Friday, March 09, 2012

Radley Balko: The War Over Prescription Painkillers - Huffington Post

Over the last few months, the Centers for Disease Control (CDC), the Drug Enforcement Administration (DEA), and several other government agencies have been issuing some alarming reports about abuse of prescription painkillers, and what the government says has been a dramatic rise in overdose deaths. These reports, along with another recent report by the journalism non-profit ProPublica, have spurred calls for tighter policing of painkillers, instituting digital databases to monitor pain patients and their physicians, and more aggressive tactics to prevent drug diversion.

There's no question that prescriptions for opioid painkillers like Oxycontin and Percocet have soared in recent years. It's also clear that there are some rogue doctors and "pill mills" who unscrupulously hand out prescriptions, sometimes to patients who shouldn't get them, sometimes to drug addicts and drug dealers pretending to be pain patients. But it's also far from certain that the painkiller abuse and overdoses are as dire as the government is making it out to be. And to the extent that there is a problem, it's due more to a decade of aggressive policing, obstinate federal law enforcement agencies, and the encroachment of law enforcement into the practice of medicine than lax government oversight. The DEA in particular has been scaring reputable doctors away from pain management since the late 1990s. People who suffer from chronic pain simply can't find doctors willing to treat them over the long term. The unscrupulous doctors and pill mills in the headlines have sprung up to fill the void.

The issue takes on a particular resonance as the country turns to Florida for tomorrow's Republican primary. Florida was the site of the first big painkiller panic in the early 2000s, and the state has also played a central role in the most recent flare-up. There has been little discussion of the issue in the 2012 presidential campaign. But perhaps there should be. It's a topic that touches on important issues and trends like Medicare, Medicaid and health care; the aging U.S. population; the drug war; and, pain patients would argue, the basic human rights of a large and growing portion of the public.


Parts 2 and 3: