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Doctors, Patients, Latest Drug War Casualties

By Radley Balko | FOXNews.com | Straight Talk | September 22, 2004

It’s uncomfortable to hear Dr. Frank Fisher speak. His eyes are usually glassed over, seemingly on the verge of tears.

Above them rests a sweeping coif of white hair; below, a thick, well-manicured white beard. A gentle man, he speaks softly, with jaws and temples tensed, projecting a belabored voice that toils to get from sentence to sentence. As he talks, you get the impression that he’s just a small dose of bad news away from shattering into a thousand pieces.

And with good reason. Fisher, a Harvard-trained physician, once specialized in the treatment of chronic pain. He served a predominantly rural and poor population in California. About 5-10 percent of his 3,000 clients were pain patients, victims of illnesses like cancer, steep falls, or car accidents.

A little more than five years ago, California Attorney General Bill Lockyer initiated a high-profile campaign against pain doctors who prescribe high doses of opioids — drugs such as Oxycontin, Vicodin and codeine.

Lockyer made Frank Fisher his example. Lockyer and other California prosecutors likened Fisher to a crack dealer. Then, to a mass murderer. Fisher was charged with multiple counts of drug distribution, fraud, and most sensationally, 15 counts of murder. The state seized his assets. His bail was set at $15 million and he faced a possible life sentence.

[Suetaznote: It's amazing how much damage one person can do with enough power. What kind of person charges a doctor with murder for prescribing pain medication?]

Over the next five years, all of the charges against Fisher flitted away. A judge immediately threw out the murder charges in a preliminary hearing. Four years later, another judge threw out the other felony charges — manslaughter and fraud. In May of this year, a jury considered the remaining misdemeanor charges against Fisher and acquitted him on every one of them. One juror said Fisher had been the victim of a “witch hunt.”

Frank Fisher is still a broken man. He spent five months in prison and paid hundreds of thousands of dollars in legal fees. He has yet to get his assets back from the state of California, and he still faces the possible revocation of his medical license.

“To add insult to injury,” the 50-year-old man says, “I’ve been forced to move back in with my parents.”

Fisher’s case isn’t unusual. According to the U.S. Drug Enforcement Administration, doctors all over the country have been or are being targeted. Professor Ronald Libby of the University of North Florida, who has a book coming out on the topic, said the DEA began targeting pain doctors in 1999. That’s the year a General Accounting Office report rebuked the DEA for failing to decrease the illegal drug supply, despite a 30-year effort armed with an annual budget of billions of dollars.

Shortly after that GAO report, Libby says, the Department of Justice identified prescription drug abuse as the “primary drug threat to the U.S. population,” and two years later put a plan in place to go after licensed doctors. Prescription drug abuse became a measurable, achievable way for the DEA to justify its budget. A federal prosecutor in Alexandria, Va., told the Washington Post at the time, “Our office will try our best to root out [prescription pain doctors] like the Taliban.”

The media gladly assisted. Despite little supportive evidence, television and newspaper reporters spun up a maelstrom of coverage on how prescription painkillers such as Oxycontin had become the designer drugs du jour. In 2003, the Orlando Sentinel published what was probably the height of the hysteria with a series called “The Accidental Addict,” about doctors who unknowingly addict their pain patients to opioids.

After months of criticism from patient advocates who poked gaping holes in the series, the paper finally printed an apology and retraction.

But by then, the painkiller myth had been loosed, and local, state and federal officials were collecting trophies. Estimates vary among patient advocates, researchers and the DEA, but between 50 and 300 doctors per year have been brought up on federal charges related to prescribing high doses of narcotics since 2001.

According to the Pain Relief Network's Sioghan Reynolds, many more have been prosecuted at the state and local level. Others have lost their medical licenses, or had their malpractice insurance cancelled. Consequently, Reynolds said, the number of doctors willing to treat chronic pain has dwindled, and even among those remaining, there’s a growing fear of prosecution, meaning most will err on the side of under-treatment.

[Suetaznote: The whole point of this was to make it look like the DEA was earning it's huge budget and all they have done is cause a huge amount of suffering among those in chronic pain. No wonder there aren't enough doctors to go around when the DEA is scaring and manipulating them. If doctors are so afraid to prescribe pain killers for chronic pain, it's no wonder they are afraid to prescribe medical Marijuana.]

Of course, under-treating pain can subject those same doctors to malpractice suits from frustrated patients. For doctors, it’s damned if you do, damned if you don’t. It’s of no surprise then that many of them have fled the field altogether, Reynolds said.

That’s devastating news for the 48 million Americans who suffer from chronic pain. For them, it’s getting more and more difficult to get a prescription for the drugs they need. And they’re turning to ever more desperate measures for relief.

That’s what happened with Florida pain patient Richard Paey. After a car accident and a botched back surgery confined him to a wheelchair, Paey developed multiple sclerosis. He moved his family to Florida in 1994, but had trouble finding a doctor willing to write the prescriptions he needed.

Out of desperation, Paey turned to his former doctor in New Jersey, who wrote Paey undated prescriptions, which Paey then photocopied. Paey’s prosecutor acknowledged that all of the medicine in Paey’s possession was for his own use. Nevertheless, he charged Paey with intent to distribute. After three trials, Paey was convicted. Mandatory minimum drug sentencing laws gave Paey’s judge no choice but to send him to prison for 25 years, with a $500,000 fine. At least one juror has since expressed regret for the verdict. Paey today sits in his wheelchair in a Florida penitentiary.

This crackdown on pain medication is obscene. We now have a system where law enforcement officials tell doctors how to treat their patients. Physicians are required to turn in patients they suspect of opioid addiction. At the same time, cops are posing as pain patients attempting to lure doctors into writing bad scripts, or threatening patients with prosecution unless they testify against their doctors.

The result, patient and doctor advocates say, is that pain patients don’t trust their doctors, and pain doctors don’t trust their patients. It casts a pall over the doctor-patient relationship, and makes honest dialogue between the two impossible. It’s a disgrace.

The Pain Relief Network and the American Association of Physicians and Surgeons report that many of the patients of doctors either prosecuted, suspended, or otherwise run out of the field by this ugly new face of the drug war have deteriorated into dysfunction, lost their jobs, endured divorce or other shattered relationships, or turned to underground drugs for relief. Many have committed suicide.

Two patients interviewed for this column say they’re down to their last doctor, and they’re fearful of what they’ll do if that doctor gets targeted, or decides treating pain patients isn’t worth risking his savings, his license, or his freedom.

There are tens of millions of Americans in chronic pain, some of it unimaginably severe. At the same time, we have an abundant supply of drugs with a proven record in alleviating their suffering. It’s shameful that America’s backward, uncompromising drug war has built an ever-widening schism between the two.

[Suetaznote: I wonder how many people living in chronic pain have started growing their own Marijuana and taking their chances at getting caught. They would either have to get prescription drugs illegally or buy illegal Marijuana or grow it.

The devastation and the destruction of lives that the DEA is responsible for is mind blowing. I honestly don't know how anyone could work for the DEA and be proud to admit it. When Montel Williams was explaining to his audience why the government hasn't legalized medical Marijuana, he said, "follow the money trail!" That's all the DEA cares about, they obviously don't care about humanity or compassion.]

Radley Balko maintains a Weblog at: www.TheAgitator.com.

__________________

 

xxdr_zombiexx

[zombienote: The DEA takes pride in gleefully pursuing medical doctors.]

Appointment With Dr. Feelscared
By Maia Szalavitz, Reason. Posted September 7, 2004. | AlterNet

Why are millions of Americans being undertreated for pain? Because prescription painkillers have become the new frontline in the 'drug war.'

On Feb. 1, 2002, Cecil Knox was seeing patients in his Roanoke, Virginia, clinic when more than a dozen federal agents burst through the doors with guns drawn. Helmeted, shielded, and wearing bullet-proof vests, they terrified waiting patients and employees. One worker later told the Pain Relief Network, a patient advocacy group, she thought she and her husband, who was helping her in the office that day, would be shot. She looked on in horror as an agent put a gun to her husband's head and ordered, "Get off the phone! Now!"

Knox, a pain management specialist who had been practicing medicine in Roanoke for seven years, was dragged out in handcuffs and leg irons. The local U.S. attorney's wife, a TV reporter, was among the journalists tipped about the raid in advance. She stood outside with a gaggle of other media people to announce her husband's triumph. Knox's assets were frozen and bond set at $200,000.

He and several employees soon faced a 313-count indictment, including charges of drug distribution resulting in death or serious bodily injury, prescription of drugs without a medical purpose, conspiracy, mail fraud, and health care fraud. Prosecutors said Knox had illegally distributed millions of dollars' worth of OxyContin, a timed-release version of the narcotic painkiller oxycodone.

