Warning! This diary is part informational and part rant. I apologize ahead of time for the rant part. I am just one of the millions of victims of this ongoing war waged by the DEA against legitimate doctors prescribing pain medications to legitimate patients. I am one of the millions who is pissed off at all of the BS we have to face day in and day out to try and get relief from our chronic pain. I do promise to give as much information as I can gather and link to the stories where I can. So let the fun begin.
Way back at the dawn of time, or at least the end of the greatest decade ever, the 80s, doctors began to really change the practice of pain medicine. Much before then it was considered "good" for a person to have pain. It was considered a part of the healing process. This change towards a more compassionate view coincided with the large drug manufacturers bringing out new medications to control pain. In 1995, Purdue Pharma brought out a fantastic new drug called OxyContin. It was a time-released version of the opioid drug Oxycodone. In the first year on the market it made up only 1.3 percent of Purdue Pharma's gross sales. Within 2 years OxyContin sales had jumped and now made up half the revenue of the company. By 2003 it had skyrocketed to 1.6 Billion dollars and accounted for 94% percent of the company's revenue. Sales have remained strong since then.

Doctors were prescribing pain medications in record numbers. It wasn't just OxyContin prescriptions that accounted for this. During 2001, pain medication prescriptions jumped 150 percent from the previous year. Between 1997 and 2005, prescriptions for Oxycodone, the active ingredient in Oxycontin and many other pain killers under other brand names, jumped up by 600 percent.
With this easy access to pain killers, they began to be abused. That's where the DEA comes in. Our War on Drugs began back in the 60s but the term itself didn't really become popular until after a press conference given by President Nixon on June 18th, 1971, during which he declared drug abuse to be "Public Enemy #1".

He also created the DEA in 1973, which has become the lead agency for the enforcement of the Controlled Substances Act. We are all pretty familiar with the agency and its running battles with drug lords and gangs, both in the US and across the world. The big problem is that it can never win the War on Drugs. There is no one single enemy and there is no single leader with which to do battle. Take out one drug lord and there is always someone waiting in the wings to step into their shoes. Heck, there are times when it is two or even three somebodies waiting. The lure of easy money to be made by selling illegal drugs is huge. The large amounts of cash generated mean the drug dealers can arm themselves with machine guns and automatic weapons. It is a dangerous job trying to stop the flow of drugs across our borders and within our cities.
Just reading the above you would get the feeling I support the DEA. I do to a point, but I hate how much of it is waged. Sure, they do get some dealers and even the occasional drug lord, but mostly they take down users. That is bad. The way we treat users is horrible. We incarcerate them instead of treating them. With the advent of mandatory sentencing regulations, many users who did nothing more than smoke some dope or get high from an illegal substance have been sentenced to extremely harsh sentences in prison. The War on Drugs is failing and, in an effort to justify its continued existence, the DEA changed course in the early days of the new century. It started to focus more on prescription drugs and their abuse. Coke and heroin are still problems on our streets, but instead they have chosen to go after people who don't shoot back: people who are in the business of treating those of us who live with chronic pain.
The government has lots of statistics to justify the turn to illegal prescription drugs. There was a growing market on the street for these drugs. But one major statistic they don't trumpet is this: 95% of all illegal prescription drugs sold on the streets come from thefts from pharmacies, warehouses and trucks. So only 5% comes from illegally diverted prescriptions. With those figures, you would think the DEA would target the thieves, but nope. They don't bring in cash and lots of it. They go after doctors. Now before you start the PR campaign, I know there are some doctors who ran and do run pill mills. These doctors are very few and far between, though. Take a look at any city and I bet you can not find even one. (Okay I know some cities have more than a few.) So who could the DEA turn on since there were so few actual pill mills? How about legitimate doctors who practice what is called pain management? These doctors write a ton of prescriptions for all those wonderful opioid pain medications that sell so well on the street. When I say a lot, I mean A LOT: Take a look at it this way. I take 4 pills a day for my chronic pain. Now let's see, that comes to 4 x 30 = 120 pills a month. Now for 1 year that would be 120 x 12 = 1440 pills per year. Now let's multiply that by 100 patients. That is now 144,000 pills a year. That is a huge number and I can bet that most pain management doctors see well over 100 patients a year. Sure, some will not be taking 4 pills a day, they may only take 2 or 3, but they could also be on 6 or 8 a day. So I used 4 as an average. Now think about all the headlines you have seen about so called pill mill doctors. They say that they provided 5 million pills over 4 years or 10 million pills over 7 years or whatever. Guess what? That is the normal doctors' practice in pain management in 1 year. It sure sounds great, doesn't it? Makes for these huge headlines and makes it look like the DEA is looking out for us poor schmoes who happen to live in whatever city they pull their raid in. But here are the true facts. Those figures can fit just about every single pain management doctor in the US. Yep! Every single one of them is writing these same type of scripts for this so called "HUGE" amount of pain killers. Here is an even bigger secret. Want to know who writes more scripts than a pain medication doctor? Go take a look at a Urologist. I did, at a website that lets you see how much pain medication your doctor is writing scripts for. My Urologist is tops in the state. Them kidney stones are painful! I know because I have passed well over 200 of the little buggers. I can't find that link but you can check to see who is prescribing what in your area with this little gem: top prescribers search

