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They ARE Addicted

(A great suggestion for your letter)
By Dr. Joel Hochman, M.D. Executive Director
National Foundation for the Treatment of Pain

I believe that every member of this foundation (NFTP)...and every pain patient in the United States should write this letter to their Congressional Representatives and Senators. Then at the end, add one paragraph about your own situation and experience like this:

"I am a pain patient, about whom this letter speaks. Etc., etc., about yourself. Please Respresentative (Senator)___________, stop the War on Doctors and Pain patients. We need a Congressional Investigation to reveal the outrages and to put an end to this vicious campaign against those who least deserve such treatment."

I am addicted.
I am addicted to the relief of being pain-free.
I am addicted to being able to walk up the steps in my home rather than having to crawl up.
I am addicted to being able to fully participate in life.
I am addicted to being able to walk around the zoo with my daughter, or the Mall or the library.
I am addicted to being able to be involved in family activities.
I am addicted to not being confined to a chair in my home because it hurts too much to get out.
I am addicted to not having to sleep most of the day because it hurts to do anything else.
I am addicted to being able to do housework, wash my dishes, make it down to my basement to do laundry and all the other things I can't do when I am in pain.
I am addicted to not being in a state of severe depression because of not being able to move without pain.
I am addicted to being a fully participating mother to my children.

Yes, I use Oxycodone on a daily basis, (2 and a half up to 3 and ¾ pills per day), and have been on this medication for over 5 years. I've tried everything else out there first and found out that this is the only thing that truly helps.

I think it is sad that the Rush Limbaughs of the world and those who sensationalize the few who choose to misuse drugs, give opioids like a bad name, making it extremely difficult for people with chronic pain such as Fibromyalgia and various types of Arthritis, who would benefit greatly from this and similar medications, and who are frequently denied this help or undertreated by doctors who are "opiophobic" or who would rather prescribe dangerous drugs with severe side effect profiles (Nsaids), rather than prescribe a drug that has been around for many, many years and is actually the safest drug to use for moderate to severe pain when used appropriately.

This happens because a surprising amount of doctors are not educated in the proper treatment of chronic pain, they don't understand that physical dependence, tolerance and addiction are discrete and different phenomena that are frequently confused, or who are so afraid that if they prescribe drugs that will help their patients, the DEA will come after them. There are some doctors who will prescribe, but are so afraid of the DEA, that they won't even renew a prescription even 1 day early, making the patient run completely out of pills before renewing their prescription! This is something they would never do with any other type of medications.

The fact is that the DEA looks for doctors who are prescribing unusually large amounts of drugs to an unusually large number of patients; assuming that these doctors are involved in drug selling, not the legitimate prescribing narcotic pain medications to patients who need them. It is just the opopsite. These are the Doctors who are courageous and ethical enough to treat those most in need, despite the threat of prosecution and ruin.

According to an article in the Journal of Law Medicine and Ethics, 29 (2001), titled "Pain Management and Provider Liability: No More Excuses", the author Barry R. Furrow states

"Pain is undertreated in the American health care system at all levels. The result is needless suffering for patients, complications that cause further injury or death, and added costs to treatment overall... The term "opiophobia" has been coined to describe this clinical aversion to proper use of opioids to control pain… physicians are poorly educated in medical school about narcotics and proper pain management, and they remain ignorant in practice about appropriate treatment choices for pain management, often rapidly absorbing professional norms that simply reflect a culture hostile to drug use.

"Chronic pain is usually viewed as appropriately treated by opioid analgesics on a long term basis. The use of opioids in the class of morphine is the cornerstone of pain management. Yet patients and clinicians continue to be unduly concerned about addiction.

"Addiction is viewed as an evil to be avoided even when its likelihood is low, leaving patients to a stoic absorption of pain that most cannot achieve. Recent studies confirm that abuse of opioid analgesics has remained low in spite of increases in their medical use…Failure to manage pain — to assess, treat and manage it — is professional negligence."

Thank God the tide is turning and doctors are becoming more educated about the value, safety and necessity of using opioid drugs in the treatment of chronic pain, but we still have a long way to go.

"The Lord hath created medicines out of the earth, and he that is wise will not abhor them." ----- Ecclesiastes 38:4
C. Manzano


The Honorable ___________
Dear Senator/Representative:

I am writing to bring your attention to a problem affecting many pain patients and physicians. Throughout the United States, physicians are being threatened, impoverished, delicensed, and imprisoned for prescribing in good faith with the intention of relieving pain. The "War on Drugs'' has come to mean a war on lawful drugs also-and against the doctors who prescribe them and the patients who take them.

Prosecutors make 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 from "friendly fire." Physicians have been drummed out of practice, sent to jail, and even been driven to suicide in the face of these 21st century witch hunts.

If this continues, not one doctor will be willing to prescribe the drugs that patients so desperately need. The real problem is not drugs, but drug misuse. But repeated and frequent abuse of prosecutorial discretion is compounding the problem.

Prosecutors charge doctors with murder when a patient dies as a result of overdosing on legally prescribed drugs, usually combined with alcohol or illegal drugs. Then they pile on dozens of unrelated counts, such as drug kingpin, fraud, and RICO charges. The physician is so frightened that he will usually plead guilty to lesser charges carrying hefty fines and some prison time to make the case "go away."

In other cases, drug-dependent patients may be arrested, then promised drugs if they will testify against a doctor or threatened with prosecution if they don't. Psychiatric patients may be threatened with involuntary confinement, addled geriatric patients coached to change stories. Prosecutors commonly use stalling tactics to bring defendants to their knees. They know the longer the accused goes without being able to earn a living while the legal fees mount, the better the chances are that the desperate target will make a bad deal just to bring the nightmare to an end.

I urge Congress to hold hearings to investigate ways to protect physicians against unwarranted prosecution, to protect patients' access to medications, and to encourage physicians to make chronic pain management available in their practices.

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