The Distortion of Medicine and Confusion of StandardsIn pain medicine we have the deeply disturbing situation that what most doctors do (medical community norm) is at odds with, and clearly below, the medical standard of care. Literally, in the treatment of chronic pain, an ethical physician attempting to practice in good faith, according to the clinical literature, is an outlier deviating from how most reputable physicians would practice. Highly Recommended Pages…Take a moment to scan one or two of these Highly Recommended documents… good background reading for any serious student of the war on docs and the pain crisis.
- A Critical Assessment of the Impact of Drug Testing Programs on the American Workplace is a good review of this important related drug war topic that is currently in the news (govt push to drug test high school students);
- War on Drugs, War on Doctors, and the Pain Crisis in America — this is probably THE CORE document; if you only read one article on my sites, let it be this one. This paper is my best attempt to date at putting our current nightmare into historical, epidemiological, and ethical context;
- War on Pain Sufferers Special Collections — These are intended to be timely and time-saving resources especially for journalists, researchers, and students
- Finally, on the substance use disorders side a few gems:
- Abstinence vs. Harm Reduction - a False Dichotomy is probably the best thing I’ve ever written, and,
- The Controlled Drinking Debates - a Review of Four Decades of Acrimony, by Dr. Brook Hersey, is a simply phenomenal article - scholarly yet eminently readable - covering our fascinating, peculiarly American, relationships with alcohol.
Criminalization of Pain ManagementMany physicians are concerned that prescribing opioid analgesics in chronic pain treatment is accompanied by an unacceptable risk of unwarranted prosecution. The validity of this fear is evaluated by examining the standards through which physicians are targeted and prosecuted. Prohibition law is identified as an error in social policy that distorts medical standards. Pain Docs, Drug War Scapegoats, Speak OutI am very glad to see physicians, who have themselves been savaged by the government, publishing their stories. Consider Dr. Jackson’s article, Conviction without a Crime, to be a companion piece to Dr. Rottschaefer’s article discussed in the previous item here, The Criminal Criminal Justice System. Together these two articles will give the reader a good sense, I think, of the utter breakdown of professional ethics, common sense, and fairness in any case involving controlled substances. The Criminal Criminal Justice System
The Criminal Criminal Justice System”; Alex DeLuca; Pain Relief Network; 2008-12-05. Revised: 2008-12-09 (’See also’ link to Dr. Jackson article added).
Permalink: http://doctordeluca.com/wordpress/archive/crim-crim-justice/
Refers in large part to:
Third Circuit Gives New Meaning to Term “Criminal Justice System” (PDF)
Dr. Bernard Rottschaefer, J. Amer. Physicians and Surgeons, 13(2), 2008
See also:
Conviction Without a Crime: a True Story (PDF)
Dr. Michael D. read more.. The Reeking Soul of US Justicecriticisms and description of federal prosecutorial behavior rings true to me from my experience and knowledge of war on docs/pain crisis cases. Our justice system is withering, ‘the drugs exception to the Bill of Rights’ has gone from being a tragic lawyers joke to business as usual, and we now routinely apply asset forfeiture and RICO laws, intended by Congress to combat drug cartels, to individual pain-treating physicians. Doctors and sick people are easy, profitable prey for law enforcement and federal prosecutors pandering to the electorate through a media willing to be exploited for their share of the spoils. Civil Liberties Implications of Our Nation’s Approach to ‘Drug Control’There are so many who need opioid pain medications and can not get them... These people have their lives destroyed every day as they drag themselves from doctor to doctor being lied to, verbally and sometimes physically abused, forced into unnecessary rounds of expensive testing... They are sneered at by pharmacists, called addicts by doctors, drug tested, called “frequent-flyers” and other derogatory names by emergency room nurses and doctors, denied reimbursement... Treatment of Pain and Substance AbuseUnrelieved pain has a devastating impact on the physical, emotional, social, and economic well being of patients and their families. Diagnosing and treating pain is, therefore, fundamental to the public health. Terminology is review, myths identified, and medical understanding is stated. Wassup 2008 Commercial (full version)Excellent pro-Obama youTube video extension/take-off of what was originally an Anheuser-Busch beer commercial. Free Days for Richard PaeyArticle from PascoTribune, including video interview of Paey, about Paey's readjustment to live out of prison as a pardoned chronic pain patient. Permalink: Hurwitz Released - Challenge of Drug MisuseI spoke to Billy's wife briefly, recently, and am very happy to be able to report that Dr. Hurwitz is no longer in federal prison. He is currently in a half-way house in D.C. and will be transitioning to house arrest as part of his parole and probation requirements...