So why has the DEA gone after doctors so hard ? I can give you my opinion, other opinions, but no hard facts. No one in government is talking about this switch in prosecutions against doctors. In fact, the DEA denies it is waging a war against doctors. Yet when you look into the facts, they sure state otherwise. Both investigations and prosecutions are way up. Just investigating some doctors is enough to put them out of business even without any prosecution. The taint of the investigation kills a doctor's practice, or they yank the doctor's prescription ability while they "Investigate". And even when they file no charges, the doctor is stuck because they can't write scripts while waiting for the investigation to finish. Up at the start of this paragraph I asked why they switched to doctors. In my own view it is because it is much safer to investigate doctors than real drug dealers. Heck, doctors don't shoot back. Plus, they push stats like the one in the picture to the left. Just looking at it is kind of scary. I mean heck, 15,500 deaths is a lot. While any death is not a good thing, let's look at that figure for a moment. There are about
100 MILLION people who suffer from chronic pain. While not all of them take opioid pain medications, a good many of them do. That figure of 15,500 is just 1/1000th of a percent and do not take into account how many of those were deliberate because of under-managed pain. In fact, there are no stats about how many people take their lives because of under-management of their chronic pain. There is a great article in the NY Times about an investigation of a doctor in South Carolina. You can read it if you like here:
NY Times Story
Well that is just one doctor, you will say. I could give you links to dozens more of very similar stories about doctors across the nation. Sure, the DEA has found some true pill mill doctors

who were writing scripts for patients they never met or for drugs, sex and money. I am happy they took those guys off the street and I bet if you asked the doctors, they too would support the DEA in that. However, when they start going after doctors who are doing nothing more than trying to help patients, it is getting out of hand. What is so bad is that the DEA is using out-dated medical practices or testimony from extremely conservative doctors when they go after the doctors. These doctors offer expert testimony about how the practices of the doctor on trial are just over the top. The problem is that if you give me a room full of any specialty practice, I am betting I can give you 5 different but perfectly acceptable medical opinions on treatment. So say you have 100 doctors. You ask them what is the acceptable level treatment for X condition, you will get 10 on the far left that say X, Y and Z are perfectly okay. Then you will have 20 more who lean that way but say that you should only go up to W and not beyond it. Then you get the middle of the road 40 who say "Nope, you should never go beyond S when treating it" and then you have the 20 who lean towards the even more conservative side who say "Nope, never I would never even go to Point P". The last group, meanwhile, is so conservative they are still playing with leeches. Okay I exaggerated that last one. But you get the point. Even with Medical Science there are varying opinions on any one subject and the practice in that field. So who do the juries believe? Take a wild guess. Go on, I am betting you will guess the prosecution witnesses. I mean, heck, here is Dr. X, he is widely respected in his field, and he says "giving any patient Y many pills a day is excessive. I wouldn't give more than S many ever." He pontificates and the jury laps it up like mothers' milk. Yet there is a major problem with what the government experts are saying. It is a huge and yet popular misconception even among many doctors. While it is true that high doses of opioid pain medication can cause respiratory failure in patients who have not been on them before, the exact same dose in a patient who has had their doses increased slowly over time will cause no such result. When a person has their dose changed gradually over time, slowly increasing the dosage in a process called Titration, then there is no real ceiling on how high their dosage may go. The truth of the matter is that it can be much safer to take high doses of opioid pain medications than it can be to take high doses of Aspirin or Ibuprofen, which can cause stomach bleeding and death at high doses. In fact every year between 5 and 6 thousand people die from taking high levels of these so called "safe" pain medications and yet we hear of no call to ban them or pull them from the shelf.
There is also the supposed addictive aspect of these opioid drugs. We have all heard about it in the news, from friends or relatives or even from our doctor. Just about anyone will tell you that if you start taking these medications, you will be hooked, addicted, your life screwed up. Well it actually turns out everyone is wrong. Yes addiction can occur but it is not as much of a chance as everyone makes it out to be. Just because you have to take them does not mean you will be addicted to them. There is a certain segment of the population that has a genetic makeup that predisposes them towards addiction of just about anything: gambling, alcohol, drugs or anything else like sex even. That group makes up just under 10% of the population. The truth is that, with proper monitoring, about 90% of the country can take these medications with little to no risk of addiction, while they will become physically dependent upon the drug; it is not the same as addiction. Addiction is defined by loss of control and cravings and the psychological desire to take the drug even when it will harm you. The physical effects of dependence can be mitigated by tapering the dose down and weaning the patient off of the medication. Even when a person is predisposed to addiction, it does not mean they will become addicted to opioid pain meds. Many will not have any issues. Those with no prior addiction issues will most likely not become addicted, especially if they are older, according to Russell K. Portenoy, chairman of pain medicine and palliative care at Beth Israel Medical Center in New York and a leading authority on the treatment of pain.
