Jewish World Review Nov. 25, 2004 / 12 Kislev 5765
Drs. Michael A. Glueck & Robert J. Cihak
New Weapons in the War on Pain Patients and Doctors
The current Congress has a few lame ducks, but they're still mighty busy
birds - trying to push through lots of big legislation such as 1000 pages of
a $338 billion omnibus spending bill. They're also hoping that little bills
zip right through, below the public's radar, such as H.R. 3015 which targets
physicians and pharmacists in the take-no-prisoners war on pain drugs and
patients suffering chronic pain.
H.R. 3015, the National All Schedules Prescription Electronic Reporting Act,
the US House of Representatives in October. It's now before the Senate where
it's slated for a voice vote before the current session of Congress expires
on January 2, 2005. A voice vote is a way to pass a bill quickly without a
record of which way each senator voted.
This bill would encourage states to establish programs requiring physicians
and other providers such as pharmacists to report any and every prescription
for a wide range of commonly prescribed drugs, including pain medications
and anti-depressants. In addition to the medicine and dose, the doctor would
have to give the government the patient's name, address and telephone
number. This private prescription information would then become part of a
national computer database, available to the police and also possibly to
employers, newspapers, blackmailers, or anybody else curious about such
The patient would not even know about the release of this prescription
information, much less consent to its release or review. Police would have
access to personal prescription information without having probable cause to
believe a crime had been committed and without convincing a judge to issue a
Drug Enforcement Administration (DEA) agents and state licensure boards
already have great powers. They currently can get information on
prescriptions written for controlled substances and have sweeping authority
to investigate anybody they choose and to prosecute doctors for prescribing
more pain killers than agents think appropriate.
HR 3015 would dramatically enhance the reach of police and DEA agents into
the privacy of doctors and patients.
Some government officials liken doctors to terrorists, and want equal
judicial vigor in pursuing doctors. For example, Assistant U.S. Attorney
Gene Rossi declared to a reporter that "our office will try our best to root
out [certain doctors] like the Taliban. Stay tuned." according to a
September press release from the Association of American Physicians and
In opposition to the bill, Rep. Ron Paul, MD, of Texas said HR 3015 "is yet
another unjustifiable attempt by the federal government to use the war on
drugs as an excuse for invading the privacy and liberties of the American
people and for expanding the federal government's disastrous micromanagement
of medical care."
He pointed out that the government is embarking on a "war on pain patients
and their doctors" which "has already resulted in the harassment and
prosecution of many doctors... whose only 'crime' is prescribing legal
medication... to relieve their patients' pain. These prosecutions, in turn,
have scared other doctors so that they are unwilling to prescribe an
adequate amount of pain medication, or even any pain medication, for their
Could it be that government agents are going after innocent and hard-working
doctors because the doctors are easy targets? Are real criminals going free
because these same government agents find it too much work to break through
the complicated logistic and legal defenses that real criminals sometimes
build and hide behind?
Rather than giving non-medical officials more authority, power and money,
congress and the president should restrain the DEA from essentially telling
doctors how to practice medicine.
Rather than using resources to send trained actors feigning pain to entrap
doctors, the DEA and other agencies should communicate and cooperate with
To further this goal, the Association of American Physicians and Surgeons
(AAPS) recently developed a 3-point "Communicate and Cooperate" proposal to
encourage physicians and law enforcement to work together to prevent
prescription drug abuse. The proposal includes several ways law enforcement
agents can work with doctors, such as:
1. Working together to track suspected drug abusers. To balance current laws
requiring doctors to provide information about suspected abusers to the
government, government agencies would notify doctors about suspicious
patient behavior such as contact with know drug dealers or abusers.
2. Reviewing possible cases with professional medical boards before filing
charges in court. Doctors would review a physician's practice with police
before non-medical prosecutors would file criminal charges. This would help
prevent embarrassing errors by government agents and would prevent worsening
the current shortage of doctors willing to adequately treat patients with
chronic and painful medical conditions.
3. Mutual training of law enforcement and medical personnel. Law enforcement
people would educate doctors about recognizing patterns of illegal activity
and criminal intent; doctors would educate police about modern pain
And why is the US Senate vote scheduled for only a "Yea" or "Nay" voice
vote, without recording which senator voted which way? One reason is often
so that senators can't be held to account for their votes.
As Rep. Paul says, "Instead of further eroding our medical privacy, Congress
should take steps to protect it."
Please let your senators know what you think, before it's too late.
Editor's Note: Robert J. Cihak wrote this week's column
Michael Arnold Glueck, M.D., is a multiple award winning writer who comments
on medical-legal issues. Robert J. Cihak, M.D., is a Discovery Institute
Senior Fellow and a past president of the Association of American Physicians
and Surgeons. Both JWR contributors are Harvard trained diagnostic radiologists.
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