William Hurwitz, a McLean, Virginia internist and prominent pain specialist, received similarly heavy-handed treatment when he was arrested last fall. Hurwitz, who is Jewish, was visiting his children on Rosh Hashanah eve when federal agents descended upon his ex-wife's house in McLean and took him away in handcuffs. As with Knox, the government froze Hurwitz's assets; his bail was set at $2 million. He was charged with 49 felony counts, including drug trafficking resulting in death or serious injury, conspiracy and running a criminal enterprise.

Like Knox, Hurwitz attracted attention largely because of his OxyContin prescriptions. Attorney General John Ashcroft said "the indictment and arrests in Virginia demonstrate our commitment to bring to justice all those who traffic in this very dangerous drug." Prosecutors said Hurwitz was "no better than a street corner crack dealer" who "dispenses misery and death." Assistant U.S. Attorney Gene Rossi had earlier declared that the feds would "root out" such doctors "like the Taliban."

[zombienote: Federal prosecutors DO act just like the Taliban - what an oddly honest claim for this man to make...]

Knox and Hurwitz are just two recent targets of an aggressive push by the Drug Enforcement Administration (DEA) and the Department of Justice (DOJ) to impose their judgments about the proper use of opioid painkillers (drugs derived from opium and synthetics that resemble them) on doctors throughout the country. In their attempt to prevent prescription drug abuse, the DEA and the DOJ in effect have taken upon themselves the authority to regulate the practice of medicine, traditionally the province of the states. Worse, they have transformed disagreements about treatment decisions into criminal prosecutions, scaring physicians away from opioids and compounding the suffering of patients who have trouble getting the drugs they need to relieve their pain.

[zombienote: That's some good work! The DEA and DOJ have accomplished. Ashcroft has totally failed in the "war on terror" but has managed to arrest medical doctors and Tommy Chong, and medical Marijuana providers. See: Ashcroft is 0 for 5000]


Drug Control vs. Pain Control

Few disagree that pain is already poorly treated in the U.S.

"Even the DEA admits that 30 to 50 million people are undertreated for pain," says Ronald Libby, a professor of political science at the University of North Florida who has studied the issue. A 1999 survey of 805 chronic pain patients conducted by Roper Starch for the American Pain Society and Jannsen Pharmaceutica found that roughly half of those with serious chronic pain could not find relief – and that the more severe the pain, the less likely it was to be alleviated.

Other surveys have yielded similar results. Only a tiny fraction of the nation's nearly 1 million health care professionals licensed to prescribe controlled substances are willing to consistently use opioid medications, recognized as the best drugs for severe pain. A 2003 analysis by the Ft. Lauderdale Sun-Sentinel found that less than 3 percent of Florida's doctors prescribed the majority of opioids for Medicaid patients there.

During the 1990s, pain experts, patient advocates and drug makers sought to reduce exaggerated fears about opioids and increase prescribing. Research and clinical experience had shown that few patients without a prior history of serious drug abuse get hooked on narcotics during pain treatment, resulting in addiction rates no higher than those seen in the general population.

In one important study, reported in the journal Pain in 1982, the researchers surveyed 181 staffers of 93 burn units who had seen more than 10,000 patients and worked in the field an average of six years. Most patients had been given opioids to cope with agonizing debridement treatments, but the staff could recall no cases of addiction in anyone without a prior history of it. A study of 100 people taking opioids for chronic pain over prolonged periods, reported in the Journal of Pain and Symptom Management in 1992, likewise found that none became addicted.

No new evidence has contradicted this research, and a study of prescribing from 1990 to 1996, published in 2000 in The Journal of the American Medical Association, found that massive increases in the use of particular opioids were not associated with proportional increases in misuse; in fact, as use of some medications rose, emergency room "mentions" of them dropped.

But in the minds of police and prosecutors, such reassuring findings were overwhelmed by concerns about what was dubbed the OxyContin "epidemic." Introduced by Purdue in 1995, OxyContin was designed to deliver steady pain relief over an extended period of time, avoiding the peaks and valleys of shorter-acting pills that have to be taken several times a day. It soon became a $1 billion blockbuster. When illegal drug users figured out how to defeat its timed-release mechanism and get all the oxycodone at once, street demand – and media coverage – soared.

