This Will Make Your Blood Boil

Our new ombudsman has an infuriating piece about what can only be described as malicious prosecution:

Siobhan Reynolds entered this fray when her late ex-husband Sean, began suffering the symptoms of a congenital connective tissue disorder that left him with debilitating pain in his joints. After trying a variety of treatments, he found relief in a high-dose drug therapy administered by Virginia pain specialist William Hurwitz. But Hurwitz was later charged and convicted on 16 counts of drug trafficking. The judge acknowledged that Hurwitz ran a legitimate practice and had likely saved and improved the lives of countless people. His crime was not recognizing that some of his patients were addicts and dealers. Meanwhile, Reynolds’ husband died in 2006 of a cerebral brain hemorrhage, which she believes was the result of years of abnormally high blood pressure brought on by his pain.
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All of this moved Reynolds to start the Pain Relief Network, a shoestring nonprofit that advocates on behalf of pain patients and physicians. Reynolds quickly learned how to convey the frustration of pain patients and their families. I first met her at a 2005 Capitol Hill forum. She had the entire room in tears. I later commissioned and edited a paper for the Cato Institute about painkiller prosecutions.

***

In 2007, Treadway announced the indictment of Kansas doctor Stephen Schneider and his wife Linda for overprescribing painkillers. The indictment followed a familiar pattern: Treadway held a press conference, used terms like “pill mill” and “drug dealer,” and, with the aid of some questionable science, linked the Schneiders to 56 alleged patient overdose deaths (Wichita Federal District Court Judge Monti Belot later reduced the number to four). Reynolds went to work on the Schneiders’ behalf. She organized patient protests outside their closed clinic, and encouraged them to speak out about how Schneider’s treatment had improved their lives. She paid for a billboard proclaiming the Schneiders’ innocence

The savvy and unusual countercampaign didn’t sit well with Treadway. She first tried to get a gag order preventing Reynolds from talking about the case in public. Judge Belot said no. Several of Schneider’s patients say they were then visited by federal agents, who forced their way into their homes and took documents (including a letter Schneider had sent one of them from prison). Treadway next asked the judge to move the case out of town, arguing that Reynolds’ advocacy had tainted the jury pool (never mind Treadway’s own press conference). Belot denied the change of venue request, too.

Treadway then launched a grand jury investigation of Reynolds, presumably for obstruction of justice, though she told Reynolds’ attorney that she would neither confirm nor deny that an investigation was under way. She issued Reynolds a sweeping subpoena demanding all of her records for every case in which she has ever advocated on behalf of a doctor or patient—every e-mail, letter, and phone record, as well as Facebook wall posts and status updates. Complying cost Reynolds tens of thousands of dollars and hundreds of hours of labor. With help from the ACLU, Reynolds sued to have the subpoena quashed. She lost. A second judge, Julie A. Robinson, hit her with a $200 fine for contempt each day she didn’t comply. Robinson also declined Reynolds’ request to make the subpoena and related proceedings public, effectively imposing a seal on the subpoena, Reynolds’ challenge to it, and any materials related to either.

In the meantime, the Schneiders were convicted in federal court of drug trafficking. During their sentencing, Federal District Court Monti Belot called Reynolds “stupid” and “deranged,” and referred to the Pain Relief Network as a “Bozo the Clown outfit.”

You really need to read the entire piece. It’s just outrageous. There is something seriously wrong with Drug Warriors.

I’ve always been angry about this treatment of pain providers for a while, but my shoulder injury in January-March really brought the issue home. When you are in chronic, excruciating pain, anyone standing in between you and relief is just a monster. When I was sitting there for three months feeling like someone was stabbing me in the shoulder with an ice pick, pain medicine was a survival necessity. People in pain aren’t taking pills for the “high.” Hell, I bet a lot of pain users were like me- the drug somewhat stopped the pain, but brought on all sorts of other nasty side effects, like a histamine effect, and lethargy and confusion, etc., but the pain was so bad the trade-off was worth it. And under-prescribing pain killers out of fear of prosecution is as clear an example of the government getting in between you and your doctor as is possible.

This really is sick.

50 replies
  1. 1
    scarshapedstar says:

    Our new ombudsman

    Are you saying that E.D. Kain and Radley Balko are one and the same?