Let's jump down below the orange jungle gym and explore more of this war.
So we still can't pinpoint the real reason why the DEA has targeted doctors. We have my own theory that it is much safer and still pretty lucrative to go after doctors. When I say lucrative, I mean just that. They can seize a doctor's bank accounts and property as the spoils of war, just like they do to real drug dealers. Another theory is that they have come to realize that they are not winning the war on drugs. Back in the late 90s and around the turn of the century, they were getting horrible ratings on their effectiveness and their purpose. They needed to show they were still in the game, so to speak, that they could do their job. So they changed direction from going after street dealers and the cartels to going for doctors. It quickly generated big headlines for them as they took down doctor after doctor. The only problem was that what they were actually doing was sitting in judgement on doctors who were, for the most part, just trying to help their patients.
The DEA conducted 1,173 investigations in 2009 and 3,731 in 2010. I was unable to find out just how many of those resulted in prosecutions or convictions. As I said up above, though, just an investigation of a doctor can kill his practice and ruin his professional reputation. The DEA contends that they only go after the really egregious cases, but the evidence doesn't support that. There have been so many cases in the news of doctors being prosecuted because they are prescribing higher doses of pain killers than is the norm in an effort to actually help their patients relieve their pain. They weren't letting their patients sit at a pain level of 5 but were aiming for lower. This is outside the so-called norm for pain management practices, but it sure as hell shouldn't be. Allowing a patient to remain in pain at a level of 5 (which is what my own PM clinic has done with me and the rest of their patients) should be considered malpractice, not trying to get it lower. To compare that would be like a doctor allowing a patient to die because he only stitched up half their wounds or a doctor allowing a patient to leave the ER with only half a cast.
Part of the problem is the way the law is worded. The ambiguous wording is what is allowing the DEA to prosecute these doctors. The law says: "a physician cannot prescribe to someone he knows or should know is improperly using the medications." That is kind of a scary sentence to me and I am not a doctor. Even the most ethical and strict doctor can be fooled by a junkie. That is because so many of the signs of a junkie are also the signs of a patient trying to get out of pain. A junkie will complain that the dose is not working and they need a higher dose but so will a legitimate patient who's pain is not being controlled. The junkie is not going to be telling the doctor he is selling his medications or taking too many. That is a good part of the reason that PM clinics have taken to treating all of their patients as junkies. That is the reason behind the piss tests and the rest of the patient contracts, but those contracts will not save a physician from being prosecuted by the DEA. In fact a lot of the doctors prosecuted used many of the same tools we see at just about every PM clinic and yet they are no longer practicing because the DEA went after them. Heck, what is a doctor supposed to do ? Hire a firm of private detectives to follow all of their patients? Who can really define "Should Have Known"?
Another large part of the issue is all of the celebrity news we see about this or that celebrity being addicted to pain killers. Teens look up to them and figure if they do it it is okay as well. So they get their hands on pain medications from their mom or dad and other relatives and bring them into school to share with their friends. They never realize how dangerous these drugs are nor how addicting and before they know it they are hooked. There have been studies that show that teens and adults both see pain medications as "Safer" than street drugs.
The press is not blameless as well. Sure they have reported on this but at times they have seemed to be working for the DEA. They have trumpeted on the front pages when doctors are investigated and when they are arrested or charged but we never see anything when they are cleared or if we do it is buried in a small story in the middle of the paper. Another way they have helped to fuel this is that they have told the junkies exactly how to get around the time release features so they can get high off of them. In some areas the stories on this "epidemic" have appeared before these drugs even hit the street. You can figure out which came first on your own.
We have seen many reasons for the DEA targeting pain management doctors. None really show what benefit they have reaped from the investigations. What we can clearly see is that doctors in all fields are becoming more and more scared to prescribe these medications. That is leading to untreated and under treated pain patients. That is not good. Leaving anyone in pain is not good for the body. There are many physical effects that can damage key organs such as the heart and kidneys. It can also lead to suicide as pain patients reach the end of their rope and decide it is not worth going on with all of the pain. There are no stats showing how many pain patients have decided to kill themselves because of being under treated. The stats are masked under the ones for overdoses and accidents. This needs to change and change now. We can't allow the DEA to continue to practice medicine without a license.