity on prescription pain pills is meant to push the Obama Administration's new war on drugs agenda that is mainly a war on doctors who prescribe drugs.

I am suspicious of this sudden governmental concern, for a number of reasons. How much of this is a smokescreen to combat designer drug trafficking which is cutting into big pharma's profits?

For a really great read on how one small Iowa town got caught up in the grip of meth addiction, I highly recommend "Methland" by Nick Reding. Agribusiness moved in, destroyed local farming and the population took to cooking meth to stay awake to work three minimum wage jobs. The federal government did NOTHING to stop it, because the pharmaceutical lobby did not want to lose the profits on the raw materials going into meth manufacture. And Agribusiness liked things the way they were -- hopped-up employees working around the clock for no money. The town eventually solved its own problem, with the help of one lone doctor and a police chief. Very compelling.

Anonymous said...

The "kids" don't need to do Meth. They can get Oxycontin from their doctors for a variety of complaints, real or imagined. They bring them to school and share or sell them. Oxycontin is expensive and no ore effective than several generics costing much less. Between over prescribing and not prescribing generics billions are waisted on pain medication each year. That money should be saved or put to better health care use.


Lilly Abbott said...

The quantity of chronic pain patient is not very nominal and this is increasing day after day. Nothing can be more disastrous than living with a chronic pain. The cause may vary from patient to patient. This is the most complicated issue that you need to overcome with proper medication and prescription.

Anonymous said...

Let's not forget the other big reason drugs are still illegal: the hugely profitable prison industrial complex.

P.S. I love the NYT comments by several of the regulars there! It's often so much better than the actual columns. I'm glad you guys can work through the Brooks/Douthat columns. My eyes glaze over and my brain gets befuddled trying to make sense of them sometimes and I just skip to the comments.

turnipseed said...

I just had another longish post that I spend some time on be rejected by the system! This is the third time. Is there any reason for this. I think I'll start copying and pasting them into a file before I try to post!

Karen Garcia said...


Comments issues have been reported (off and on glitches/difficulties posting). Meantime, if you have a comment, feel free to email me kmgarcia2000@yahoo.com and I will post it. Thanks, and sorry for the inconvenience. And don't forget that RealityChex (next door to your right) now has a comments feature up.