  2. 2

    Dude, come on, you know our motto for the drug war:

    “Better a million people suffer needlessly, cops and citizens get killed, the Constitution get shredded, and we empower ruthless vicious killers and terrorists, than one addict get high.”

    Do you want the DFH’s to drag this country to a drug fueled, free love hell, man?

  3. 3
    Maude says:

    Pain med acts differently when someone is in pain. It is used by the brain to dull the pain.
    btw, what does Rushbo do for that back pain now?
    In one of the far north countries, they use opiates for pain and found that people didn’t feel high at all after a couple of weeks and they could function.
    This is Nixon all over again.
    The DEA scares doctors.
    I have read that in pain management, patients are drug tested if they are on opiates.
    This is a real problem and it doesn’t look like there’s a solution on the horizon.
    I don’t care if a chronic pain sufferer gets as high as a kite as long as the pain is held down to an acceptable level.

  4. 4
    evinfuilt says:

    @Comrade Dread:
    I wish that wasn’t so accurate.

  5. 5
    beltane says:

    DKos’s DarkSyde has an excellent diary up about his personal experiences with this: http://dailykos.com/story/2010.....ug-problem

    Funny how the Death Panel crowd never gets worked up about this kind of government intrusion into their lives.

  6. 6
    Erik Vanderhoff says:

    I admire how Balko can be a complete douchenozzle to you, John, and you still have the integrity to highlight work of his you feel is noteworthy.

  7. 7
    Maody says:

    these people, the DOJ, prosecutors, judges, police et al deserve the hell of chronic pain. a pox on their houses. fuckers.

  8. 8
    Silver says:

    As someone who hates to waste Vicodin on pain, I can confirm that it just don’t work the same way when you’re hurt.

  9. 9
    Carnacki says:

    Did you see the story about the Montana jury pool that “mutinied” and refused to take a marijuana possession case seriously because the amount was so small? Link

  10. 10
    Shadow's Mom says:

    On top of that, those suffering from chronic pain and who expect to suffer from it for their lives are often offered opiates and other drugs instead of pain management strategies in conjunction with pain killers.

    My sister has Regional Sympathetic Dystrophy (RSD); her husband wrecked knees and shoulders as a flooring worker. Both have gone through years of having pain meds prescribed. She started backing herself off the daily meds and finding alternative pain management techniques (many of which include learning to cope with daily pain and opting for meds only when it reaches unmanageable levels) about 2 years in. He was, at one point, put on methadone as a pain med. It took them 2 years to get him weaned off the methadone, which had horrible effects on his personality and physical health.

    They had been 12 years into recovery for drugs/alcohol abuse when the physical issues started. Since her disability began, she has completed her bachelor’s degree and only needs to finish her thesis to complete her masters in sociology.

    They are not addicts; they need the pain meds that are now taken only when absolutely needed. For example, in California are experiencing a wave of winter storms. Something in the changes to barometric pressure cause a flareup in my sister’s condition that leaves her unable to get out of bed because of excruciating pain in her back and leg. On good days, she uses hot box yoga as one strategy to keep her functioning well.

    Those who do not live with chronic pain should not begin to judge the plight of those who do. Chronic pain is debilitating both physically and emotionally.

  11. 11
    west coast says:

    hen you are in chronic, excruciating pain, anyone standing in between you and relief is just a monster.

    And the problem is, these prosecutions lead doctors to under-prescribe for pain. Been there. Even when the site of the pain is clear to the naked eye, red and swollen, doctors never seem to want to go more than over-the-counter drugs to treat pain.

    One modest solution: Every drug warrior should have to endure three months of chronic pain (induced would be fine, check with our intrepid “enhanced interrogation” squad for ideas) before they’re allowed to authorize a single raid or bring a single charge.

  12. 12
    celticdragonchick says:

    I live in excruciating pain every day, and I will for the rest of my life. The only thing that allows me to function at evn a minimal level is the medication I am prescribed from a pain management clinic. Not many of those left, of course, because doctors are scared to death to prescribe pain meds anymore with Inspector Javier Treadway trying to shove them under the jail on some Gods-damned holy quest.

    Canada is looking better every day.

