DEA steps up its efforts to make life miserable for people in chronic pain

Radley Balko comments on a Reuters article about the DEA's vigorous campaign to make life miserable for doctors, pharmacists, and pain patients.

The DEA is now quite literally treating doctors and pharmacists like potential drug dealers.

The agency has expanded its use of tactical diversion squads, which combine special agents, diversion investigators and local law enforcement officers to track down and prosecute prescription drug dealers.

Forcing the two sides to come together was not easy at first, Leonhart said, since special agents initially were reluctant to work on “pill cases.”

But the effort has shown some results. Asset seizures on the diversion side rose to $118 million in 2011 from about $82 million in 2009, Leonhart said.

That’s a telling metric, isn’t it? The same drug warriors who tell us prescription overdoses are skyrocketing claim, at the same time, that their decade-long anti-diversion efforts are working because . . . the government has been more successful at taking money and property away from people. Let’s not forget that in a civil asset forfeiture case, the government needn’t even charge you to take your stuff, much less convict you.

Reuters on the Painkiller Issue

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The Snowden Principle

jandrese

Technically, Pharmacists ARE drug dealers, it’s what they do.
- Ito Kagehisa
  
  Yeah, but see, there’s these other drug dealers who aren’t paying the vigerish to the house, see? And we want people to know that something might happen to these low-lifes, see? You’ve got to have protection to do business, see?
  - psulli
    
    Your comment has accrued some very nice likes I see. It would be horrible if anything would to happen to them likes. A nice comment like that one probably would need some protection, if you don’t mind me saying …
blueelm

It is a telling metric. People continue to abuse drugs. People continue to OD. But look… we’ve taken lots of other people’s stuff so it’s all good!
http://twitter.com/writebastard Ian Wood

This is entirely the result of the DEA’s failure to provide clear and proper guidance for the legitimate distribution of opioid pain relievers. It is Kafkaesque: no set rules, any of which dispensaries, doctors, and patients can be arrested for breaking at any time with no warning.

The simple fact is that the United States government is run by ass-covering bureaucrats. Vote for Obama. Vote for Romney! Doesn’t matter. The bureaucrats remain.
- Cowicide
  
  Vote for Obama. Vote for Romney! Doesn’t matter.
  
  I agreed with you until you got there. Actually, it really does matter. A LOT. Please, for the love of God, look at their voting records overall:
  
  http://votesmart.org/
  - Antinous / Moderator
    
    You crazy kids and your facts.
    - Ito Kagehisa
      
      Facts! Phhfft. Facts are meaningless. You could use facts to prove anything that’s even remotely true! –Homer Simpson
    - Cowicide
      
      Pesky!
  - Ultan
    
    That site has no information on Romney votes or positions. (Which no doubt is how Romney wants it.) Obama’s record is basically similar to Bush, though Obama may actually be even more conservative/fascist than Bush when it comes to expanding executive power and seeking revenge against whistleblowers. At least Cheney had the grace to cover up the assassination program. Sadly, it appears that Romney has less of a criminal record in public office than Obama, though most of that is likely just less opportunity.
    - Cowicide
      
      That site has no information on Romney votes or positions.
      
      Actually, it does:
      
      http://votesmart.org/candidate/political-courage-test/21942/mitt-romney/
      
      And there’s more if you search his name, etc.
- Boundegar
  
  I agree! Let’s all go to a land with no bureaucrats! Where laws are enforced by wise people who aren’t bureaucrats at all!
Ambiguity

Once, during campaign season, I ran into someone running for county prosecutor at the post office, handing out leaflets and trying to drum up support.

Her main campaign platform seemed to be “sticking it to the drug dealers and bad guys through seizure and forfeiture.” I told her that system had been widely abused, that all the time people were having their property taken from them without so much as a charge being filed, that the system was fundamentally flawed and unjust, and, oh yea, I wouldn’t be voting for her.

She seemed fundamentally, honestly bewildered. It was as if I were speaking a foreign language, as if to say anything other than “hell yes!” to the tough-on-crime BS was incomprehensible. She said she had never heard of anything like that before, and for some reason I believed her. The fact that the prosecutors could be on the wrong side didn’t seem to exist in her little universe.

