Addiction, Pain, and Public Health website - war on doctors/pain crisis blog

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Other Commentators:
Selected Comments to John Tierney's blog Entries on Hurwitz Retrial

Selected Comments to TierneyLab
articles posted between 2007-04-23 and 2007-04-30; compiled by DeLuca; 2007-05-10.

Related resources:  
Drug War Journalism and Advocacy archives  ; 
 WAR ON PAIN SUFFERERS Special Collections
War on Docs Academic Literature and Official Reports 
See also:
Deadly Morals -
Katherine Finkelstein, Playboy, 1997
The Police State of Medicine - William Hurwitz, M.D. Drug Policy Foundation, 1997-10-18
Jailing the Healers and the Sick - Rufus King; Yale Law Journal, 784-7; 1953
Message from Dr. Hurwitz: Sentencing, and Letters of Support - William Hurwitz phone call to DeLuca; 2007-05-04
War on Doctors/Pain Crisis blog and RSS feed


April 30th, 2007.  In response to Hurwitz Jurors Explain Their Verdict - John Tierney; TierneyLab; 2007-04-30.

... My father was a primary treating physician who was charged and convicted of violating the C.S.A. He is currently serving 60 months in federal prison. He went to all the pain conferences to which you have probably been. He listened to all the advice given at those conferences about how to properly record patient ailments so as to not be investigated. He followed those recommendations. He prescribed very minimal amounts of pain medications to patients who very much needed the medication. Yet after the DEA spent millions of dollars raiding his office, his accountant's office and his billing clerk's home, they could not walk away. Within 3 years of the initial investigation my father was convicted of violating the C.S.A. based on the actions of 5 out of over 3000 patients he had. All 5 were facing criminal prosecutions of their own. [see: The 'Sex for Drugs' Trials of Dr. Bernard Rottschaefer; War on Pain Sufferers collection #14]

The point is that these investigations cost a lot of money and they need a conviction to establish a reason for the costly investigations. What you see reported from the trials are only the most egregious facts skewed entirely in favor of the government. While I have yet to see one doctor who actually dealt drugs as defined by the C.S.A., there are hundreds in jail through trials or plea bargains. I am sure that Dr. Hurwitz had excellent record keeping which is the only reason he still has his head above water while swimming for his life. - Posted by M.R.

April 30th, 2007. In response to
Hurwitz Jurors Explain Their Verdict - John Tierney; TierneyLab; 2007-04-30.

Is it true the DEA Agents had patients cooperating in the investigation and were letting said patients still receive the opioid medications? Were these patients selling the medications while they cooperated in the investigation? Why did the DEA not seize these medications (or did they)? Did the DEA ever bring their specific findings on these patients to Dr. Hurwitz and ask him to seize prescribing? If the DEA knowingly facilitated these patients in fooling Dr. Hurwitz and let these patients sell the medications, is the agency not itself facilitating drug dealing? - Posted by James

April 30th, 2007. In response to Hurwitz Jurors Explain Their Verdict - John Tierney; TierneyLab; 2007-04-30.

So basically the jurors are telling us they sent this man to prison for the rest of his life because he was negligent. Seems like in the old days one could be sued for negligence but were seldom convicted of criminal wrongdoing without criminal intent. No wonder we have become the United States of the Incarcerated. Perhaps you should run an article on jury nullification since seem to be trying hard to squash any knowledge of the practice. - Posted by Dave_D

April 29th, 2007. In response to
Hurwitz Convicted on 16 Counts of Drug Trafficking - John Tierney; TierneyLab; 2007-04-27.

"MD, ABA, subspecialty pain, DAPM" writes that "Dr Hurwitz has done more damage to the field of pain medicine by his insistence on martyrdom than any help he claimed to be doing."

I have seen this point of view expressed before, but I have to point out that Dr. Hurwitz is only one of literally dozens of pain physicians prosecuted in recent years under similar circumstances. His case is the highest profile, but the others were fairly high profile as well. Unless one believes that prosecutors around the country would not have brought charges against those other doctors were it not for Dr. Hurwitz (a rather implausible belief, in my opinion), I don't see how the argument can hold up.