  13. 13
    R. says:

    Australia got the prisoners, we got the Puritans — so much for enlightened policies on practically anything. It doesn’t help that we have hordes of pandering politicians who exploit the drug war for easy votes and law enforcement cash.

  14. 14
    Sasha says:

    Really, John. Would you please wait until January when it’s *really* cold before posting stuff that’ll heat our blood?

  15. 15
    Short Bus Bully says:

    Having also recovered from an extremely painful shoulder injury I can testify along with John and others that when you are in that kind of pain nothing matters other than getting that pain to stop. It’s not a macho, dick swinging, “I can take it” Rambo kind of stuff, not after several weeks of 24/7 debilitation. To fuck with the doctors who try to help people who are suffering like this is tantamount to supporting torture.

  16. 16
    jibeaux says:

    It is an infuriating story, and probably the only potential I see for a productive outcome is recommending that state medical boards get a lot more willing and proactive about policing their own — it’s a matter better suited to medical boards than prosecutors. Reputable pain management physicians do regular drug screening tests, both to ensure that folks aren’t taking drugs they aren’t supposed to be taking but just as importantly to ensure that they ARE taking the drugs prescribed to them for pain rather than selling them. Reputable pain management physicians have policies for the probation and possible discharge of people who aren’t in compliance with those policies. (Even if you’re a complete libertarian about drug use, it’s not in our best interest to have someone using their health insurance or Medicaid we all pay for somehow to procure prescriptions they don’t need so they can make money selling drugs.)

    And if they’re sloppy about it, the medical board needs to deal with it, not prosecutors. (I could see a role for prosecutors if, say, a person took the prescribed dosage of a drug which then killed that person, but I assume most people dying from prescribed drugs either weren’t prescribed that drug or not in that dose, and doctors shouldn’t be responsible for other people’s stupid.)

  17. 17
    jibeaux says:

    Anyway, to finish my point there, if doctors could feel sure that as long as they are running a responsible practice — and that if there is any question about that, then they will have the opportunity to have that decision made by other doctors — that they can do their jobs and prescribe appropriate medications to people with real pain, then it won’t have nearly the chilling effect that it’s had, which so unfairly affects people with legitimate, chronic pain.

  18. 18
    PurpleGirl says:

    In my mid-40s I experienced the referred pain of a herniated disc. It felt like there was a tiny, tiny man inside my leg, running up and down with a blowtorch on full power. Constant pain, 24/7. The only time it stopped was if I lay absolutely still. Pain killers didn’t work. The pain was caused by the compression of the disc, it was the nerve itself. The only drug that helped a bit was valium. Valium was originally developed as a muscle relaxant. But you know how if a doctor prescribes valium too often they are harassed by DEA and state boards. Luckily my neurosurgeon did give me valium for the short time leading up to the surgery. (In my case the surgery worked; I woke up in the recovery room pain free and thankful to my surgeon.)

    I have friends who have suffered with headaches or other pain conditions. And the management of that pain has been hard.

    People who have not experienced these levels of constant pain do not understand how bad it can be. They believe the person in pain is faking it, among other things. I have on occasion wished that everyone who has ever worked against doctors being able to use all the tools in pain management, wake up one day with my little man and his blowtorch running up and down their leg.

  19. 19
    aimai says:

    Mr. Aimai was just in the hospital for a week on high doses of pain meds. He was having back spasms that rendered him unable to stand up or roll over and sometimes locked up his breathing. The doctor was wonderful and said to us what John says in his post “people who need pain relief are not looking for the high–they are not likely to get addicted the just need the masking effect to get back to normal.” During our saga to get him diagnosed, however, we ended up in the ER twice and each time had to run the gauntlet of a medical profession that spends most of its time having to try to prevent addicts from getting their hands on pain meds so they exhibit extreme suspicion of patients unless you “qualify” on some class/race/deportment scale (which we did) as a real person with real problems.

    Up on the hospital floor, however, the old school nurses began cutting his meds because they didn’t think he was as deserving as their chemo patients. I had to take him home early in order to give him the prescribed doses. I’m still sitting on my letter to the hospital because its so hard to reduce the subject to something tidy.

    aimai

  20. 20
    PurpleGirl says:

    Ajax isn’t letting me edit my comment…

    I also wanted to comment on the difference in the experience of taking a drug when you need it, as opposed to taking it for “pleasure”. When I’ve need valium or a pain killer for its meditative efforts, I don’t feel high, I just experience a calming feeling, an ending of the pain.