Most news stories neglected to mention that OxyContin abusers generally were not new addicts freshly minted from innocent patients by irresponsible doctors. Rather, they were drug aficionados who scammed physicians for the latest media-hyped high. According to data from the federal government's National Survey on Drug Use and Health, some 90 percent of illicit OxyContin users have also used cocaine, psychedelics and other painkillers. The typical profile is a person who has abused many drugs in many combinations for many years. OxyContin poses no greater addiction risk than other opioids when taken as directed. But the media helped teach addicts and thrill seekers how to do otherwise.
[SNIPPED - Lengthy - Go To Original]



[zombienote: Meanwhile......just trying to get decent basic medical care is difficult for most Americans.

The efforts to curtail medical Marijuana use are nothing but crimes against humanity. Marijuana prohibition and the broken mentality that goes with it spreads disease, pain, suffering, and death.

It APPEARS that eliminating Marijuana smoking is more important than providing aid, treament, and comfort to the ill and dying.]


Poor Medical Treatment Kills Thousands in U.S., Says New Report on Health Care Quality
ABC News

WASHINGTON Sept. 23, 2004 — Requiring doctors and hospitals to report publicly on their performance and tying their pay to the results would dramatically reduce avoidable deaths and costs attributable to poor medical care, says a new report from an organization that works to improve health care quality.

Wild variations in medical care led to 79,000 avoidable deaths and $1.8 billion in additional medical costs last year, the private National Committee for Quality Assurance said in its annual report released Wednesday.

[zombienote: During that same period, millions of people used Marijuana medically with no reported fatalities - only arrests and harrassment. Note: I smoke pot and have for 25 years - I'm still alive and kickin'...]

The report described a substantial gap in quality between the best providers and the national average for treating a range of common conditions that would not be tolerated in almost any other sector of the U.S. economy. For example, failure to control high blood pressure resulted in up to 26,000 deaths last year that could have been avoided with competent medical care, the report said.

The differences in health care quality persist even as health insurance premiums have risen by more than 10 percent annually for the past four years. "This report underscores that all too often we are not getting good value for that money," said Peter V. Lee, president and chief executive of the Pacific Business Group on Health, a coalition of businesses that provide health insurance to 3 million people.

On the other hand, the report found that health insurance plans that publicly report their performance showed marked improvement in most areas, including cholesterol management, diabetes care, breast cancer screening and flu shots for adults.

Better control of blood pressure will lead to 2,500 fewer fatal heart attacks in 2004, the report said. Health plans also did a better job of reducing cholesterol levels among patients with diabetes, it said.

But those plans cover only about a quarter of the U.S. population, about 69 million people.

"The data we have tell a great story, health care quality is improving consistently and dramatically," said Margaret E. O'Kane, NCQA's president. "Why don't we have performance data for the other 75 percent of the U.S. health care system?"

Last year's Medicare prescription drug law took a step in this direction by linking a small portion of Medicare payments to hospitals' willingness to submit quality data and conducting trial runs that tie pay to performance for some health care providers.

One notable exception to the upward trend in quality was treatment of mental illness, which showed no improvement over 2002.

"Patients get the correct care only about 50 percent of the time," the report said.

[zombienote: And the DEA is directly involved in this complex equation.]

Harvard Pilgrim Health Care of Massachusetts was the top-rated health plan for both clinical care and member satisfaction, the report said.

__________________
Alien Space Signal

There's no money for your issue so long as we're squandering $50 billion a year on the DrugWar. Ben Masel

Fear became the ultimate tool of this government - V.

xxdr_zombiexx

Health Care in America

And Then I Got Sick...
By LORI SMITH | COUNTERPUNCHWeekend Edition | September 18 / 19, 2004

Four and a half years ago I was a single mom climbing the corporate ladder. I had a happy and healthy daughter, a secure job with great benefits and the respect of my colleagues. Life was good.

Then I got sick.

I was diagnosed with Lupus and Multiple Sclerosis and after a series of events, I was fired from my job. Needing health insurance now more than ever, I signed up for COBRA, my only option for health care coverage at the time. The monthly premiums were very expensive and my financial resources were dwindling quickly.

I was scared, I was nearly broke and I was sick.

It was a hands-on lesson in just how quickly your life can change and how quickly you can lose everything. It was also a tough dose of reality to learn that insurance companies aren't out to protect you. They're out to make money. And you aren't guaranteed health care in this country no matter how sick you are.

When I could no longer afford COBRA, I applied for and received TennCare, Tennessee's health care program for the poor, disabled or uninsured. At the end of the year, an administrative error made by the TennCare Bureau accidentally kicked me out of the program. I went without health insurance and health care for nearly six months. After months of wading through administrative red tape, I was allowed back into the program. I qualify for TennCare because I am uninsurable.

