To understand the war on pain patients, it is necessary to look beyond the current crisis effecting patients’ access to opioid medicines.
Most of those seeking to limit or eliminate our access to these medicines look at the past 15 years, when opioids began to be prescribed more widely to treat pain. The problem with that time frame is that it isolates the current war on patients from the longer history of the war on drugs, first declared by President Nixon in 1972.
Over the last 40 years there have been major developments in the war on drugs that have had deleterious effects on pain patients. Examining a few similarities between the two wars sheds light on our current struggles.
A few statistics first, taken from www.legalizationfacts.com.
In 2000 local, state and federal authorities spent $50 billion on the war on drugs, with an astonishing $20 (billion?) million provided by the federal government. While the government has interdicted huge amounts of illegal drugs and taken them off the street, that interdiction has done nothing to drive up street prices by reducing supply. In reality, prices for many street drugs like cocaine have fallen in recent years.
This war on drugs affects some of our society more deeply than others. In 2006, nearly 1.5 million of our citizens were incarcerated in state and federal prisons. To put that number in perspective, the U.S. has 5% of the world’s population, but 25% of the world’s prison population.
The average length of a federal sentence for a violent felony is 63 months. The average sentence for drug felonies is 75.6 months.
It does not make sense that getting apprehended crossing a state line with a trunk load of diverted opioid medicines will lead to a longer incarceration than shooting a customer during a bank robbery.
The societal damage from these incarceration rates can be seen in these disturbing statistics from the U.S. Department of Justice:
- Between 1991 and 2007, the number of parents held in state and federal prisons increased by 79% to 809,800.
- During that same period, the number of children of incarcerated parents increased by 80% to 1,706,600.
This collateral damage has serious implications for minority neighborhoods where large portions of young men are imprisoned for nonviolent drug related crimes. In 2000, nearly two-thirds of all prisoners were African American.
Into this mix is the rise of the repressive surveillance state. After 9/11, Congress created the Department of Homeland Security, and worse, the Patriot Act. This has brought us nationwide search warrants, roving wiretaps, surveillance of computer communications, foreign intelligence procedures applied to domestic criminal investigations, and perusal of library and book records. We’ve seen a steady deterioration in privacy protection and civil liberties.
Restricting Access to Opioids
What, the reader might ask, does this have to do with the current assault on pain patients and their access to opioid medicines? The answer is that this crisis landed in the midst of a country relying ever more heavily on law enforcement solutions to perplexing problems.
Additionally, with our nation divided into red and blue states, there has been a corresponding rise in suspiciousness of each other’s motives. When combined with a latent Puritanical attitude toward pain and drugs, the current assault begins to make terrible sense.
I have heard from several pain patients that friends, family and even spouses often don’t believe that they are really in pain, especially with disorders like fibromyalgia that are not readily visible. Adding to this disbelief is the opposition of family and friends to opioid medical treatment. Many in our society believe that the patient should shut up, make do and move on.
With millions of Americans suffering from chronic pain, the push to reduce access to opioids will put many families in the same predicament as families with a father or mother in prison.
There are parents who suffer from such horrendous pain that — left untreated by opioids — they are as absent from their families as an imprisoned parent is. A parent destroyed by pain may be physically present, but is missing in action from almost all parenting duties, condemned to a life without the iron bars of confinement.
This shows the collateral damage of depriving people with pain the relief that opioids can provide. Just as in families where a parent is incarcerated, untreated or undertreated pain robs a family of a parent; a parent who may not be able to work and who withdraws from social or community life.
Of course, the same can be said for those addicted to opioids or who die from an overdose. But addiction is aberrant behavior in which pain patients do not engage.
Just as there’s been a wholesale destruction of families through incarceration for nonviolent drug offenses, there has been destruction of families with a parent in terrible pain. The repressive organs of state are applying the same discredited law enforcement techniques to a social-medical problem.
Treating unsanctioned drug usage as a law enforcement and military problem has spilled over onto the legitimate use of opioid medicines. Law enforcement agencies now target prescribing doctors, pharmacists, pharmaceutical suppliers and patients. The misguided and destructive war on drugs has spilled over onto the safe use of opioid medicines, thus conflating the two in a way that is harmful to pain patients and their families.
I know that this won’t happen any time in the near future, but we need to end the war on drugs and its cousin, the war on pain patients.
Imagine what we could do with the $50 billion squandered on our international war on drugs and the subsequent high cost of incarcerating nonviolent drug offenders.
Imagine having enough treatment centers for those seeking to kick their addictions.
Think of spending some of that largesse on pain treatment research that could lead to the replacement of opioid treatment for those of us unable to live any other way.
Enough individuals and families have been destroyed. It’s time to end the war on drugs. And it’s time to end the war on pain patients and their families.
Mark Maginn lives in the east bay of San Francisco where he is a poet, writer and social justice activist. Mark suffers from chronic pain and was a longtime volunteer with the American Pain Foundation. His blog can be found here.
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