I literally think that public officials (especially in smaller offices) can at times go through an entire career with crazy, hate-filled “tough on crime” rhetoric and never be called on it. That’s why it’s important to call them on the BS. It’s one thing for them to be lying sacks o’ excrement, but compassion forces us to try to prevent them from actually falling for their own crap.
http://twitter.com/rvitelli Romeo Vitelli

It’s hard to see even the DEA managing to make a dent in the prescribing of pain medication across the US. According to the Institute of Medicine, an estimated 116 million American adults deal with chronic pain - more than all patients directly affected by cancer, heart disease, and diabetes combined. Medical treatment and lost productivity related to chronic pain costs more 635 billion U.S. dollars each year. That means that 10 per cent of all prescriptions written by doctors in the US is for pain medication (most of it opioid). Good luck controlling that.

http://drvitelli.typepad.com/providentia/2011/07/116-million-in-pain.html
Powell

This country just sucks now.

I have seen this personally lately with the difficult my wife has had getting pain killers after her SPINE SURGERY.
- Cowicide
  
  I’ve found that coping with a loved one who is dealing with a major health issue within this American for-profit health care system does wonders for lowering one’s opinion of this country and many of its duped inhabitants.
- awjt
  
  I had no problem getting painkillers after my surgery… SHITTY ONES THAT DIDN”T WORK
  - Antinous / Moderator
    
    Tylenol with codeine? Do they still give that crap out? It’s not any stronger than ibuprofen and it makes a lot of people really nauseated.
    - awjt
      
      It was oxycodone, and I hated it. Constipated and extremely agitated. Some people love that stuff, I hear, but it seriously didn’t work for me. By the time I was going to call and ask for something else, I didn’t need it anymore and was on Advil/Aleve. Next time…
      - Antinous / Moderator
        
        Oxycodone and hydrocodone can both be slightly speedy, which works out fine for a lot of chronic pain patients who also have fatigue issues, but might not be so great for everybody. Constipation’s a pretty common complaint.
    - Ito Kagehisa
      
      Ibuprofen in sufficient quantities to manage a migraine gives me black tarry stools (aka internal bleeding), although it’s not as gastrointestinally nasty as cafergot.
      
      Sufficient quantities of tylenol3 or vicodin merely destroy the liver, which is much less uncomfortable in the short run. I don’t get any nausea from APAP.
      
      Straight codeine would work perfectly (I don’t have any opiate allergies) but the doctors won’t give me that, because the DEA would come down on them. They’d rather systematically wreck my liver than lose their ability to practice, I guess; and it’s hard to blame them for that. As Opus the Penguin said, “I prefer to blame Congress”.
      - Antinous / Moderator
        
        I wish they would get the Tylenol out of those compounds. The FDA is recommending it. But I’ve been on Vicodin for about 15 years and my liver function tests haven’t changed. I suspect that a lot of people really do take more than the maximum.
http://www.jimdraws.com Thorzdad

As someone who has been through two back surgeries, I find this seriously distressing. Even though I’m more-or-less recovered from the last surgery, I still have occasional periods where I need to take a serious pain-killer and lay-out for the day.
http://www.aarongilliland.com/ Aaron Gilliland

Ohhhh, assets and property are correlated with being a drug dealer, so by removing assets and property you take away the ability to deal drugs.
DamnitDani

They’ve done so well reforming those fiendish doctors in Broward County.
Jen Onymous

The flipside of the problem is rampant “pill milling” by SOME doctors which makes life hell for real doctors.

Case in point:

Exhibit A: I have a family member who is a pain-management specialist, specializing in facial pain (think chronic pain from having your jaw busted open in any number of awful ways, etc). He went into the field after surviving spinal cancer himself, which meant that he had to abandon his dental practice. He has a TENS unit installed at all times, hex nuts up and down his back under the skin from his spinal stabilizers, and tons of drugs on him at all times for himself as needed. Luckily (sort of, in a gross way) his way to get out of getting harassed at airports is for him to per-emptivly remove his shirt (this exposing said hexnuts, scars, TENS needles, etc). They pretty much tell him to put his shirt back on and wave him through. BUT his practice (he’s part of a larger group) gets audited CONSTANTLY for every scrip they write, even when they have supersolid evidence for diagnosis (X-rays, surgical reports, accident reports, etc). The irony is that insurance companies have also become crap at long-term payment for NON-drug pain relief items (ie TENS units, physical therapy, non-medical device pain relief things like gel pillows/orthodics/swimming therapy/etc). My relative spends more time doing the justification answers to greedy health insurance companies and suspicious law enforcement bodies than diagnosing and treating new patients, which is tragic.

