Federal War On Drugs Threatens The Effective Treatment Of Chronic Pain
11 February 2004
HON. RON PAUL
OF TEXAS
IN THE HOUSE OF REPRESENTATIVES
11 February 2004
2004 Ron Paul 4:1
Mr. PAUL. Mr. Speaker, the publicity surrounding popular radio talk show host Rush
Limbaughs legal troubles relating to his use of
the pain killer OxyContin will hopefully focus
public attention on how the federal War on
Drugs threatens the effective treatment of
chronic pain. Prosecutors have seized Mr.
Limbaughs medical records in connection with
an investigation into charges that Mr.
Limbaugh violated federal drug laws. The fact
that Mr. Limbaugh is a high profile, and often
controversial, conservative media personality
has given rise to speculation that the prosecution
is politically motivated. Adding to this suspicion
is the fact that individual pain patients
are rarely prosecuted in this type of case.
2004 Ron Paul 4:2
In cases where patients are not high profile celebrities like Mr. Limbaugh, it is a pain management
physician who bears the brunt of
overzealous prosecutors. Faced with the failure
of the War on Drugs to eliminate drug cartels
and kingpins, prosecutors and police have
turned their attention to pain management
doctors, using federal statutes designed for
the prosecution of drug kingpins to prosecute
physicians for prescribing pain medicine.
2004 Ron Paul 4:3
Many of the cases brought against physicians are rooted in the federal Drug Enforcement
Administration (DEA)s failure to consider
current medical standards regarding the use of
opioids, including OxyContin, in formulating
policy. Opioids are the pharmaceuticals considered
most effective in relieving chronic
pain. 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.
2004 Ron Paul 4:4
Furthering the problem is that 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 such a large number
of pills to effectively treat chronic pain.
However, zealous prosecutors show no interest
in learning the basic facts of pain management.
2004 Ron Paul 4:5
This harassment by law enforcement has forced some doctors to close their practices,
while others have stopped prescribing
opioids — even though opioids are the only way
some of their patients can obtain pain relief.
The current attitude toward pain physicians is
exemplified by Assistant U.S. Attorney Gene
Rossis statement that our office will try our
best to root out [certain doctors] like the
Taliban.
2004 Ron Paul 4:6
Prosecutors show no concern for how their actions will affect patients who need large
amounts of opioids to control their chronic
pain. For example, the prosecutor in the case
of Dr. Cecil Knox of Roanoke, Virginia told all
of Dr. Knoxs patients to seek help in federal
clinics even though none of the federal clinics
would prescribe effective pain medicine.
2004 Ron Paul 4:7
Doctors are even being punished for the misdeeds of their patients. For example, Dr.
James Graves was sentenced to more than
60 years for manslaughter because several of
his patients overdosed on various combinations
of pain medications and other drugs, including
illegal street drugs. As a physician with
over thirty years experience in private practice,
I find it outrageous that a physician would be
held criminally liable for a patients misuse of
medicine.
2004 Ron Paul 4:8
The American Association of Physicians and Surgeons (AAPS), one of the nations leading
defenders of private medical practice and
medical liberty, has recently advised doctors
to avoid prescribing opioids because, according
to AAPS, drug agents set medical standards.
I would hope that my colleagues would
agree that doctors, not federal agents, should
determine medical standards.
2004 Ron Paul 4:9
By waging this war on pain physicians, the government is condemning patients to either
live with excruciating chronic pain or seek
opioids from other, less reliable, sources —
such as street drug dealers. Of course,
opioids bought on the street will likely pose a
greater risk of damaging a patients health
than will opioids obtained from a physician.
2004 Ron Paul 4:10
Finally, as the Limbaugh case reveals, the prosecution of pain management physicians
destroys the medical privacy of all chronic
pain patients. Under the guise of prosecuting
the drug war, law enforcement officials can
rummage through patients personal medical
records and, as may be the case with Mr.
Limbaugh, use information uncovered to settle
personal or political scores. I am pleased that
AAPS, along with the American Civil Liberties
Union (ACLU), has joined the effort to protect
Mr. Limbaughs medical records.
2004 Ron Paul 4:11
Mr. Speaker, Congress should take action to rein in overzealous prosecutors and law enforcement
officials and stop the harassment of
legitimate pain management physicians, who
are acting in good faith in prescribing opioids
for relief from chronic pain. Doctors should not
be prosecuted for doing what, in their best
medical judgment, is in their patients best interest.
Doctors should also not be prosecuted
for the misdeeds of their patients.
Finally, I wish to express my hope that Mr.
Limbaughs case will encourage his many fans
and supporters to consider how their support
for the federal War on Drugs is inconsistent
with their support of individual liberty and Constitutional
government.
Note:
Chapter 4, taken from Congressional Record of February 12, 2004 and dated February 11, 2004, is essentially the same as Chapter 5, as found in Ron Pauls Congressional website, but they have different titles.