  21. 21
    Uloborus says:

    It’s the crazy stuff about the subpoena for information and the daily fine that makes this sound like malicious prosecution. Who knows the actual facts of the case itself?

    I’ve talked to doctors about pain med regulations. A LOT of doctors. I live with a psychiatrist who does ER work and sees addicts come through her door trolling for pain meds (and all sorts of other stuff) every single day. There really is a problem with pain med abuse, and a big one. There’s also a great deal of money involved, as you can imagine, although if there’s a problem with doctors exploiting pain med prescriptions for their own profit I haven’t heard of it. What the doctors themselves are more worried about is that it’s fantastically easy to turn someone into a junkie and destroy their lives with this stuff. They use regulations to police each other to prevent that. They also use regulations to police each other. That’s the other thing they’re worried about – not writing prescriptions for addicts, exploiting the system to steal medicines. Way too many health care professionals are addicts because it’s so much easier for them to get the drugs. Keep all of this in mind while you judge.

    While you’re keeping that in mind, yes, the doctors are also scared of these regulations. They can be prosecuted for not noticing a pattern in how a patient asks for prescription refills. They can be prosecuted for believing what their patients tell them, or for being good Samaritans and giving a patient who lost their pills even a few extras to get them to the next scheduled prescription. Especially since most addicts don’t know they’re abusing their medications. The drug war, like most ‘vice’ issues in Puritan America, is fucked and some of the bleedover hits here.

    It’s just that in this case there’s a lot of ‘fucked’ built right into the problem, so it’s not quite as bad as it looks.

    Oh, and let’s throw another odd little detail on the pile. Never underestimate the power of the insurance industry to make things worse. Better treatments like drug rehab or less addictive pain meds may not be ‘cost effective’ and the doctor can’t prescribe them without going through a regimen of other options first, wasting huge amounts of time and money and damaging the patient. That kind of crap is why I support the ACA. The insurance industry needs regulation SO bad.

  22. 22
    Don K says:

    @R.:

    Not only did we get the original Puritans (although they seem to have evolved into the relatively easygoing New England Yankees), but here in Michigan we seem to have gotten all of the social conservatives from the Netherlands, Minnesota seems to have gotten all of the social conservatives from Scandinavia, and Iowa, Minnesota, and Wisconsin seem to have gotten most of the social conservatives from Germany (there might be some left in Bavaria). Combined with the hillbillies and Confederates who seem to be all over these days, and we are well and truly fucked when it comes to having some sort of sanity on these matters.

  23. 23
    Maude says:

    @aimai:
    I had someone in pain in the hospital and the nurses did the reduced dosage. I called the doctor and he called the nurse’s station.
    I hope your husband is better. muscle spasms are no joke.

    @PurpleGirl:
    I am so glad the surgery worked.

  24. 24
    El Cid says:

    I tried to make a post about how there is a National Pain Care Act languishing in the Senate since 2009 (of course, having passed the House), but apparently the moderation didn’t like it.

  25. 25
    PurpleGirl says:

    @Maude: Thank you.

  26. 26
    Jay C says:

    Let me add my voice to Chorus Of Outrage: my wife is a chronic-pain patient (Ehlers-Danlos Syndrome); and for her, the issue comes down to a sad, but unavoidable choice: a complex regime of expensive (and hard-to-get) drugs, or crippling pain 24/7/365. We are fortunate in that we have a “respectable” (i.e., older, accredited, hospital-affiliated) PM specialist who runs a simple, well-regulated practice: but even so, the stories he has told us of the more-or-less institutionalized harassment he and his PM colleagues have to endure (up to loss-of-licenses) from State agencies makes our blood run alternately hot and cold. That she (and I) have no good choice in matter except as I outlined above is bad enough; but the idea that her supply of medication is potentially subject to foreclosure at the whim of some unelected “law enforcement” type in the service of an inhumane and absolutist “Drug War” ideology is frightening in the extreme.

  27. 27
    Sarcastro says:

    Suck it up, you pussies.