Then…

Exhibit B: Several years ago I was going through a rather rough patch and my then-MD refused to give me any sleeping aids whatsoever. I found a local shrink who suggested that I try Xanax and a few other things. And I mean a LOT of Xanax. After calling Relative listed in A above, he suggested that I just take less than what she was prescribing. She was also over-prescibing some really bananas items as sleep aids, including a VERY strong tranquilizer normally used as a precursor to anesthesia for deep surgery. No, I still couldn’t get some damn Ambien from her. Long story short, she moved down to FL, and kept FedExing me scrips after “phone sessions.” Then she just…vanished, after one scrip delivery done by hand by one of her “New York office assistants.” Luckilly I had been hoarding my Xanax so I didn’t have to deal with cold turkey. The kicker: About 3 weeks later, I get a call from someone claiming to be the Sherrif’s department in Broward County. It sounded like bullshit so I asked for a contact and a return number. Having verified that it really was them, I called back. Turns out that they raided her office for pill milling, and (ILLEGALLY, btw) went through her patient contact book in an effort to find her whereabouts. They didn’t give me a hard time (it woulda been hell going through the motions on that, glad they let it go) once I said that she left NYC months ago, and thanked me for my time.

So, you have doctors creating addicts to keep business going, insurance companies who ONLY pay for pills and damn little else, overzealous anti-drug hysteria on the part of the folks with badges and guns, and good doctors getting stuck in the middle as patients suffer. A totally toxic stew.

PS–My current MD gladly writes me for Sonata now for my chronic insomnia, but I have to go through a convoluted route to get Xanax from the “prescribing doctor” for a therapist. Luckily they are affiliated with a major medical center so it all is very legit and they have an army of people to deal with the paperwork bullshit, but it shouldn’t have to be this way.
flickerKuu

..Or we could just use a plant that grows everywhere, is free, and has zero side effects. If only we could find one…
- Antinous / Moderator
  
  Thanks, but I’ll stick with the semi-synthetic opioids since they actually work.
  - slayer1
    
    Thanks, but semi-synthetic (or real) opioids make me vomit uncontrollably out of both sides, and feel like I’m on a small boat in a large ocean. The plant actually works for me, I’d like to stick with it.
    - flickerKuu
      
      ^^ There are LOTS of people like this.
  - flickerKuu
    
    Cannaboids work fine as well, ask the thousands who use them. The problem with opioids is the terrible tax on your liver, and the physical dependancy issues it causes. Cannibis has none of those side effects, and all of the benefits. I would suggest you consider having a more open mind.
    - Antinous / Moderator
      
      The problem with opioids is the terrible tax on your liver, and the physical dependancy issues it causes
      
      The reason that opioids exist is that they work for pain control. Cannabis is not a serious pain control drug.
      
      Cannibis has none of those side effects, and all of the benefits.
      
      Of course it has side effects like any other drug. It’s a plant, not a magic ring.
      
      I would suggest you consider having a more open mind.
      
      I’m not the one suggesting that everybody should use only one drug for every situation.
      - awjt
        
        If I’m doubled over in pain, the LAST thing I wanna do is take a lung full of smoke or eat something that is going to make me belch grass clippings for 4 hours. HAND ME THE OPIATES -OIDS -UMS DON’T CARE PASS THE OPE!!!
      - donovan acree
        
        “Cannabis is not a serious pain control drug.”
        That depends on the type of pain and the person. Take glycerine based cannabis delivery for example. It’s applied topically and does wonders for neuropathic pain like HIV associated peripheral neuropathy. Opioids are the general treatment, however many people cannot handle opioids. With the nausea and vomiting associated with opioid intolerance, many HIV patients have found topical glycerine based cannabis to be the only option that works.
        
        There are other non-smoke cannabis options as well. For example, tincture drops under the tongue relieve pre-menstral cramping among women and give almost zero ‘high’.
        
        To say it’s not a serious pain control drug pretty much shows us you are uneducated on the subject. Plenty of patients would describe their cannabis treatment as ‘serious pain relief’ despite your arguments.
        
