Chip Taylor

Our insane drug policy

In a perfect world every pain-ridden patient would get the pain relief they need and nobody would abuse pain relievers. But since we don't live in a perfect world we are forced to choose between two sets of policies: Policies that allow everyone who legitimately needs painkillers to have access to them, even if it means that abusers are able to persuade doctors to prescribe unneeded medicine. Or policies that try to make sure absolutely no abusers get access to pin relievers, even if it means that some who are truly pain-wracked do without.

I prefer the former. It's more humane for the pain patients and if the abusers don't get their OxyContin they'll just get something else.

The United States government prefers the latter. Federal drug agents and prosecutors have no qualms about second guessing doctors who treat pain patients.

If the DEA thinks it knows better than trained medical professionals, perhaps it should issue some guidelines or something. Oh wait, it did. Here is what the DEA Administrator had to say about them:

"The medical and law enforcement communities continue to work together to carefully balance the needs of legitimate patients for pain medications against the equally compelling need to protect the public from the risk of addiction and even possible death from these medications. . . . The DEA is committed to assisting the overwhelming majority of health care providers who successfully strike that balance every day, as well as the law enforcement officers investigating diversion and abuse of pain medications."

Of course, that was before a doctor tried to rely on them as a defense in a drug-trafficking trial.

The Drug Enforcement Administration has reversed its support for a set of negotiated guidelines designed to end a controversy over the arrests of hundreds of pain specialists who prescribed powerful narcotics for their patients. The agency took the document off its Web site earlier this month, less than two months after announcing it with great fanfare.

In rescinding its endorsement, the DEA wrote on its Web site that the 31-page document "contained misstatements" and "was not approved as an official statement of the agency." The agency declined to give any more specifics, saying that it hoped to issue a statement "in one or two weeks."

Worried doctors who had worked on crafting the "consensus" document -- written over the past year by DEA officials and prominent pain management specialists -- criticized the agency's unannounced decision to disavow it. They said they were given no explanation or told whether the agency had changed its position on the contentious question of when and how doctors can prescribe the popular painkillers without risking prosecution.

Advocates for aggressive pain management said the DEA's decision appears to have been triggered when defense lawyers tried to introduce the guidelines in the upcoming drug-trafficking trial of William Hurwitz, a McLean physician.

In late September, Hurwitz's defense team sought to introduce them as evidence. Several weeks later, the DEA took the document off its Web site and said it was not official policy.

Twelve days after that, U.S. Attorney Paul J. McNulty, who is prosecuting Hurwitz, filed a motion in the case asking that the guidelines be excluded as evidence, again saying that they do "not have the force and effect of law."

It's a tragedy -- one among many -- that neither man who has a chance of winning the presidency gives a damn about issues like this.