Pain Relief in the 'Land of Plenty'

God have mercy on you if you live in this "Land of Plenty" and develop some form of horrific pain. You'll end up with "plenty" alright: plenty of unnecessary pain and suffering. The government is so obsessed with "fighting" drugs that they've destroyed the ability of doctors to reduce suffering among their patients.

A recent example of this, published in The New York Times, is typical of the mess we are in. Five years ago, Frank Fisher, M.D., was arrested by goons from the California Gestapo (known as the Attorney General's office) and charged with drug trafficking and murder. And what was Dr. Fisher actually guilty of? He was guilty of relieving his patients' severe pain with legal narcotics for which he had a license to prescribe. After five months in jail, loss of his home and practice, he was released and told it was all a mistake. The patients who had died succumbed from their injuries or from medical illnesses, not from the narcotics Dr. Fisher prescribed. But these "apologies" (if you can call them that) are too little too late for Dr. Fisher and his family: His practice and his reputation are ruined. And who's going to compensate them? No one. The state is the state. It has no sense of responsibility or morality. It is not a source for good, as pinko liberals think in their childish minds. It is a continuous source of evil.

Dr. Fisher's case is not at all unusual. Even patients are not immune. Richard Paey, a patient suffering from intractable pain, was unable to obtain enough Percocet to relieve his pain, so he forged undated prescription forms his doctor had given him to get what he needed to relieve his misery. He refused to take a plea bargain when charged as he maintained he was innocent. He never sold a pill; he paid for the medication, and maintained he was being denied his right to pursue a pain-free life. So he received a 25-year sentence for pleading not guilty. He is now in jail, in a wheelchair, and on a morphine pump.

Cops take charge of your medical care

To understand the duplicity of the Drug Enforcement Agency (DEA) and to be clear as to whose side they are on, consider their behavior earlier this year. They publicly acknowledged the need for a "principle of balance" to address the necessity of access to pain medications. Their document was, according to Dr. Sally Satel who authored the New York Times article I referenced above, a thoughtful and lucid description of the problem of prosecuting doctors. But the agency pulled the document from the Web a few months later claiming there were "misstatements" in it.

How can the narcotic police judge individual cases intelligently, assuming they are intelligent, when they do not know the patient and they know nothing about medicine in the first place?

As Dr. Satel stated in her article, "It is not known how many patients need long-term treatment with opioids, particularly at high doses. Dr. Russell K. Portenoy, chairman of pain medicine and palliative care at the Beth Israel Medical Center in New York, cites surveys estimating that as many as 6 to 10 percent of Americans suffer from chronic, disabling pain. He speculates that maybe 1 in 10 of them could benefit from long-term, high dose treatment."

I beg to differ. If a patient has "chronic, disabling pain," I maintain that 10 out of 10 of them could benefit from long-term, high-dose treatment. Something tells me that if Russell suddenly found himself in chronic disabling pain, he might alter his opinion.

Quality of medicine takes a nosedive

Thanks to cases like Dr. Fisher's, which are becoming increasingly common, doctors are quitting by the hundreds. Many are switching to nursing because it is less stressful, less responsibility, less malpractice, and shorter work hours. As a result of this "doctor shortage," the quality of applicants admitted to medical school has decreased to allow more people into the profession in order to fill the gap.

CAT scans, a multi-million-dollar laboratory and computerized EKG readings will not compensate for dumb doctors. I have seen this in many third world countries: Some of them have remarkably sophisticated equipment (paid for by guess who) but because of the low quality of the doctors, they are still dangerous places to get seriously ill. This is a scenario coming soon to an operating theater near you.

The quality of medicine and the status of doctors are deteriorating concomitantly. And so is the publics' attitude toward them. As doctors become less affluent, respect for them declines. They envy those with high incomes, nice cars, and big homes on the water. But if a doctor drives an old Dodge and wears Wal-Mart shoes, the consensus seems to be: "Who would go to him? Look at the car he drives."

This is the road to ruin for American medicine. Unfortunately, there's not a whole lot we can do about it.

Action to take:

My best advice to you is to pay close attention to your doctor's credentials and treatment techniques. Odds are if you suspect he doesn't know what he's doing, you're probably right.

If that's the case, I suggest you look for a new doctor – preferably one who can help you get the pain relief you need. Physicians with a background in alternative medicine are usually more understanding about this sort of thing, and are better equipped to offer you numerous options for pain relief than mainstream docs. To locate an alternative physician near you, contact the American College for Advancement in Medicine (800-532-3688; 714-583-7666).


"Doctors Behind Bars: Treating Pain Is Now Risky Business," The New York Times, 10/19/2004

"AAPS Supports Due Process in Licensure," AAPS News 2004: 60(8)

June 23, 2005