After aCrackdown on aPain Clinic, aTragic Double Suicide
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p“In my mind, what the DEA [Drug Enforcement Administration] is essentially doing is telling anbsp;diabetic who’s been on insulin for 20nbsp;years that they no longer need insulin and they should be cured. They just don’t understand what chronic pain is.”/p
pThat’s what Gretchen Elliott’s brothernbsp;a href=https://www.vice.com/en/article/wxnyb9/dea-fentanyl-doctor-patient-suicide target=_blanktold/anbsp;emVice/emnbsp;at his sister’s funeral last month. Gretchen and her husband Danny committed suicide because they could no longer endure anbsp;pain that doctors were terrified of treating. It was the most recent of the many dreadful outcomes that follow when cops practice medicine./p
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pDanny had chronic, searing pain from an electrocution accident years earlier. For treatment, he and Gretchen, his caretaker, traveled regularly from their home in Georgia to anbsp;pain management physician in Beverly Hills, California, to receive pharmaceutical fentanyl. But on November 1, DEA agents suspended the Beverly Hills physician’s narcotics prescribing license, having decided that he was inappropriately prescribing painkillers. Anbsp;week later, Danny and Gretchen killed themselves./p
pThe DEA has not formally charged the physician, David Bockoff, who has been practicing medicine with anbsp;spotless record in California for 53nbsp;years. He was treating many “pain refugees” like Danny: patients with chronic pain, well‐managed with opioids, whose previous physicians had either closed after anbsp;DEA visit or abruptly cut off their pain medication fearing the wrath of law enforcement./p
pExactly one year before Danny and Gretchen ended their lives, Casonya Richardson‐Slone, the widow of Brent Slone, won anbsp;a href=https://www.statnews.com/2021/11/22/her-husband-died-by-suicide-she-sued-his-pain-doctors-a-rare-challenge-over-an-opioid-dose-reduction/ target=_blankwrongful death/anbsp;medical malpractice suit against her late husband’s pain clinic. He committed suicide after the clinic abruptly curtailed his pain medication./p
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pAfter losing access to opioids, many patients can’t live with constant pain./p
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pInnbsp;“a href=https://www.cato.org/white-paper/cops-practicing-medicine target=_blankCops Practicing Medicine/a,” anbsp;new paper for the Cato Institute, Trevor Burrus and Inbsp;trace the history of law enforcement’s intrusion into the patient‐doctor relationship, from the war on drugs’ earliest days—when Congress passed the Harrison Narcotics Act of 1914—to the present. By 2006, policymakers mistakenly attributed the overdose crisis tonbsp;doctors “overprescribing” opioids. This formed the basis for an even more gigantic intrusion of federal and state power into the privacy of medical records, into patient‐doctor confidentiality, and into the very ways doctors are allowed to use scientific and professional knowledge when practicing medicine./p
pToday,nbsp;a href=https://ballotpedia.org/Opioid_prescription_limits_and_policies_by_state target=_blank38 states/anbsp;have laws on the books that limit the dosage and amount of pain relievers doctors can prescribe to their patients. Many of these laws have cast in stone the Centers for Disease Control and Prevention’s now‐discredited 2016nbsp;a href=https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm target=_blankGuideline for Prescribing Opioids for Chronic Pain/a. The guideline came under so muchnbsp;a href=https://www.cato.org/blog/lawmakers-really-want-follow-science-they-will-repeal-codified-opioid-guidelines target=_blankcriticism/anbsp;from pharmacologists, clinicians, and academic physicians that the agencynbsp;a href=https://www.cato.org/blog/cdc-replaces-flawed-2016-opioid-prescribing-guideline-flawed-2022-opioid-prescribing-guideline target=_blankrevised/anbsp;it this past November. No matter. The flawed 2016 guideline remains the basis of the prescribing laws in most states. Doctors face losing their licenses or, worse, jail time if they violate these laws.nbsp;/p