  28. 28
    aimai says:

    @Maude:

    Maude,
    It was an interesting experience. The Doctor was horrified when he found out what was happening but he was low man on the totem pole compared to the old guard. He wants us to write the letter to the head of the hospital, and we are going to. My main issue is that it took two Ph.D’s (one of them, admittedly, blurred with drugs) to figure out what was going on and confront the nursing staff with the facts. If my husband had been in the hospital on his own, if I hadn’t been able to be with him all day monitoring his condition, and if I didn’t come from the upper class I’m pretty sure we either wouldn’t have known what was going on or wouldn’t have been able to get any satisfaction.

    aimai

  29. 29
    Russell says:

    Hell, I bet a lot of pain users were like me- the drug somewhat stopped the pain, but brought on all sorts of other nasty side effects, like a histamine effect, and lethargy and confusion, etc., but the pain was so bad the trade-off was worth it.

    I was in an accident, in 2005, that shattered my right ankle, wrenched my back and shoulders, and almost severed my right arm. I was prescribed a significant amount of painkillers by the ER doctor(This is Canada, mind you…) and discovered rather rapidly that I *hated* them. I can distinctly remember one day, watching ‘Bambi’, and having to phone my parents who were in Arizona, so that I could ask how Bambi’s mother died. I heard the gunshot, she was lying on the ground, but I just could not put 2 and 2 together to get 4. I rapidly switched to over-the-counter medication after that.

  30. 30
    Triassic Sands says:

    I suffer from severe systemic chronic pain. (Cause unknown.) I’ve been taking opioids for several years without any unusual problems. My pain relief is adequate. Over the years I have voluntarily tried many different drugs (and alternative therapies) to deal with my problem, but the only thing that has made my life tolerable is opioids, and then not just any opioid.

    Earlier this year, the Washington State legislature, supposedly concerned about an increase in overdose deaths, wrote new guidelines for prescribing pain medication. Last week I saw my (now former doctor) to get a refill. He entered the room in a confrontational mood and things went down hill from there. In the course of our conversation, he said some of the stupidest things I’ve ever heard a doctor say. (I concluded he’s a Republican.)

    He started off by refusing to refill the prescriptions he’s been writing for the past ten months. I asked what my alternatives were. “Methadone three times a day.” Well, two years ago I voluntarily took methadone and it was the worst experience I’ve ever had with a medication. He tried to convince me I should “try it again.” Unbelievable. Having a horrible experience is overridden by a new legislative decree. “OK, you can take MS Contin (extended release morphine).” Been there, done that. Morphine and I don’t mix. I’ve also tried MS Contin and while it doesn’t work particularly well for me for pain, it does make me itch uncontrollably.

    Making things worse he said a bunch of really stupid things like “MORPHINE” “MORPHONE” they’re the same thing. (I’m currently taking hydromorphone — somewhat stronger than morphine, but generally well-tolerated, with fewer side effects like nausea and itching). I said fine, then I guess you can prescribe diacetylmorphine for me…MORPHINE MORPHINE…they’re exactly the same thing. (Note: they aren’t the same thing and diacetylmorphine is heroin.)

    I asked him about a couple of other alternatives, but he brushed me off claiming — “I’ve never worked with that.” So, he couldn’t consult with someone, call the manufacturer, or do a little research in order to prescribe a new drug that conforms with the legislators (idiotic) new guidelines. Finally, he said, “OK, you are going to take suboxone!” End of discussion.

    This morning I have an appointment with an ARNP who is supposed to prescribe suboxone for me. Only I don’t want to take suboxone. First, why switch from an affordable drug that works and is well-tolerated, to a grotesquely expensive drug ($8 a pill) whose primary use is as a replacement for heroin (it’s the new methadone, so to speak)? Second, I have had a lot of trouble with drug side effects and suboxone has the same side-effect profile as methadone. I see no reason to experiment with debilitating side effects when I already have something that works.

    According to my now ex-doctor, taking hydromorphone “makes no medical sense” (even though he has been prescribing it for the past ten months and another doctor in the same clinic prescribed it for at least two years prior to that. Why? Because it is a short-acting opioid and I have to take it four times a day. But methadone is OK, because I only have to take it three times a day. That’s the crux of the problem. It has nothing to do with safety, since methadone is a vastly more dangerous drug than hydromorphone (brand name Dilaudid), something I discovered first hand.

