Michael Arnold Glueck and Robert J. Cihak
Tuesday, July 1, 2003

Prosecutors and law enforcement officials throughout the country are egregiously targeting doctors for helping patients manage crippling pain with controlled, legal drugs.

We've addressed this topic before ("The Painful DEA") but find the need to keep commenting until justice is done and the Drug Enforcement Administration (DEA) and other government officials get it right. Judging from letters we've received, many people – particularly seniors, the chronically ill and disabled – are very upset about the DEA's interference with their ability to receive appropriate medical treatment.

For example, in an overzealous prosecution, the Arizona medical community was shocked by the indictment of Tucson physician Jeri Hassman, M.D., on charges stemming from her legal prescriptions for pain relief for her patients.

Speaking at a news conference on June 26 at Hassman's Tucson offices, Jane M. Orient, M.D., Executive Director of the Association of American Physicians and Surgeons, explained why AAPS has decided to support Dr. Hassman: "Throughout the United States, physicians are being threatened, impoverished, delicensed, and imprisoned for prescribing in good faith with the intention of relieving pain."

For some government officials, the "War on Drugs" has come to also mean a war on lawful drugs and against the doctors who prescribe them and the patients who take them. Some prosecutors try to make political careers out of high-publicity cases involving the hot "drug du jour" such as OxyContin. But this war is causing enormous collateral damage and deaths to innocent patients from "friendly fire."

Physicians have been drummed out of practice, jailed and even driven to suicide in the face of these 21st century witch hunts. "These doctors are treating patients at great personal risk. If this continues, not one doctor will be willing to prescribe the medications that patients so desperately need," warned Dr. Orient.

The real problem is not drugs, but drug misuse. Drugs are dangerous and must be treated with respect. Yet to many patients, drugs are life-saving.

"Law enforcement agents are using deceitful tactics employed to snare doctors, and prosecutors manipulate the legal system to frighten doctors and patients who might be willing to testify on behalf of the wrongfully accused doctors," said Orient. For example, she explained that law enforcement sends undercover actors to doctors to feign pain and beg for drugs.

Several of Hassman's patients spoke about the debilitating pain they suffer and their problems finding doctors to treat them now that their doctor's license and ability to write prescriptions have been suspended. Physicians at the press conference confirmed they now practice in an atmosphere of fear and intimidation.

Physicians and pharmacies already do report potential "drug-seeking" patients to law enforcement, yet are never warned by law enforcement officials about patients they believe are "drug seekers" trying to take advantage of physicians or pharmacies. Communication is flowing in only one direction.

Law enforcement uses outdated norms for assessing excessive prescribing. Investigators frequently look at the volume and duration of drug use as the primary trigger for an indictment. This is no longer appropriate, as standards for appropriate and accepted treatment have changed, leading to indictments of pain specialists simply due to the volume of their necessary prescriptions.

To stop the misuse of prescribed drugs without depriving patients of life-saving medication requires cooperation between police and physicians, not persecutions and prosecutions In order to focus the debate on criminals rather than innocent patients and doctors, AAPS kicked off a national three-point "Communicate and Cooperate" campaign at the press conference to work with law enforcement, making the following recommendations:

1. Work Together

Doctors, pharmacists and law enforcement officials should work together to track and report potential drug abusers to each other.

2. Professional Medical Review of Potential Cases

Before charges are filed against a pharmacist or doctor, a review board of medical professionals should meet under the auspices of the Department of Justice to assess a physician's practices, rather than totally relying on judgments made by non-medical police and prosecutors.

3. Mutual Training and Communication

Law enforcement investigators should received training in modern medical treatment and current trends. Medical professionals should be informed of suspected drug abusers.

Notes Orient, "In the art of medicine, investigators must be able to distinguish between a difference of opinion in what is proper treatment, and specific criminal intent. The DEA could pull the plug on most drug diversion by working with doctors instead of against them."

Currently the war on legal drugs ensnares too many doctors and not enough dealers. Those who require legal medications ought to be able to receive them without their doctors and pharmacists going to jail!

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.

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Contact Drs. Glueck and Cihak by e-mail.

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