THE PRESUMPTION OF JUSTICE


By Barry Tuttle


It's an absolute travesty of justice for our officials to waste so much time, energy and money investigating & prosecuting physicians who are doing nothing other than trying to reduce the suffering of millions of Americans who, ironically enough, are paying the salaries of those who are investigating & prosecuting the physicians who are doing nothing other than attempting to reduce the suffering of millions of Americans who, ironically enough, are paying the salaries of those who are investigating & prosecuting the physicians who are doing nothing other than attempting to reduce the suffering of millions of Americans who, ironically enough, are paying the salaries of those who are investigating & prosecuting the physicians who are doing . . . Gee Whiz, can somebody please make it stop?

I fully realize that there are some people with medical degree's who are masquerading as dedicated physicians, while in reality they are stuffing their mattresses with the money they're making by 'selling prescriptions' for controlled substances. Fortunately, these represent an extreme minority of those who have made a career practicing medicine. They are driven by nothing less than their own greed and hopefully, will be caught and made to pay. It's these few swine that are causing so many problems for so many others. They make it difficult for reputable physicians to be able to prescribe controlled substances without undo scrutiny and cause valid patients requesting these medications to be suspected of wanting them for purposes other than their own legitimate medical needs.

Unfortunately, there are far too many people who mistakenly believe that any doctor who writes a lot of prescriptions for controlled substances, such as opioid pain medications, should be classified as a 'pusher' operating a 'pill mill' and thus, should be prosecuted and sent to prison. A Cardiologist probably writes a large percentage of prescriptions for medications that help to control blood pressure and other drugs, such as nitroglycerine. A Psychiatrist can probably be expected to issue quite a few prescriptions for medications such as anti-depressants and anti-anxiety drugs. Why then, is it so difficult for so many people to understand that some physicians who specialize in treating pain are frequently going to prescribe a good deal of drugs designed to relieve pain, such as opioid pain medications? Sure, there are other drugs that are touted as 'pain-killers', such as Nsaid's, some classes of antidepressants, systemic steroids such as prednisone etc. and they are all effective in certain applications. For many types of pain, nothing is as safe and effective as narcotic pain medications. This seems to go 'against the grain' according to what most of us have been told over the years – laypersons and physicians alike. Many studies, especially those performed over the past decade, have indicated that the benefit's of these drugs far outweigh any risk's, many of which have also been shown to be nothing more than perceived risk's. Trying to change the perceptions that our society has hammered into us regarding these drugs, will be an enormous task; some people will never accept the fact that these medications are anything but evil.

One of the most common objections to the use of narcotics is that they are "highly addictive". While addiction is a valid concern and the possibility does indeed exist, it is not nearly as prevalent as was once believed. Many studies regarding this phenomena have been performed and one of the most interesting and frequently referred to is a two year study that was conducted by the National Institutes of Health in the early '90's that followed 24,000 patients suffering from various degrees of chronic pain. They were all using opioid pain medications of which, the type and amounts varied, depending on their particular needs. At the completion of the study, they were able to identify only 7 subjects with active addictions. That's less than three one hundredths of one percent! This finding has been reproduced in numerous other clinical settings with almost identical results, which seems to indicate its accuracy. If this finding were ten times – or even one hundred times higher, it would still be acceptable to most patients who live every single day with moderate to severe pain. It's nearly impossible to describe with words how unrelenting pain affects, not only the patient, but the friends and the families of those who are made to needlessly suffer. After living with this pain for years, it's not difficult to imagine that even with the fear of addiction present, the superior analgesia that is afforded by opioids is preferred to all other options. Regrettably, this 'option' often is not an option at all, due to several factors such as the physician's refusal to prescribe, expense or undesirable side effects. These problems, along with many others, have combined to make the under-treatment of pain in this country a very serious issue – one that the National Institutes of Health has publicly referred to as "A national disaster."

Along with the under-treatment of pain, an equally tragic problem is the over-treatment by non-narcotic medications known as Nsaids, or 'non-steroidal anti-inflammatory drugs' such as aspirin, ibuprofen etc. You know, the one's that are touted to be 'safe' in literally billions of dollars worth of intensive advertising that saturates all forms of media. You can rarely turn on the television any longer, without being subjected to crowds of dancing, singing, laughing, clapping 'sufferers', who have taken their daily dose of Celebrex®, Vioxx® or Alieve®. These medications, including the now hugely popular Cox-II inhibitors such as Celebrex® and Vioxx®, are frequently prescribed by physicians because, other than the fact that they still require prescriptions, there is no additional regulatory oversight involved. While they are indeed effective for some type's of mild to moderate pain, at least that which is associated with inflammation, they are all too often prescribed in lieu of because there is no fear of retribution by medical boards or law enforcement agencies.

Once again, according to the National Institutes of Health, since 1995, between 16,000 and 17,000 Americans die each year as a result of complications arising from the use of these 'safe' medications. Mostly, this is from GI bleeding, liver and/or renal damage, but include other, less common complications. But, by-golly they're non-addictive! Of course, if you bleed to death internally from your pain medication, addiction is probably going to be moot.

A shocking example of the inappropriate governmental intrusion into our healthcare is seen with the current case of Dr. William Hurwitz of Virginia.

I can no longer just sit and watch. This is too much like being forced to witness the execution of someone who you know is innocent of the crimes for which they are being punished. Although I have never met Dr. Hurwitz personally, I am quite familiar with his reputation of compassion, understanding and his apparent professional competence as a 'no-nonsense' Pain Specialist.

He is a nationally recognized and well-respected physician who sometimes uses opioid medications in the treatment of non-malignant chronic pain – a method that is, for some reason, controversial to certain people who obviously do not physically suffer themselves. He is, once again being targeted by investigators from numerous government agencies. He was featured on CBS's ' 60 minutes' after winning his previous battle with regulators back in 1995. They've been stewing ever since they failed and are now pursuing him with an obvious vengeance, using all of the resources at their disposal. Of course, their 'resources' include scores of investigators from numerous agencies, dozens of attorneys and of course, their famous bottomless pockets - our tax dollars.

Dr. Hurwitz doesn't have the luxury of unlimited access to our money, so he has announced that he will have to close his practice in December unless something is done to keep the intrusive government agencies from attempting to practice medicine, so that he can. After all, he is the one with the medical degree. They attended a police academy and probably took a first-aid course, while he went to medical school and trained to become a physician. He is 'voluntarily' closing his doors and has given several months notice so that his patients will have the time to make alternate arrangements for treatment with other doctors. Hopefully, this will help to prevent the tragic outcome that occurred last time, when they closed him down with no warning whatsoever, leaving many of his patients suffering in agony with nowhere to turn. Between the return of their physical pain and the hopelessness that they had lived with prior to finding Dr. Hurwitz, the combination proved to be too taxing on their, already drained constitutions, causing several people to take their own lives. To make matters even worse, the indifference demonstrated by those who insisted on persecuting the doctor and others like him, who treat sufferers of chronic pain, displayed a lack of humanity that makes one wonder how they ever achieved a position of authority and trust in a civilized society.

Much of what we read in the mainstream media is frequently written with the author's and/or the editor's bias toward narcotic medications winking back at you from the ink. Decades of misinformation, myths and even propaganda, is helping to perpetuate the hugely profitable 'War on Drugs'; profitable that is, to the agencies that employ the "warriors" and the prisons that warehouse it's P.O.W.'s. It is anything but profitable to the taxpayers who unwittingly support it or to the loved one's who languish and wait - sometimes for decades. Sometimes in vain.

Barry Tuttle

Please feel free to contact the author at: [email protected]



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