Criminalizing Pain Sufferers

Washington state is suffering an epidemic, or so claims the state’s law enforcement community. While appearing a medical system issue,  it’s the police and government acting to stop it. The epidemic is addiction to prescription pain medications based on opiates. Law enforcement wants to severely restrict the use of opiates in the state, claiming that there are alternatives to opiate pain control that should be employed instead.  As I read the article  in the newspaper, I marveled at the numbers, which claimed that here in Spokane, about 12 people in 100,000 have pain pill addictions. They define addiction by claiming that anyone taking more than 120mg of opiates per day is abusing drugs. Their numbers include everyone who takes opiate pain control medication, regardless of the reason. The vast majority of these numbers are victims of painful and profound illness, and do not fit the example of “a bad back” or a “broken finger” used to illustrate law enforcement’s point.

I’m a part of the so called drug abusers because I take 45mg of sustained action morphine every 12 hours, and I take one to two 15mg immediate release tablets for breakthrough pain. On my worst days, that puts me over the threshold and into the problem category. The thing is, that in spite of the quantities I require to control bone pain created by my cancer, I have never once felt “high.”  To the contrary, I remain as sober as a judge. I asked my doctors about this once, saying that I didn’t understand why people abused opiates, what with my never having experienced pleasurable sensations that might encourage me to keep on taking them when I wasn’t in pain.  On the contrary, it’s just the opposite. When I have a 125mg in 24 hour day, I sometimes have to take medications to reduce the nausea I feel, the queasiness caused by the morphine. So taking the amount of medications that classify me as an addict in Washington parlance, I’m still not feeling very good.  Morphine doesn’t eliminate pain, it merely dulls it to the point that it’s tolerable.  The doctor’s reply to my question was that in people experiencing pain, the brain is too busy processing the pain signals to accept pleasure signals, and it’s entirely common for pain sufferer’s never to get the “euphoric” sensations achieved by abusers. This alone demonstrates us as a different class of users, yet we are still lumped together with actual abusers.

As to there being other methods of pain control, I have  the pain control regimen I do because this is what works. It took the better part of a year of trial and error to finally establish a workable medication regimen. None of the non-opiate pain controls have any positive effect on the pain caused by cancer. Every doctor I’ve spoken with about alternatives has said so. Their answers are a simple “No” –and without qualification.  Worse yet, state and federal law enforcement believes that no one should need to take these medications on a long term basis, oblivious to the fact that some of us who use these medications have cancers that will remain with us for the duration of our lives. Further, the police assert that a any history whatsoever of using marijuana classifies them automatically as a drug abuser when prescribed opiate pain medication. This, in Washington, which  is a state whose legislature has approved the use of medical marijuana as state law. Many cancer sufferers use marijuana to reduce the amount of opiates they depend on, and cancer patients and patients of other profound illness constitute the majority of the people using opiates in the state. The epidemic, if that’s the proper expression, involves cancer more than the abuse of prescription medications. It is also true that while the opiates are considered “prescription medication,” that much of the abuse has little to do with prescribed drugs, instead they are being used without a doctor’s prescription as purchased or stolen. It is true as well that many individuals try to con physicians into the prescribing of opiates with faked symptoms, or visits to multiple emergency rooms, duplicating their complaints among a series of doctors.

To that end, the state is firmly behind a shared medical records system, which allows any medical facility to work from a single record.  I tend to like this idea in spite of obvious vulnerabilities to invasion of privacy. Shared records means that people other than doctors could get hold of information and use it in prejudicial or other negative ways. But it beats the idea of criminalizing medical prescription processes.  The problem is that state law enforcement, spurred on by federal law enforcement wants both.

The DEA is, of course, in on the action and leading the charge. At their suggestion, state law enforcement believes that doctors who prescribe opiates in large doses should be prosecuted.  Fearful doctors are likely to deny patients needed relief, instead making themselves feel better at the expense of patient comfort. Law enforcement insinuates itself into the medical processes by making declarations about patients with which they have no knowledge, painting them with the same brush with which they paint abusers. With proponents of controlling the ‘epidemic’ blinded by zealotry and ignorance in large doses, I’d have to say that there is an epidemic, but it’s got little to do with pain medications and a lot to do with uninformed generalization. Law enforcement needs to keep its eyes on law breaking and averted from assumptions of individuals which they have no patient expertise.

“We have qualified, expert physicians” claims law enforcement. Yes, they have doctors who are qualified to make generalized statements in some respects. Put put them on the stand and ask them if they have expertise in the specific patients that would be affected by proposed legislation and they would reply that they did not. They would if they chose not to make false claims. All physicians are aware that patients absolutely cannot be painted with the same brush, no matter the topic. But law enforcement can afford to make more simplified generalizations, and often do. More and more militarized every day, their job is to uphold the law that society be protected from predatory actions. I have no objection whatsoever with their arresting people who engage in predatory acts. To throw out a wide net of a law, expanded so broadly to encompass the sadly huge number of cancer and other genuine pain sufferers falls into the realms of the cruel and human. I have experienced pain so severe I begged those around me to end my life to escape it. Fortunately the doctors helping me put a higher value on life than law enforcement does, so I’m here today to write this. A federal agency, the Veterans Administration understands the destructive nature of pain and recognizes that certain illnesses require different rules in terms of pain medication. So their oncology departments are exempt from the more restrictive policies employed by their other medical departments. The recognize that all patients requiring pain management cannot be categorized together. That law enforcement agencies of the same federal government have not reached this level of wisdom is one of the many mysteries of inefficient governing. That the state law enforcement officials subscribe to such rank misconception to the point they misrepresent the problems with fallacious statistics and examples that demean pain sufferers is equally mysterious. Especially so in a state that recognizes the problems created by pain to the point it approves of self medication with marijuana. Pain is an indicator of extreme discomfort, not condemnation of the guilty.

Law enforcement has no business in medical choices. None at all, regardless what their hubris tells them. People, being as they are, will always include a few who will take advantage of a situation for their own gain or pleasure. Twelve people per 100,000 isn’t an epidemic unless we’re talking about Ebola, and there is no reason to impinge on the comfort and lives of the 99,988 people in 100,000 who are not abusing medication. When this legislation comes to light, wherever it arises, voters should take a page from drug enforcement and  just say NO.