The Corner

Health Care

Pain Doctors Face Greater Scrutiny Than Death Doctors

(Photo: Vadimgozhda/Dreamstime)

Our society often sacrifices law-abiding and productive people to protect the dysfunctional from themselves.

The current attack on opioid addiction threatens more of the same. To prevent over-prescribing and pill-pushing, pain patients who need strong drugs to function are being pushed off their proper dosages. The result too often? Agony.

Reason has a very good article on this problem in the current issue. I am not a believer in its libertarian approaches to drugs, but the article does a splendid job of describing how the well-being of legitimate pain patients are being sacrificed in the fight against opioid addiction. From, “America’s War on Pain is Killing Addicts and Leaving Patients in Agony“:

Some physicians have decided the safest course is to stop prescribing opioids altogether. “There are many pain clinics flooded with patients who have been treated previously by their primary care physician,” says Jianguo Cheng, president-elect of the AAPM. These refugees include patients who “have been functional” and “responding well” to opioids for “many years.”

Schnoll sees similar problems. “Pain is still undertreated, and unfortunately it’s getting worse because of the backlash that’s occurring,” he says. “I still get calls from patients whom I treated years ago, who were on stable doses of medication, doing very well, who have chronic pain conditions, and they can’t get medication to treat their pain. They’re being taken off medication on which they had done very well for years.”

One such patient, a former cable company salesman named John, successfully used OxyContin to treat the back pain caused by injuries sustained during a mugging in 2011. Before he found a medication that worked for him, he recalls, “my wife was about to leave me, because I was a miserable bastard. When you’re in that much pain, you want to just go to sleep and not wake up.”

After the CDC guidelines came out, John was told that his daily dosage had to be cut in half. “My whole life turned upside down in a matter of 30 days,” he says. “I’m back in bed now. I can’t really get up very much, and I’m right back where I started in 2011.”

The story has other such awful examples of functional lives on pain medication ruined by doctors afraid to treat their patients’ adequately or abandoning them for fear of government scrutiny. It’s very worth your time reading.

And here’s the thing: At a time when assisted-suicide pushers fear-monger about unrelieved pain as a reason to legalize doctor-prescribed death, physicians are so afraid of the feds they leave some pain patients in the lurch, thereby unintentionally pushing them toward suicide — assisted and otherwise.

Making matters worse, doctors who intentionally prescribe lethal doses of opioids for use in assisted suicide have far greater legal protections than physicians who prescribe the same drugs responsibly to control pain.

What, Wesley? How is that possible?

Assisted-suicide laws merely require that doctors act in “good faith,” such a low standard of care that it is almost impossible to violate barring malicious intent.

In contrast, drug laws hold pain-control doctors to a much stricter and detailed standard of care — which places the palliative clinician under greater legal risks for making mistakes.

So, here’s where we are:

  • Legitimate pain patients are being abandoned to agony that could be relieved because the responsible are being swept up with the dysfunctional and criminal.
  • Doctors who practice the difficult specialty of controlling pain find themselves increasingly under a darkening cloud of suspicion and greater threat of government scrutiny.
  • Doctors who prescribe opioids to patients for use in assisted suicide are free to do so with without worry about oversight or accountability.

Talk about a topsy-turvy world.

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