It's the GOVERNMENT that is to blame for the damage done to pain control, not Dr. Hurwitz. Agree with Hurwitz's actions or disagree with them, but keep it in perspective. -
Posted by David Borden,

April 24th, 2007. In response to
What's an Ethical Doctor to Do? - John Tierney; TierneyLab; 2007-04-23.

The chilling effect of prosecutions like this do so much harm as opposed to the few cases of addiction and/or illegal drug behavior probably caused by the prescriptive practices of the Doctor involved that it is a good area for juries to nullify the law. This also connects to the recent discoveries leading to the high suspicion of politicization of the U.S. Attorney cadre. We need to get the political will of the near or actual majority of the population that wishes to overhaul all the drug laws and by act of congress take most or all drug behavior out of the criminal justice system and go for legal distribution along with true public education as with smoking and alcohol. - Posted by robert tichell

April 24th, 2007. In response to
What's an Ethical Doctor to Do? - John Tierney; TierneyLab; 2007-04-23.

Pain has a long and distinguished history of serving the moral qualms of others. The religiously impaired have utilized pain throughout history as a moral purifier, with countless examples blighting history. Even our intrepid armchair Attorney General has claimed that pain may be doled out generously without contravening the Geneva Conventions.

Given that these medieval concepts are alive and well in the USA, it is hardly surprising that we have been host to many movements to eliminate any substances that can give a moment's reprieve from life's lesser and greater pains.

When Prohibition was finally imposed, it was universally ignored and violated, but an adventuresome criminal underclass of rum-smugglers and distillers were made quite rich in the process...

The main and objective result of criminalizing drug use has been to jail many minority "users". This has eviscerated countless neighborhoods, while doing little to "control" drug use. Criminalizing social and medical problems solves nothing while assuring that the widespread graft and corruption at all levels of the "drug war" are not endangered. It is not unreasonable to suspect that removing voters who otherwise might be expected to support Democratic candidates is an unspoken goal of the drug war, given the moralizing tone of Republicans on the matter.

What defies all sense is that deaths from illicit drugs are a tiny fraction of those from alcohol, tobacco, and even legal drugs, both here and in Britain.

However, as the moral and legal case for criminalizing drug use becomes more suspect, drug enforcers have sought to widen their search for heretofore unrecognized criminals in our midst. What could be better for the drug police than the discovery of a network of medical doctors and patients intent on circumventing drug laws by contracting and treating chronic pain? Spreading self-interested fear to doctors who might have the temerity to suggest that current drug laws are ineffective and even beside the point clearly serves the interests of those with a vested interest in keeping the status quo.

And chronic pain patients, by the nature of their afflictions, can never form an effective political force as long as they are kept in pain.

Most importantly, by mixing up in the public mind fallacious drug policy with medical judgments, the valid medical arguments against the bogus policies are weakened, again in service of keeping the failed status quo.

In the meantime, hundreds of thousands languish in prison needlessly, billions of dollars of public money is wasted, large numbers of patients fail to be treated for chronic pain and more Republicans are voted into office, with their moral Schadenfreude unruffled. - Posted by Nicholas

April 24th, 2007.  In response to
What's an Ethical Doctor to Do? - John Tierney; TierneyLab; 2007-04-23.

The ethical dilemma presented in Dr. Hurwitz's case illustrates two important facts: One, the responsibility for the use of pain management medications must fall on the patient, not on the doctor. Two, the regulation of pain medications (but not alcohol, which is just as addictive) by the government severely limits patient's options.

Putting a doctor in the position of having to police pain medication really does not empower the patient. It is the patient who must bear responsibility for his over-use of drugs - not the doctor.

Clearly Dr. Hurwitz made many responsible decisions in his practice. He shows responsible compassion, which many doctors are lacking, particularly when it comes to pain.

Again, this case illustrates that patients need more freedom of choice when is comes to pain medication–and the government should not be the one making those decisions. -
Posted by C. Hosler



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

Alexander DeLuca, M.D.

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Originally posted: 2007-05-07

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