Sunday, December 18, 2011

Articles that restore my faith in humanity...

I am often faced with fear of repercussion for speaking my mind, here or anywhere else. It's easy to judge. It's easy to follow the party line. It's safer. It's the nail that stands up that gets hammered down. A quick Google search by any one of my doctors, and I could quickly be seen as a "problem patient" before the word go. I could easily be branded a rabble-rouser... a trouble-maker. Discrimination is rampant and has very real consequences on my access to care, let alone the quality of that care. But when others speak out too, I take heart. I'm not the only one standing up and pointing out the emperor has no clothes. Here are some choice articles from doctors and law enforcement about how prohibition is harming us all.

From, Legalizing marijuana: Police officers speak out:
[Once] again, the inbox contained a much greater number of pro-legalization comments than those supporting continued prohibition. Here’s what I got from MacKenzie Allen, a retired King County (Wash.) sheriff’s deputy who was also formerly with Los Angeles Sheriff’s Office.

“I think the first thing with which we all must come to grips is the fact that drug use can never, will never be done away with. Humans have been intoxicating themselves (as have some lower orders of animals) throughout history. We will never “arrest” our way out of this. The drug problem is a health and education issue, no less so than alcohol and tobacco. We’ve been fighting the “War on Drugs” for more than 40 years. It has cost a trillion dollars and thousands of terminated and/or ruined lives with nothing to show for it but more drugs, cheaper drugs, higher quality drugs, more corruption and infinitely more violence. We need to legalize, regulate and strictly control all drugs. Continuing on our present course is insanity.”

From the first part in a series, Tales From the Trenches in the War on Pain, comes this strong supporter of pain relief:
Although I practice child, adolescent, adult, and forensic neuropsychiatry, the majority of my clinical practice is in the field of pain management, and I am a strong supporter of using opioids for the treatment of chronic noncancer pain. I have come to this position after approximately 11 years of face-to-face patient interaction, along with ongoing intensive review of the medical and scientific literature dealing with opioids, and the other forms of analgesic medication, as well as the neuroscience behind chronic pain disorders.

For several years now, and especially over the past several months, there has been an ongoing barrage of news media attention focusing on the fact that overdose deaths due to prescription opioids have reached “dangerous” or “alarming” levels of epidemic proportions. In response to these statistics has come an almost mob-like crusade to track down and punish incompetent, unethical, “pill mill” physicians and their practices, which is justified and one would think this could be easily attainable. Inexplicably, these objectives do not seem to be that easy to accomplish. Why?

At the same time, there also seems to be a push to punish and/or eliminate the pain physician who by some mysterious standard is considered to be over-prescribing pain medications, and/or prescribing medications in “extraordinary” or inconceivable combinations. Of course, these assertions fly in the face of science, and the experiences of the untold myriad of patients who literally have new, functional lives, less troubled by the specter of chronic debilitating pain. These patients still have pain and they always will suffer from it; however, with the right combination of medications — including and especially opioid medications — they once more can experience lives that contain a modicum of tranquility.

As stated above, I am a neuropsychiatrist. I am certain that I see great medical benefits bestowed upon the vast majority of my patients with chronic pain who are prescribed opioid analgesics. They and their families tell me that this is so, and I believe with an objective eye that I see the benefits as well.

From Chronic Pain in America is a National Disgrace, we learn that:
“Federal and state drug abuse prevention laws, regulations, and enforcement practices have been considered impediments to effective pain management….” Among other barriers, they say “Twenty-nine percent of primary care physicians and 16 percent of pain specialists report they prescribe opioids less often than they think appropriate because of concerns about regulatory repercussions.”

The report observes that, “Ironically, while many people with pain have difficulty obtaining opioid medications, nonmedical users appear to obtain them far too easily.” However, the panel also states in italics for emphasis that “the majority of people with pain use their prescription drugs properly, are not a source of misuse, and should not be stigmatized or denied access because of the misdeeds or carelessness of others.”
(Emphasis mine.)

And one of the most hopeful pieces of information I've seen, from Myth-Representations of Opioids & Their Risks is:
Forest Tennant, MD, has assembled an extensive array of documented cases in patients with chronic pain, ranging in age from 30 to 83 years, who have responded well to and thrived on opioid analgesic therapy for from 10 to 35 years. He observed relatively few complications of the therapy, and those were easily managed.
(Emphasis mine.)

Here we have officials with good standing in the community who are laying that at risk to stand up for what they see is right. That warms my heart to no end. They have so much more to lose than I do. In this video from Freedom Watch, and the first article linked here, we learn that there are professional law enforcement individuals losing their livelihood because they said something in favor of legalization.

There are doctors being pushed out of their practice. There are patients who are suffering. There are non-violent citizens made criminals because of putting something in their body. There are people of good standing being marginalized for speaking out. But there are those still willing to stand, still willing to say, "This is wrong..."

I thank them for it.

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