He is in a sort of "titration to house arrest" best I understand it.
Meaning, he is starting to get overnight visits with his family - YEA! - and more and more of that till he sort of "stabilizes" on a regimen of maintenance house arrest. (Is house arrest a substitution therapy for real life in the new world order?)
Once the titration is complete, he will be able to communicate freely again, and accept visits by invitation. I think he has a job lined up as part of his probation.
Billy Hurwitz is coming back to us! Dr. Rosa Martinez: New Charges?Update on the case of USA v Dr. Martinez in Washington state. Martinez has been acquitted of all drug crime charges. The fraud charges remaining after her 2007 fed trial have also been dismissed, but the govt can bring the fraud charges anew. Also examined is a recent Yakima Herald article announcing "new" charges that are not, in any reality-based sense, "new" at all. High Dose Transdermal Buprenorphine for PainAbstract of peer-reviewed article reporting multicenter outcomes for safety and analgesic efficacy of high-dose, transdermal buprenorphine in the treatment of chronic pain, and brief comments on same by Dr. Alex DeLuca, and with links to related discussions on the Pallimed blog. Untreated Pain as Serious as Drug AbuseExperts: Untreated pain as serious a problem drug abuse. By Tristan Scott of the Missoulian. With the specter of prescription drug abuse looming large, health care workers stressed Friday that untreated pain in Montana is a public health crisis commensurate to that of addiction. Pain Crisis: Chickens Come Home to RoostThe article well describes the public health chaos this is the predictable consequence of clinical and public health authorities abandoning their real mission to uphold the medical standard of care for their citizenry, and instead focusing exclusively on the policeman's agenda which prioritizes 'catching a few addicts' over providing adequate pain management for legions of innocent patients. Should “Alcohol Abuse” Mean Untreated Pain?
Should Alcohol Abusers Not be Treated for Pain?; Alexander DeLuca, M.D., MPH; War on Doctors/Pain Crisis blog of the Pain Relief Network; 2008-07-14. (Discuss on PRN’s Pain Forums)
Permalink: http://doctordeluca.com/wordpress/archive/alcl-abuse-mean-pain/
It seems to me an uncivilized and insane notion that just because someone in current moderate to severe pain had a history of an alcohol or drug read more.. APS Conference on Opioid Dosing Guidelines
APS Symposium: Opiate Dosing Guidelines - Outrage or Imperative?; Alex DeLuca; War on Doctors/Pain Crisis blog of the Pain Relief Network; 2008-07-10. Broken link to Opioid Therapy for Chronic Pain fixed: 2008-08-08. (Discuss on PRN’s Chronic Pain Forums)
Permalink: http://doctordeluca.com/wordpress/archive/aps-guideline-confaps-guideline-conf/
See also:
Opiate Dosing Guidelines: Outrage or Imperative1
PRN State Tort Claim vs WA State
PRN Complaint for Declaratory/Injunctive Relief, read more.. Judge Refuses to Gag Dr. Schneider’s DefenseA federal judge on Thursday denied the government's efforts to gag defense attorneys, family and supporters of a Kansas doctor accused of unlawfully prescribing medication. In his ruling, U.S. District Judge Monti Belot said the government had not shown a compelling government interest in restraining speech. PRN files State Tort Claim vs. WA State
Pain Relief Network files State Tort Claim vs. WA State; Laura Cooper, Esq.; Pain Relief Network; 2008/07/08. [Full text PDF]
Permalink: http://doctordeluca.com/wordpress/archive/prn-tort-claim-vs-wa/
See also:
PRN Complaint for Declaratory and Injunctive Relief, and Damages - 2008
and,
WA’s Interagency Guideline on Opioid Dosing for Non-Cancer Pain - 2007
SUMMARY:
Nature of Relief Sought: This lawsuit is the result of grossly misinformed prejudices about read more.. Chronic Pain is a Medical EmergencyAcademic quality, fully footnoted, article on why untreated or undertreated chronic pain is a medical emergency.
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