    In all the years I’ve been taking opioids there have never been any misuse incidents, no lost prescriptions, no irregularities. It’s just the legislature thinking they’re solving a problem.

  31. 31
    celticdragonchick says:

    @aimai:

    I know just what you mean.

    When I was first injured on the job (ruptured disc at L1/L2) I was taken by ambulance to the Moses Cone hospital ER. Thay let me languish for four hours on a gurney in a hall before a doctor aid ever saw me, and it took an angry long distance call from my mom (a former ICU nurse) to get them to even give me any pain meds at all. I was never actually given an Xray or any examination at all for the injury.

    The orthopedist I saw was actually astonished that they had not even taken any rudimentary steps to see what was wrong. I later found out that any back injury is treated as “drug seeking behavior” and ignored.

  32. 32
    gene108 says:

    Unfortunately, there are pain centers (not sure what they are called), who stay in business because they are known to prescribe painkillers for all comers.

    There is a real problem with abusing pain killers, since pain killers are basically opiates and opiates are very addictive.

    I don’t know how you differentiate between the good doctors and the bad doctors, who prescribe stuff to anyone with a pulse.

  33. 33
    BonnyAnne says:

    @aimai: that is doubleplus ungood. I hope you took names; don’t hesitate to call them out in the letter. The standard nowadays for nurses is really straightforward: pain is what the patient says it is. Full stop. And you should be able to get the full dose up to what the doctor wrote, every time.

    I know some nurses who try and negotiate it with the patient, offering 1 oxy instead of 2 to start out with etc, usually to prevent the patient from spending the entire day asleep or unable to get out of bed post surgery. But if the patient insists, they get all the meds, every time, because it’s not just good medicine, it’s The Law. Hospitals can now lose their accreditation if the Joint Commission finds institutionalized standards of not treating pain properly. And being an Old School nurse back from the days of yore doesn’t cut it, and they all should have known better.

    Something to keep in mind…

  34. 34
    Tata says:

    Seems like Treadway needs the attention of pain patients, lots of letters and exposure to more seasoned perspectives. Further, if I were a lawyer looking to make my name, I might take up appealing that malicious prosecution.

    I am not, though. I’m a middle-aged lady with arthritis who refuses to take aspirin more than a few times a year because when pain gets bad down the road, I want it to really work.

  35. 35
    Don says:

    What’s most maddening about this is how poorly defined the “problem” being solved is. Ask any of these people prosecuting this supposed crime what they’re trying to prevent and they’ll say what exactly? Drug abuse? People getting high on painkillers?

    This is really a problem?

    This is a problem that makes it worth preventing the worthy from getting pain meds?

    This is a problem that justifies spending significant amounts of money prosecuting this?

    I don’t really have an issue with people thinking it’s morally wrong for folks to get high, though I don’t really understand it. But I really don’t get how folks think it’s an offense worth what this pursuit costs us. We’d rather fire public workers and put kids in huge classes than raise taxes a few bucks… but this is a good way to spend money?

    Maybe we anti-drug-war warriors need to stop talking sensibly and attack this like the deficit nuts attack other spending.

  36. 36
    celticdragonchick says:

    @gene108:

    Unfortunately, there are pain centers (not sure what they are called), who stay in business because they are known to prescribe painkillers for all comers.

    Twenty years ago?

    Pain management centers of any sort are hard to come by now, and are difficult to get referred to. Doctors are scared to death of being prosecuted for doing their fucking jobs, so they don’t do pain management.

  37. 37
    Kirk Spencer says:

    Add to the drug issue the “moral” issue. Escaping pain is somehow thwarting God’s intent, or at a minimum it’s weakness. Enduring pain without aid is Strong and Noble.

    Bah.

  38. 38
    Don says:

    Unfortunately, there are pain centers (not sure what they are called), who stay in business because they are known to prescribe painkillers for all comers.

    SO. WHAT.

    Seriously, why is this a big problem? Why is it a problem that needs the attention of the LEGAL SYSTEM?

    Let’s be perfectly honest with ourselves: If this was a seriously out-of-control issue the insurance companies would be all over it. These are organizations that would kick a small child to the curb and refuse leukemia treatments – you think they wouldn’t crawl up the ass of an over-prescribing doctor so far that s/he could taste their after-shave?

