Editorial: What's the Real Reason? 3/5/04

David Borden, Executive Director, borden@drcnet.org, 3/5/04

As readers of this newsletter know, one of the most destructive problems in the drug war is the government's targeting (or lynching, it could be called) of physicians engaging in legitimate but enlightened treatment of severe, chronic pain with narcotics. Dozens of physicians have been prosecuted in recent years, their reputations smeared, their bank accounts depleted, in many cases their freedom taken away while they seek exoneration for the scurrilous accusations rogue DAs have brought against them.

Frequently the cases against these doctors collapse. The murder charges brought against Frank Fisher for three patient deaths were withdrawn when the California prosecutors realized they wouldn't fly -- one of the purported victims was killed in a car crash, for example -- she was a passenger in the car. All of a huge number of counts against Virginia's Cecil Knox were voted down by a jury, except one juror among twelve kept some prescription fraud charges alive for the monster prosecutors to retry him on. After publicly labeling Tucson, Arizona, physician Jeri Hassman "a drug dealer with a pen," prosecutors (persecutors) dropped 358 charges against her; Hassman made a deal to end the ordeal, in which she plead guilty to four counts of not informing authorities that some patients had apparently made use of some pills that had been prescribed to family members. (I hope my doctor would respect my privacy that much.)

Sometimes, unfortunately, a doctor is convicted because jurors who trusted the state a little too much couldn't believe officials would deceive them so outrageously so it had to be true, or their defense lawyers didn't manage to make the true case well enough. And sometimes, of course, there is actual prescription fraud, some few bad doctors abusing the system, some addicts or people selling to addicts, who also may need safe and legal supplies of their drugs but whose use of them isn't sanctioned by the government.

In all such cases -- the court victories, the defeats, the actual abuse -- the result of law enforcement's pogrom against pain treatment is the same: patients living or dying in severe, continuous pain can't get the medicine they need for relief. It doesn't matter that only a small handful of doctors get destroyed by the federal and state villains. Even just one or two would be enough to scare the rest of the doctors. And medicine is thereby undermined, patients in great pain subjected to needless agony, in effect torture, for no legitimate reason or benefit to themselves or society as a whole.

In the face of such terrible, evil misconduct, such great harm done to our nation's most vulnerable and suffering, the new national drug control budget offered by the Office of National Drug Control Policy (ONDCP, drug czar John Walters) proudly proclaims a war on "doctors shoppers" (patients) and "pill mills" (doctors). How can they do this, and why is it happening?

It's not because of the severity of the prescription abuse problem -- the numbers just don't compare with many other social ills -- and it's not because prescription enforcement has a record of reducing addiction in the past -- everyone knows that addicts will find the drugs they want, or substitutes for them, somewhere or somehow. Prohibiting those drugs and attempting to enforce that prohibition only makes the drugs more expensive, increasing the incentive to divert them to the black market and the inevitability that such diversion will occur.

I suggest an alternative explanation: The prescription abuse focus may have been suggested by the same prosecutors who have colluded nationally the past few years to bring the wave of prosecutions against good pain doctors, or who hope to participate in the next wave. Their purpose, conscious or subconscious, is the likelihood that taking down a doctor will help them get on television and in the papers. Win or lose the cases, the name recognition gained from the publicity, to the public and within their profession, will help them when they later seek to run for higher elected offices or apply for high-level appointments in Washington's Department of Justice or their state capitals.

And if they have to destroy a few good doctors to get there, and indirectly destroy hundreds of thousands of patients, so be it. Apparently, at least.

-- END --

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