pAll 50 states maintain Prescription Drug Monitoring Programs to surveil all prescriptions issued and filled within the state.nbsp;These primarily serve as law enforcement tools. In most states, police drug task forces use them to go onnbsp;a href=https://scripps.com/scripps-washington-bureau/your-prescriptions-arent-private/ target=_blankwarrantless fishing expeditions/a, hoping to find anbsp;doctor to bust for “inappropriate prescribing” or anbsp;patient they can arrest for “doctor shopping.” These programs have not reduced the overdose rate. If anything, they havenbsp;a href=https://pubmed.ncbi.nlm.nih.gov/29801093/ target=_blankdriven/anbsp;non‐medical users who cannot obtain diverted prescription pain pills to more dangerous drugs in the black market, causing the overdose rate to increase./p
pWith countless stories in the mainstream press about doctorsnbsp;a href=https://reason.com/2017/11/17/dea-raids-california-pain-doctor-feature/ target=_blankarrested/a, sometimes with police bursting into their crowded waiting rooms, or having their licensesnbsp;a href=https://www.northcarolinahealthnews.org/2020/03/10/chronic-pain-doc-suspended-after-tweets/ target=_blanksuspendednbsp;/afor overprescribing prescription opioids—even though there isnbsp;a href=https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3403814 target=_blankno legal definition/anbsp;of “overprescribing”—many doctors have been frightened into curtailing their patients’ use of pain medicine.nbsp;It is becoming increasingly difficult for chronic pain sufferers to find doctors courageous enough to help them.nbsp;Some refuse to see patients for pain altogether and refer them to pain management specialists, many of whom have long waits for appointments.nbsp;Many doctors have come to view chronic pain patients through anbsp;suspicious and stigmatizing lens as drug‐seeking addicts./p
pSome patients, in desperation, seek relief in the dangerousnbsp;a href=https://www.foxnews.com/health/readers-respond-to-special-report-about-the-opioid-crisis-unintended-victims-pain-sufferers-losing-access-to-painkillers target=_blankblack market/a.nbsp;Some exasperated patientsnbsp;a href=https://www.cato.org/blog/building-wall-between-pain-patients-their-doctors target=_blankthreaten/anbsp;their doctors. Tragically, some evennbsp;a href=https://reason.com/2022/06/07/americas-failed-opioid-policy-drove-the-tulsa-shooter-to-violence/ target=_blankmurder/anbsp;their doctors. Alsonbsp;a href=https://www.washingtonpost.com/health/opioid-crackdown-forces-pain-patients-to-taper-off-drugs-they-say-they-need/2019/09/10/3920f220-c8da-11e9-a4f3-c081a126de70_story.html target=_blanktragically/a, some resort tonbsp;a href=https://thomasklinemd.medium.com/opioidcrisis-pain-related-suicides-associated-with-forced-tapers-c68c79ecf84d target=_blanksuicide/a./p
pMeanwhile, opioid‐related overdose deaths reached anbsp;record high in 2021,nbsp;a href=https://www.pbs.org/newshour/health/cdc-estimates-more-than-107000-americans-died-of-drug-overdoses-in-2021-setting-staggering-record target=_blankexceeding 71,000/a, 89 percent of which involved illicit fentanyl. Despite anbsp;dramatic drop in opioid prescribing, deaths have soared./p
pAccording to government data, addiction to prescription pain relievers has been relatively stable atnbsp;a href=https://www.ncbi.nlm.nih.gov/books/NBK447253/ target=_blankunder onenbsp;/apercentnbsp;in this century. Chronic pain patientsnbsp;a href=https://www.cato.org/commentary/misplaced-blame-opioid-epidemic-harms-pain-patients target=_blankrarely become addicted/anbsp;to opioids. The overdose crisis is anbsp;prohibition‐induced crisis. Neither the practice of medicine nor the act of self‐medication belongs in the realm of the criminal legal system./p
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