        I’d also like to know, what are the side effects of cannabis use you mention? Other than the well known and beneficial side effects of hunger, relaxation, and general feeling of well being, of course.
- Jen Onymous
  
  I don’t have a problem with marijuana, but don’t say that it has “zero side effects.” It’s not a panacea either, and it is NOT good for everyone; many people with head injuries and/or neurological conditions should NOT take it. Any cure can be a poison if taken in the wrong quantities for the wrong things.
  
  FWIW, my 2c re weed: Legalize it, tax it, etc.
  - flickerKuu
    
    It pretty much has zero side effects. Oh, you mean the munchies? Yeah- that’s a bad one. Read the side effects of your big pharma stuff. A lot worse. . People die every day from Pharma. 8000 people die from Aspirin a year. No one has Ever Ever Ever died from cannibis.
    - Jen Onymous
      
      flickerKuu,
      
      Well, I almost went into seizures from it, and I watched someone who had recently acquire a head injury actually go into seizures and had breathing/cardiac difficulties from it. After both incidents, looped back to my neurologist for a reality check, and yes, it happens.
      
      Yes, it happens, and no, it’s not a panacea. There’s people who will bleed to death internally from taking aspirin; nothing with benefits is “harmless” to 100% of the population.
      
      And no, I’m not trying to pick a fight with you and I am all for legalization. But don’t minimize potential bad side effects in some of the population either.
- malindrome
  
  Also: “is free”? I don’t know where you live, but it certainly isn’t free around here …
  - flickerKuu
    
    There’s this cool thing about plants, you grow them, they make seeds, you keep growing them forever.
    
    Or if you like the seedless variety, there’s cloning, where you can continually use the plant over and over “for free”. There’s no need to pay someone for a plant. It’s called farming, and people have done it for 30,000 years. Free yourself of the consumption mentality. You don’t always need to pay for things.
    
    In any case, paying for the plant I’m talking about is considerably cheaper than the alternative medicine, and to the original point of the article – harder to get.
blissfulight

The simplest solution is just to ban the DEA. Save money, fire a lot of incompetent bureaucrats and agents, everyone gets to relive their suffering in whatever way they choose.
http://anomicofficedrone.com/ AnomicOfficeDrone

If the War on Drugs is worth funding and the DEA is a good agency, why can I buy any drug in any city in America after a 40 year war on drugs?
- Boundegar
  
  Because shut up, that’s why!
Tiny Zombie

The linked article has the following quote:

“John Burke, president of the nonprofit National Association of Drug Diversion Investigators, says the DEA behaves as though those it monitors are the enemy.”

I can’t help but think the behavior is due to the rhetoric that gets thrown around in justifying this ‘War on Drugs’ that we find ourselves in. A war needs an enemy, in this case the enemies are doctors, pharmacists and patients. It is also because of this rhetoric that we have seen the rules of bank reporting, asses seizure, and medical reporting become what they are; not to mention the militarization of the police forces. Since the local police fores and DEA are allowed to share seized property amongst themselves the ‘War on Drugs’ has become an economic factor in the budgets of the agencies. To grow and stay alive they must be granted funds by the state, or go ‘make’ money any way they can.

With this mentality they can justify if a few dealers die in the process, so be it; if a few doctors loose their licensees, well they were drug dealers; patients in pain, they are addicts.
Not that I would ever want some one injured, but when agents and officers are injured and in pain, they will need these drugs. Imagine an agent going to her doctor for pain after a line of duty injury and being treated like a criminal addict.
http://profile.yahoo.com/IW5BSGBSBJFWZQXYH2HLV5S7KQ Trey

More Americans die from: Unintentional poisoning, C. Diff infection, Suicide, Alcohol and Tobacco usage. Why doesn’t Congress address these preventable deaths? Contact your Political leadership at http://www.regulations.gov to let them know people need to have Opiate Therapy to control their pain and to call off the DEA witch hunt. Helpful Hint: Ask your surgeon for your pain relief medicine BEFORE your surgery. This will benefit you by having your Opioid pain medication ready for you when you are released from the hospital. Also, if you know that particular pain reliever will not work, you can request a prescription for an effective Opioid medicine.
A good web site for chronic pain people is http://www.livinginpain.org.
Do not settle for pain, take the time and find a good pain management Doctor. For people starting the tough and time consuming mission to start pain management go to http://www.startingpainmanagement.com.