Addiction and Pain

Tweet of the day from Maia Szalavitz:

116 million in chronic pain. 23.5 million with addiction. 2 nat instits on adxn, none on pain

There’s nothing wrong with caring about addicts, but there’s something extraordinarily perverse when we’re so concerned about preventing addicts from having access to drugs that we destroy the lives of many times more people, either through untreated pain or other drug war damage.

Here’s her article on chronic undertreated pain.

“I’m shocked and surprised at the magnitude of [the problem],” said Dr. Perry Fine, president of the American Academy of Pain Medicine, while attending the press conference on Wednesday announcing the release of the IOM report. He was not associated with the research.

Yet the reports’ authors said they believed that they had actually underestimated the incidence of chronic pain — that which lasts 30 to 60 days or more and takes a toll on personal and professional life — because their data didn’t include people living in settings like nursing homes. Further, as baby boomers age, the rate of chronic pain increases daily.

In a related story over at Points, Siobhan Reynolds talks about the Unconstitutional perversion of medical authority admitted to by the Department of Justice.

When questioned by District Judge Robert Jones as to why federal prosecutors believed they possessed the authority to use the CSA to criminalize the actions of DEA registrants, otherwise empowered by Oregon state law to assist in patient suicides, the DOJ offered the following justification, citing language found in a House Committee Report discussing the possible implications of the CSA for the federal regulation of medicine, using the criminal code:

“Although the Committee is concerned about the [in]appropriateness of federal prosecutors determining the appropriate method of the practice of medicine, it is necessary to recognize that for the last 50 years this is precisely what has happened, through criminal prosecution of physicians whose methods of prescribing narcotic drugs have not conformed to the opinions of federal prosecutors of what constitutes appropriate methods of professional practice.” Defendants’ Memorandum, pp. 16-17….” (Emphasis added)

District Judge Jones offered the following rebuke:

“Defendants [DOJ] cannot seriously conclude from the above- quoted language that Congress delegated to federal prosecutors the authority to define what constitutes legitimate medical practices. [FN15] To state the proposition is to refute it. Federal prosecutors have never possessed such powers, and the vagueness of the reference would render any alleged violation based on a prosecutor’s subjective views about medical practice patently unenforceable.”

And yet, to this day, prosecutors have regularly exercised such powers with impunity even though they don’t have them.

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21 Responses to Addiction and Pain

  1. Duncan20903 says:

    If I had a rocket launcher…

  2. kaptinemo says:

    Those who know their DrugWar history know that a vast amount of drug laws have to do with the custom of racism being enshrined into law when that racism has long been repudiated by society as a whole.

    And in this instance, when the original error is compounded by the custom of ceding unwarranted power to the Executive Branch via the drug laws (which I remind the reader that the laws themselves are based upon racism and bigotry, not science) has led to the so-called ‘Justice’ Department in effect practicing medicine without a license in telling doctors what kind of palliative measures they may use in treating chronic pain. Which has led to exactly what Ol’ Tom Jefferson said would happen:

    “Was the government to prescribe to us our medicine and diet, our bodies would be in such keeping as our souls are now.” One might add that the body and the soul of a nation might also suffer…and has.

    • Windy says:

      “the laws themselves are based upon racism and bigotry, not science”

      and also due to certain industry moguls ridding their businesses of competition via the government ban on “marihuana”.

      Nor should we forget the megalomania of H.J. Anslinger.

  3. Maria says:

    I think it goes back to the very colonialist building blocks of American society. The radical puritan notion that one must “suffer through” to attain salvation and that the suffering itself is purposeful. It’s the same mentality which refuses to consider end of life care and transitioning. Every time pain treatment is glossed over and minimized there’s an unspoken lingering message that those in pain are in pain for a reason.

    In a way, their thesis is that addiction is a weakness which can be overcome but that pain is a gift that must be accepted. Frankly, it’s an abysmally abhorrent way to relate to fellow human beings but it seems too deeply ingrained.

    • Emma says:

      So true! Religious bias is a very strong aspect drug prohibition.

      The New Testament is full of statements about the necessity of abandoning the world and earthly worries, but also says that JC is the only way – competing methods are called “escapism” by modern Christians. It’s a typical double-standard.

      One of the first drug prohibition movements was by Christian missionairies against opium in China. They were upset that the Chinese were uninterested or hostile to dogmatic monotheism, but they put the blame on opium use. Also, they saw poor sick people on the side of the road smoking opium as pain/diareah relief and assumed that opium was killing them (see “Narcotic Culture” or “‘Patient Zero’: China and the Myth of the ‘Opium Plague'” by Dikotter).

      Also I have read that Mother Theresa’s “clinics” in Calcutta did not provide pain medication or other medical treatment – people just laid there and died while Theresa ‘prayed’ over them (See “Hell’s Angel” by Hitchens). Her private letters were recently released, and she felt possessed by demons most of her life.

      It’s important to note though that most people are not pro-pain religious fanatics. If the drug reform position is explained, most people will support it. And people will be more vocal if they see that drug reform is supported by respectable institutions like the IOM, WHO, etc.

