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Comments of Frank Fisher, M.D,, at PRN Press Conference Prior to the Sentencing of Dr. William Hurwitz to 25 Years (Life) in Prison

by Frank Fisher, M.D.; PRN Press Conference, Alexandria, VA; 4/14/2005
Originally posted 4/17/2005:
Related resources:
The Dr. William Hurwitz collection  ;  Drug War Journalism collection


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Here is the text of the presentation I gave at the PRN sponsored press conference prior to Dr. Hurwitz's sentencing. There were reporters from the NYT and New Yorker present.

Today, Iąm going to talk about the physiology of pain, and the consequences that flow from our failure to treat it effectively.

The central concept in pain management is the Gate Control Hypothesis. The gate is a switch, located in the spinal cord. It modulates the transmission of pain signals. Under normal conditions, the body controls the gate with opioids. These are natural substances that are produced for this purpose.

When the gate is overloaded, it malfunctions. It opens wider, and more pain signals reach the brain. This process is called central sensitization. This drives the development of the disease, we call chronic pain.

The importance of recognizing chronic pain as a disease in its own right cannot be overstated. Chronic pain is a progressive neuro-degenerative condition. It kills brain cells, and destroys the health of its victims. It is a disease that takes your soul.

Chronic pain is a malignancy in the sense that when the disease isnąt controlled, it behaves like cancer. It spreads to parts of the body that it didnąt previously occupy. This occurs through a process called neuroplasticity. Nerves in the spinal cord make new connections. The result is that ordinary sensations like light touch, can become excruciating.

People who get this disease may end up hurting everywhere. Opioid analgesics can prevent this. Prescribing opioids is like tossing a life ring to a shipmate who has fallen overboard.

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Now I want to shift gears, and take note of the price we pay for persecuting pain doctors. I want to talk about anti-inflammatory medications. You know this class of medications by names like Motrin, Vioxx, and Bextra. The original drug of this type is aspirin.

Anti-inflammatory medications have been in the news recently, because they are dangerous. Every year 16,500 people bleed to death from the ulcers they cause. This public health disaster is preventable. If these patients were treated with opioids instead, none of them would die.

To summarize what I have said so far, we are in the midst of a pain crisis that resembles an epidemic of cancer, and we are attempting to treat it with the equivalent aspirin. Half of the elderly in this country take anti-inflammatory medications, on a daily basis, at a cost of 8 billion dollars a year. This tells us something significant about our own futures. As we age, the odds are about 50/50 that we are going to end up with chronic pain. We need to plan for this.

Did you ever wonder why so many old people can barely hobble around? Did it occur to you that they might be in hideous pain? In just a few short years, those old people will be you and me. When that happens, the old joke about łtake two aspirins, and call me in the morning, isnąt going to seem very funny.

Dr. Hurwitz was willing to toss a life ring to pain victims. Society responds to physicians like him, by conducting witch-hunts. We have to stop this, because when we persecute well-intentioned pain-treating physicians, we assure our own future suffering. By burning Dr. Hurwitz at the stake, we are literally throwing open the gates of Hell.



Dr. DeLuca's Addiction, Pain, and Public Health website

Alexander DeLuca, M.D., FASAM

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Originally posted:  4/17/2005

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