  39. 39
    Older says:

    Between about 20 and about 10 years ago, I was suffering from two different conditions (sequentially) which were both extremely painful, and misdiagnosed, so that they persisted much longer than necessary. Ultimately, for about two years I was in very great pain and was prescribed immense doses of Vicodin. Before giving me the prescription, my doctor had me sign a paper promising not to sue him should I become addicted. At the time, I couldn’t figure out how anyone could become addicted to Vicodin — if I inadvertently took too much, I just fell asleep. Didn’t seem exciting to me.

    Toward the end of this period, and soon after both conditions had been corrected by surgery, I was diagnosed with a chronic auto-immune disorder which was itself painful, so I just continued with the Vicodin (lately I have substituted Tylenol 3, since it has relatively more codeine and less acetaminophen, which I am not supposed to take).

    But just recently, I found my prescriptions being marked “Must last until (specific date)”. When I talked to my doctor about it he was evasive, but after several visits I was able to piece together the New Facts. Which were that the government (presumably federal) would no longer allow such high dosages as I had been prescribed originally, that “must last” didn’t mean “so don’t ask for more, but rather “ask if you need more”, and that my doctor was not supposed to be telling me any of this.

    Since he had been okay with my original use, which was orders of magnitude greater than my present use (not joking here), it’s clear that the objection didn’t originate with him; he trusted me to use only what was necessary.

    I have never before heard of nurses refusing to administer what was authorized by the doctor, and I’m horrified. it’s bad enough that some huge entity which has no knowledge of my condition can interfere with my medication, but to have people who can see me and know that I’m suffering interfere with it would be truly enraging. Aimai’s and Maude’s relatives have my sympathy, and my sympathetic rage on their behalf.

  40. 40
    Pongo says:

    If you think this is sick, be aware that there are more than a few fundamentalist Christian doctors out there who believe that pain is ‘cleansing’ and who refuse on principle to relieve pain because it might interfere with their patient coming to the lord. Really. I read a case once where a nurse was reprimanded for cluing the family in on the doctor’s bizarro religious beliefs so that they could demand better pain control for their loved one. The hospital, which was not religiously affiliated, but was a large academic institution, disciplined her for going around the doctor. She sued (and won). According to this paper, the ‘pain as path to the lord’ crowd is not common, but more common than one would imagine. I guess the moral is that you need to interview your doctor about his/her views on pain control prior to needing help.

    What gets me is the fear that someone who is in a terminal state will get addicted or will die from an accidental overdose. If you are at that point, who cares? The cruelty of withholding pain medication for some questionable moralistic claptrap is simply inhuman.

  41. 41
    Jay C says:

    @Kirk Spencer:

    “Add to the drug issue the “moral” issue. Escaping pain is somehow thwarting God’s intent, or at a minimum it’s weakness. Somebody that you don’t personally know enduring pain without aid is Strong and Noble.”

    Fixed.

  42. 42
    Kirk Spencer says:

    @Jay C: Oh, no, don’t “fix” it.

    I’ve seen it from my wife’s sisters toward her. It’s not the only case I’ve seen where such is true.

    If you want to fix, it’s “for everyone but me” – and even then it’s not always.

  43. 43
    Mike S says:

    I met Reynolds a few years back at her brother’s wedding. This story makes me sick.

  44. 44
    Peter VE says:

    A friend of mine lived with pain, since being torn apart when a drunk crashed into the ambulance he was working in as an EMT 15 years ago. He was on a “pain contract” with his pain clinic, with a tightly limited regimen of medication. He was required to pick up a written prescription each month, and one month mislaid his prescription. When he went back several days later to get a replacement prescription, they interrogated him as to what he done when the previous prescription ran out, and he replied that he had set aside a few pills for exactly this eventuality. From this, it was determined that he was a “drug seeker”, and the clinic cut his medication dose down rapidly, planning to cut him off medication within a couple months. Facing a future of pain with no way to ameliorate it, he killed himself.

  45. 45
    Mnemosyne says:

    @Pongo:

    What gets me is the fear that someone who is in a terminal state will get addicted or will die from an accidental overdose. If you are at that point, who cares?

    That’s the thing that really points out the total irrationality of our approach to pain meds. If someone is in the final stage of cancer and has no hope of remission, they’re not going to live long enough to become an addict anyway, so just give them the goddamned medication.

  46. 46
    Jewbacca says:

    @Shadow’s Mom:

    Those who do not live with chronic pain should not begin to judge the plight of those who do. Chronic pain is debilitating both physically and emotionally.

    QFT.

    Tell your sister to keep at it with the pain management techniques and gradual desensitization. It can get better. Mostly. I know that’s small comfort when PurpleGirl‘s little blowtorch man is on a rampage, but reminders that it isn’t futile helped me a lot in getting through the physical therapy to get my RSD in “remission”. The emotional damage will linger, but… priorities. Get the pain under control first. It sounds like your sister is on a good track, moving forward with her life. Stagnation and isolation are the big psychological hazards after the pain starts to get better, in my experience. (ETA: Well, that and the paranoid self-hatred that comes from what Kirk Spencer observes.)

    When there is improvement, getting hung up on being cured / rid of it / whatever can be problematic in its own right. It never entirely goes away. I’ve been in “remission” for almost half the decade since I was diagnosed, and I still get flare-ups from cold, weather, exertion, stress, just for the fuck of it, etc. I used to get panic attacks when this would happen, terrified that it was going to go back to how it was. I’ve eventually learned to just smoke a lot of weed, keep my legs (affected area) warm and slightly active, and wait for it to pass. It’s rough getting there when you aren’t really sure it’s otherwise gone, though. Hmm… none of that sounds as encouraging as I intended it. What I mean is, setbacks aside, it is possible to get from being essentially bedridden to, e.g., skiing ( / physical recreation of choice) again.

    Sorry, rambling now. This kind of shit really does make my blood boil. Brings back bad memories and a lot of anger, only some of it directly relating to the subject of the post.

    Also too, fuck methadone. Fuck that goddamn Nazi drug.

  47. 47
    Triassic Sands says:

    @gene108:

    At this point I think the correct name for such “centers” would probably be “myths.” Regulation and scrutiny have become so intensive and invasive that the likelihood of a pain center distributing large quantities of opioids in violation of laws and guidelines is damn unlikely. It’s a great arguing point in a dishonest war on pain patients, but little else.

    Do people abuse opioids? Of course. Do they shop for them? Of course. Is that the end of the world? Hardly.

    Once again we have to deal with how many innocents we’re willing to punish to prevent one person from getting pain medications he or she doesn’t “deserve.”

    Washington State’s new regulations will probably result in lots of unnecessary suffering, save few if any lives, and increase health care costs. A trifecta.

  48. 48
    Allen says:

    Hey, God gave you that pain for a reason. We can’t be having so-called “doctors” prescribing anything that will allow you to escape God’s worthy lessons!

    Since I don’t comment here often, I must point out that the foregoing was snark, but also certainly representative of a certain far-right, Christian mindset.

  49. 49
    M. Bouffant says:

    Didn’t read, barely scanned, but Pajamas Media has weighed in on the subject.

    Blame the British welfare state!

    In my experience as a prescriber, however, which is also supported by a lot of scientific evidence, opioids are not very effective at relieving the kind of chronic pain of which 35- to 54 year-olds complain. Methadone is particularly poor in this respect, and yet it is not only frequently prescribed but implicated in 31 per cent of all opioid deaths, more frequently than any of the others. It is difficult to resist the conclusion that relief of pain is not really what the drugs are being prescribed for.

    The nearest analogy I can think of is with the increase in sickness benefits paid out by the British state. As the population became healthier and healthier in the 1990s, as demonstrated by objective measures, so it included more and more people allegedly incapable of work for health reasons. The British welfare state thus achieved the miracle of producing more invalids than the First World War: millions of them in fact.

    Could it be that one of the largest causes of chronic pain among 35- to 54-year-old Americans is access to opioid drugs?

  50. 50
    Mnemosyne says:

    @M. Bouffant:

    The British welfare state thus achieved the miracle of producing more invalids than the First World War: millions of them in fact.

    Good thing the population of Britain has stayed exactly the same since the end of the First World War, or this guy would look like a fucking idiot.

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