  4. damaged justice says:

    Today’s fun factoid: Nora Volkow, director of the US National Institute on Drug Abuse, is the great-granddaughter of Leon Trotsky and doesn’t believe in free will:

    We think we have free will, she continued, but we are foiled at every turn. First our biology conspires against us with brains that are hard-wired to increase pleasure and decrease pain. Meanwhile, we are so gregarious that social systems — whether you call them peer pressure or politics — reliably dwarf us as individuals. “There is no way you can escape.”

  5. Matthew Meyer says:

    Nice one, Maria. I buy kaptinemo’s take about racism, but my reading indicates an important role for (certain) Christian notions of suffering, transcendence, and salvation.

    Drugs have a much more important role in the transition to secular capitalist modernity than is generally recognized, and the figure of the addict is one of our archetypes of consumption gone awry.

  6. damaged justice says:

    Opium has a documented history of thousands of years of safe and effective human use. The current “epidemic of abuse” stems from the rise of political society and the general breakdown of civil society; from the modern progressive and authoritarian mindset that equates all use with abuse and demands (unachievable) total control over everything anyone chooses to do or not do; and from the refined and concentrated nature of chemicals divorced from all previous context (from poppy tea to heroin, from coca leaves to crack, from sugar cane sugar). And so today, we are told that it is dangerous and/or forbidden to grow poppies in our back yard and drink the tea, and instead we must beg a properly licensed authority to grant us temporary permission to pay ridiculously inflated prices for a refined, concentrated and more toxic version.

    • dt says:

      I bet you could get away with growing poppies in your back yard. Even if a cop walked by when you were cutting open the bulb and collecting the goo, I bet very few cops would recognize that as illegal…

  7. david says:

    We all know doctors have been prejudiced against people in pain- and ignore the fact opioids have been used for 3500 years to alleviate suffering. If we really want to change pain care we need to change how doctors are recruited, educated, regulated and empower people with pain the right to receive good pain care- and failing that the right to legal redress that is quick, energetic and cheap-failing that pain care will unlikely improve any time in the forseeeable future

  8. Ed Dunkle says:

    Are doctors in other countries arrested for prescribing pain medications, or is this strictly a U.S. thing?

    • dt says:

      It’s probably somewhat better in European countries and much worse in third world countries.

    • filosofem666 says:

      No, not really a US thing…

      In Taiwan, where I live, anything stronger than Tramadol is almost impossible to obtain legally unless you are terminally ill. With a nationalized healthcare system, the state has near-absolute control over everything. Physicians who fail to meet the regulations are punished one way or another… Not sure if anyone has gone to jail for giving out opioids, but the fact remains that most physicians are extremely scared of prescribing strong pain medications regardless of what they believe is best for the patient.

      The War on Drugs lives on here in East Asia. No one is making a fuss about legalization. No medical marijuana. No 420 marches. No nothing. We are still in the Reefer Madness stage *sigh*

    • Emma says:

      This is a major global problem. For more info, the WHO Access to Controlled Medications Programme:
      * world opiate production must increase 5-fold before everyone can have Western standard levels of pain medication
      * 80% of people have nearly no access to opiate pain medication
      * 6 million cancer patients die each year without pain medication.

      According to the UN 1961 Single Convention on Narcotic Drugs, countries must require MD prescriptions for opiate pain medications and these medications must be distributed through regulated pharmacies, but many countries only have a few MDs per million persons and lack pharmacies.

      Also, aid workers have to go through complicated paperwork to import pain medications. This becomes an issue after every natural disaster.

      A good book on the history of drug prohibition in the US is “The American Disease” by DF Musto (warning: author is biased towards defending the establishment). He describes in detail the tragic story of how opiate clinics were forced to close because federal agents felt that providing opiates to addicts was not good medical practice.

  9. Duncan20903 says:

    Bill Bennett regurgitates his opinion on CNN. He starts with an argumentum ad liberi fallacy and things go downhill from there.

    I see Tommy Chong’s “shut up!” to Paul Chabot may have legs.

  10. ItReallyDoesSuck says:

    The invaders who murdered Hampton, Virginia resident William Cooper swiped about $900 in cash. They seized his gun collection. They took the Lexus from his driveway. By some oversight they neglected to extract the gold fillings from his teeth.

    While they made off with a decent haul, the robbers were doubtless disappointed that they couldn’t locate the large stash of illicit prescription drugs they had expected to find. They had the luxury of tossing the home at leisure without worrying about being interrupted by the police – on account of the fact that they WERE the police.

  11. Duncan20903 says:

    Wow, did anyone know that “conspiracy to commit a legal act in an illegal manner” is a crime in the State of Michigan?

    I must be very stupid. I keep thinking I’ve seen the absolute extremes of which the Know Nothings are capable yet time after time they manage to keep outdoing themselves.

    • Duncan20903 says:

      …and my post just above was made before I found out about the green tongue thing. Like I said, they just keep outdoing themselves in expanding the limits of absurdity.

  12. jewel says:

    Like Kapt. has been saying for some time, the economy will eventually impact the WOD. There is a great deal of civil unrest with revenue shortfalls for the munincipalities. Lots of tempers flaring and more civic involvement with the threat of even highter tax rates. Oversight comitties are being formed to review budget sections. I wonder if this little tidbit will stoke any fires?

    Lots more interesting headlines where that came from.

    Thanks Malc for stopping for a visit.

  13. vickyvampire says:

    Yes your right on target Maria its that Puritan Stoic way of thinking,that has become entrenched to the detriment of those in Pain. Total agreement with your points.

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