Attorney general helps those in pain

Hatch will not accept federal methods that condemn Minnesota citizens.

Not long ago, chronic pain patients trusted their doctors to prescribe the medicines they needed to live a normal, pain-free life. Attorney General Mike Hatch, says those days are now gone and Minnesota physicians are shortchanging their patients.

In a letter sent to Washington earlier this year and signed by Mike Hatch and attorneys general from a remarkable 28 other states, a solid case was laid out against the federal Drug Enforcement Agency. The letter described how the drug warrior tactics used by DEA to catch a few bad doctors is tearing apart the traditional patient-doctor relationship – especially for end-of-life patients. Hatch, of course, wants to stop those who divert Oxycontin and other opioid-based prescription medicines onto the black market. He will not accept methods that condemn Minnesota citizens to live in pain needlessly.  The case against the DEA, according to the attorneys generals, looks like this:

Spreading fear: “In our consumer protection role, working to remove barriers to quality care for citizens of our states at the end of life,” the attorneys general wrote. “We have learned that adequate pain management is often difficult to obtain Ö Many physicians fear investigations and enforcement actions if they prescribe adequate levels of opioids.” The DEA puts patients at risk by not drawing a clear legal line to define where medical practice crosses into what DEA considers illegal, drug-dealing territory. By reserving for itself the complete discretion to decide when a crime has been committed by a doctor, DEA keeps Minnesota physicians in a legal fog.

Bogus evidence: DEA’s crime indicators make little sense to a doctor. For example, the number of patients in a practice who receive pain-killers, the number of tablets prescribed and the duration of therapy with these drugs, according to DEA, are factors that may indicate drug diversion. Hatch and his colleagues disagree, writing, “Because good practice may involve precisely the factors that DEA believes might be indicative of diversion, DEA is creating a climate that puts legitimate medical practitioners in danger of investigation and discourages good practice.”

The letter adds, “As law enforcement agents, we should concentrate on drugs that are illegally on the streets and work back to see how they got there. An undue focus on potentially misleading factors serves neither the goals of law enforcement nor the needs of patients.” In other words, the DEA should get out of the doctor’s office and into the street.

Doctors play it safe: State officials are also concerned that current DEA policies give the agency a blank check to harass physicians. DEA contends “It is a longstanding legal principle that the Government can investigate merely on suspicion that a law is being violated or even just because it wants assurances that it is not.”

Attorney generals want to know why does the DEA needs such tactics. “This type of uncertainty alone,” they wrote, “is detrimental to the practice of medicine because physicians tend to practice conservatively to avoid even the possibility of legal involvement. Such practice is not primarily concerned with the best interests of patients, but is instead concerned with protecting physicians from liability. Physicians should not be put in the position of having to choose between protecting themselves and providing the best possible care for the patients who need their services.”

Who pays the price when doctors cover their legal backsides by mistreating people in pain, by withholding medicines that might raise a red flag? The patients do. The states have called upon DEA to take a close look at the collateral damage being caused by its drug war culture and to “focus on factors that distinguish the criminal trafficking and diversion of pain medicines from the legitimate and responsible practice of medicine.” Many millions of Americans in chronic pain in Minnesota and across the nation are now waiting.

Ronald Fraser writes for the DKT Liberty Project. Please send comments to [email protected]