[zombienote: Tenncare is a model of how badly something can be screwed up.]

Just when I thought I finally had some peace of mind and my health care needs would be met, I learned of Governor Bredesen's plan to reform the TennCare program by making drastic and life-threatening cuts.

The Governor's proposal is radical and unprecedented. If this is passed, other states and private insurance companies will follow suit. We will be stripped of our rights and people are going to die.

He's on a mission. And so am I.

I'm literally fighting for my life and the lives of everyone in this country. And I'm asking you to join with advocates and me to help stop this from happening before it's too late - for all of us. How Governor Bredesen's Reform is Going to Harm--or Kill--Me and Thousands Like Me

Under Governor Bredesen's TennCare reform, enrollees will be classified into groups. The group you fall into determines your benefit limits. Regardless of the group, all enrollees will be subjected to--and adversely affected by--the new "medically necessary" term.

I belong to the "able-bodied" class, which is above the poverty level. This means I will:

. Pay a monthly premium

. Pay co-pays for doctor visits and prescription drugs

. Be limited to 10 doctor visits per year (I have just had my 18th doctor visit this year with additional visits pending)

. Be limited to 10 labs/x-rays per year (I've had over 22 with more are scheduled)

. Be limited to no more than 6 prescriptions per month (At times, I have exceeded 9 per month)

Note: In June, I had my 10th doctor visit and labs/x-rays. Under the proposed reform I will have no coverage for the rest of the year! But I will still have to pay the monthly premium!

The Governor's Story

After graduating from Harvard in the 1960's, Phil Bredesen took a job as a computer programmer but had a desire to get into public office. In 1972 he entered the race for a Massachusetts state Senate seat and lost.

In 1975, Bredesen and his wife moved to Nashville after she accepted a nursing job in the city. The connection to the medical field would prove profitable for Bredesen. He began working for Hospital Affiliates International selling hospital contracts. The board for Hospital Affiliates International gave Bredesen the capital to start his own company, HealthAmerica, a firm that bought failing HMOs and repaired them. Bredesen put $10,000 into the business; when he sold it in 1986 he was a millionaire.

Needless to say, Governor Bredesen has a significant financial interest in HMOs. The Big Picture

HMOs are winning big from the existing political system. A recent study found HMO profits increased 52 percent last year alone, meaning an extra $2.3 billion was pilfered from American consumers. These are the same companies that since 2000 gave at least $13 million to President Bush and key Republicans in Congress, and who have seven former or current executives in the president's "Pioneer" club (those who gave him $100,000 or more).

Those campaign contributions bought policies that favor their agenda or actually remove the government from the market entirely. HMOs: Getting Away with Murder?

Yep. And murder is legal now.

On June 22, 2004, the Supreme Court ruled that patients cannot sue HMOs for denying needed health care--even when improper denials have tragic consequences. This means that HMOs get off the hook from any liability and will no longer be deterred from making improper decisions that could severely harm patients.

Lori Smith can be reached at: llsmith36@aol.com

[zombienote: This lady can most likely get some various pallative and actual relied form cannabis as it is well-proven to work for MS sufferers.

Pay and/or die, but do not smoke pot for any reason! Especially medical reasons. Suffering is a growth industry.]

Suetaz

Wow. Health care in the US isn't really health care or even about one's health or care. It's all about money.

If the US is supposed to be such a proud nation, how does the government expect the citizens to be proud of their government and therefore proud to be American when the government treats them like this?

Living in a country with free medical care, it's hard for me to imagine what it would be like to have to shop for insurance or to not be able to get medical care. Our system is far from perfect, but we don't let sick people die because we couldn't care less. At least in Canada, we take in the sick first and ask questions later about payment.

Here's an article that quotes Canada's ex-Prime Minister, Jean Chretien on how Universal Health Care Works.

[SNIP]
Health care has become a major political issue in the United States because of skyrocketing costs for medical services and drugs. An estimated 45 million Americans have no health insurance.

In Canada, everyone is covered.

"Our system is functioning very well, relatively speaking," Chretien said. "It's a benefit to everybody. When you go to a hospital in Canada, they take you first. They don't ask you who will pay. They ask what is your problem."
[SNIP]

It's not like the US can't afford it, they just prefer to waste the money on the war on drugs and the DEA. What kind of government chooses to give money to the DEA over providing health care for it's own people? It certainly doesn't sound like a government for the people.