Michael Arnold Glueck, M.D. and Robert J. Cihak, M.D.
Saturday, Oct. 11, 2003

In the wake of our and others' recent columns on overzealous prosecutors jailing physicians for prescribing legal medications, radio star Rush Limbaugh announced at the end of his broadcast today, Friday, Oct. 10, that he will check into a rehab clinic to treat an addiction to pain-killing drugs. Responding to a story published last week by the National Enquirer, he told his millions of listeners "part of what you've heard and read in the past week is correct."

"I am addicted to prescription pain medication," he said in his statement.

Limbaugh explained that he began taking prescription painkillers about five or six years ago to ease pain following unsuccessful spinal surgery.

Now we learn that on the prior Thursday night some Democrats thought severe pain was funny!

Media counsel for the Association of American Physicians and Surgeons (AAPS) issued the following statement in response to comments made by Sen. John Kerry during the Democratic debate on Oct. 9, 2003:

"Sen. Kerry owes an apology to the more than 48 million Americans who suffer chronic pain. Few of them would see the humor in his flippant remarks about a desperate patient's attempts to relieve a devastating medical condition – nor do we.

"Substitute 'mental retardation' or 'cancer' in his remarks, and the level of outrage would be voluminous and loud. According to the audience reaction of laughter, the Democratic party that 'felt our pain' under Bill Clinton now finds it fodder for jokes.

"Courageous physicians are being prosecuted for prescribing legal pain treatment. This 'war on drugs' has turned into a war on doctors and the legal drugs they prescribe and the suffering patients who need the drugs to attempt anything approaching a normal life. Patients are having difficulty finding doctors to treat them as a result of misguided drug policy, law enforcement, and overzealous prosecutions.

"The result of recent prosecutions of dozens of leading pain specialists is that doctors are afraid to prescribe opioids, and patients can't get the drugs they so desperately need. Physicians are being threatened, impoverished, delicensed, and imprisoned for prescribing in good faith with the intention of relieving pain. And their patients have become the collateral damage in this trumped-up war.

"Some patients require very large doses, sometimes literally hundreds of pills in each prescription – a number that may seem alarming to people unfamiliar with current treatment standards in pain management. Other patients report that they have resorted to lying about being heroin addicts in order to get pain medication at methadone clinics."

The situation has become so critical that AAPS has sent out a warning to doctors:

"If you're thinking about getting into pain management using opioids as appropriate – DON'T. Forget what you learned in medical school – drug agents now set medical standards. Or if you do, first discuss the risks with your family."

If this continues, pain patients will be back in the Dark Ages of 'pain clinics' that basically told the patients they had to learn to 'live with the pain' – except possibly if they had cancer and then they wouldn't have to live with it for very long.

Prosecutors are hell-bent on targeting career-making, high-publicity cases on the backs of patients and doctors. Recent actions show that prosecutors have little concern about the trail of destruction left by their actions as patients face crippling pain and gut-wrenching withdrawal.

If this continues, there won't be one doctor left willing to prescribe the drugs that patients so desperately need.

And that will leave Rush Limbaugh and 48 million other patients who have legitimate medical illnesses, injuries and disabilities seeking legal medications in illegal ways. Perhaps they will call their lawyers, prosecutors and judges to obtain prescriptions for legal pain medications.

Or perhaps they won't. Either way, the Democrats think pain is funny! And either way we are heading for a painful showdown.

Michael Arnold Glueck, M.D., is a multiple-award-winning writer who comments on medical-legal issues. Robert J. Cihak, M.D., is a former president of the Association of American Physicians and Surgeons.

Contact Drs. Glueck and Cihak by e-mail.

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