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Chronic pain management is officially part of the war on drugs. The Drug Enforcement Administration and the Justice Department have had such bad results with controlling the illegal importation and use of heroin and cocaine that both departments have turned their focus on pain-management clinics to get some "success" stories. With a growing population of people suffering from severe chronic pain, prescribing strong opiates such as Oxycontin, have risen. Oxycontin, a Schedule II drug, gives up to 12 hours of time released pain control. But it has also become the favorite drug of choice for illegal sale on the streets. Why? If you crush the pill, the user gets an instantaneous high similar to heroin -- without using a needle. Since it's a legal prescription drug, finding an unscrupulous doctor is much easier than finding a heroin dealer. This has resulted in a war between physicians, the DEA and patients who truly need strong medication. The DEA doesn't care about the enormous impact they are having on the good doctors and patients who follow the law. The DEA is watching pain-management clinics, mostly those owned or operated by minorities, to find a rotten apple in the barrel. But if you're rich, like conservative talk-radio host Rush Limbaugh or Rep. Patrick Kennedy, the Massachusetts Democrat, there's no need to go through the "prove it" gauntlet. All they have to do is lay out the cash. Only the poor have to prove the pain. Doctors have had to find a way to demonstrate to the DEA that patients are not selling their prescriptions on the streets. Some clinics have devised a prescription contract that the patient and physician must sign outlining how the patient will receive the medications they need. Many physicians have stopped prescribing opiates, sending patients to pain-management clinics that are more expensive. Pain-management clinics must prove what treatments have been tried and failed by ordering several tests, which can take as long as six months before they conclude how severe the patient's pain is. Federal law classifies most opioids as Schedule II drugs, the same classification given to cocaine and heroin, despite a growing body of opinion among the medical community that opioids should not be classified with these substances. One of the DEA'S few Congressional critics is libertarian Republican Rep. Ron Paul of Texas. "Unfortunately, patients often must consume very large amounts of opioids to obtain long-term relief. Some prescriptions may be for hundreds of pills and last only a month. A prescription this large may appear suspicious. "But according to many pain-management specialists, it is medically necessary in many cases to prescribe a large number of pills to effectively treat chronic pain. However, zealous prosecutors show no interest in learning the basic facts of pain management." The war on drugs has failed. It's time to admit it and move on -- to rewriting drug laws that are realistic and effective. |
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