the war on drugs can’t be won – but it can be lost

8/14/2019 The War On Drugs Cant Be Won But it Can Be Lost

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another dose, and pain patients are denied all but the barest minimum of relief for years ata time! Used correctly, opiates are the safest and most effective medications there are.The problem arises when doctors, ignorant of the textbook standards, called the MedicalStandard of Care, as opposed to usual practice, attempt to dictate the dose or theparticular opiate or both without reference to how the patient rates the effectiveness of the

treatment, and without considering any changes in functionality. Patients, finding that theopiates actually control the pain, often raise the dose themselves (called unauthorizeddose escalation, which is considered a red flag for addictive behavior) in order to getsome cleaning done, to cook a meal for a change instead of eating out of a can or to havemeals prepared and frozen for when the meds run out, to socialize, to see children andgrandchildren they hurt too much and have too little energy for on the lower dose, or justto go outside and remember what sunlight feels like. They choose to have this little bit oflife, and then to run out and suffer the pain and withdrawals (which can also causedamage or even death) because of the too-low dose, rather than to have a tiny amount oforno pain relief and no life on the inadequate dose the doctor insists on. This is littledifferent from having an anesthesiologist use the textbook dose of an anesthetic for an

operation and insisting that the doctor continue and cut the patient open even though thatparticular patient requires a higher dose than usual and is still awake! It is sheer, needlesscruelty that has nothing to do with medical ethics or standards; there is simply no otherword that fits. There are books and papers referenced in the footnotes at the end of thisarticle that constitute the correct and current "Medical Standard of Care" that are detailedand referenced for people in the medical field who want more detail and the specificscience behind current standards.

Far too often, the nurse at the doctors office believes she is protecting her doctor from anaddict and outright taunts and abuses chronic intractable pain patients, insisting thatYoure already on a dose that should handle any amount of pain! often publicly

humiliating and even blocking the patients messages to the doctor that s/he needs inorder to know how effective the current regimen is. This can cause a chilling effectthat leaves the patient afraid to complain or to ask for more or a different medication, sothe patient goes downhill and the doctor never knows why until the patient leaves to findanother doctor who might treat the pain better. Then, for the desperate patient, the wholerigmarole just starts over again, and any progress is lost. The nurses taunt is also atotally, medically incorrect statement. A regimen that handles the usual level of chronicpain in a patient does littlefor pain increased by a bad day, by too much activity, byanother operation or by the condition getting worse, which is what chronic pain doesbeyond a certain point, especially as the patient ages and if the pain has been ongoing andpoorly treated for many years or even decades. Many surgeons and PCPs refuse toprescribe additional medication for a patient who has just been operated on, erroneouslybelieving that the regular dose of opiates will handle the additional pain. This is not atall true, and the patient is thus abandoned to unmitigated post-operative or other pain,something most doctors normally wouldnt ever consider doing! This is whybreakthrough medications are also prescribed because humans are not simple machinesthat never vary, and sometimes the pain breaks through the protection of the usualregimen, which then needs to be supplemented by additional medication. Sometimes thepain is worse than average, so that increased level also needs to be handled. This is also


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part of the Medical Standard of Care. Another common error, especially in the hospital,is that doctors assume that the recommended time period for a given dose to last is gravenin stone; too often the fact that they are working with human flesh, not stone, is forgotten.Also forgotten is the fact that almost every numerical value that doctors deal with is anaverage, and if they stick with that average, the vast majority of patients on both ends of

the spectrum are left out! In dosing, this means that almost allof a doctors patients areeither under- or over dosed! Thus, when a hospital patient says the pain is back and asksfor another dose of pain medication, s/hes usually told by the nurse, Its only been twoand a half hours youll have to wait until its been four hours, or six hours, or whateverthe recommendation is, leaving the patient, again, to suffer needlessly in untreated pain.If the pain is back, it means the last dose of opiates has been used by the body itsgone! Giving another dose isnt going to cause a problem any more than the first one did,although the doctor might wish to consider a stronger medication or a larger dose if thefirst one ran out that quickly. Abandoning the patient to unmitigated pain, however, is,again, ignorant cruelty, and is not based on scientific fact but its also usual practice.

Uncontrolled pain is a death sentence. It's a recognized disease that destroys nerves,ruins the ability to rest and keeps the body permanently on high alert in the "fight orflight" reflex, which was never meant to be continuous and permanent any more than acar is meant to be run always at full throttle and nothing else, and for the very samereasons its aguaranteedway to destroy the body or the car. The pain will spread toareas that didn't have it before, and stress-related diseases will begin to appear, like lupus,type II diabetes, heart problems, high blood pressure and circulatory problems that lead tostroke - it's a long list, and its deadly. Patients lose brain mass over time as well, theyage much faster than normal due to constant unremitting stress, and they becomephysically deconditioned because it hurts too much to move unless its absolutelynecessary. They lose their families, their children, their friends, credit ratings and

possessions, and everything they've worked for over their working lives. They also losetheir own dignity, their self-respect and self-image, along with the ability to makedecisions or often even to relate to other people. The joy of life becomes a forgottenthing of the past that seems forever out of reach. Even things as simple as lifting andholding a beloved child, reading a book, staying clean and resting come to be so hard todo patients lose them. They end up, finally, unable to care for themselves or to workwhen the correct dose of the correct opiate plus a few adjuvant medications could returnmany if not most of them to work, or at least to some independence. And like almosteverything else, all of these problems are erroneously blamed on drug abuse, even whenthe patient demonstrably has hadno medications and cannot get them because providershave decided that theyre dealing with an addict! For CIPPs, doctors are the gatekeepersof their lives, of the foundation that they need in order to be able to live, and its aterrible, hard thing for a patient who is aware that a few pills would allow a return to life,to work, to usefulness, but is instead forced into suffering and immobility as their youthand then what little they survive of their age is eaten away even faster than it would beotherwise by the invisible iron suit of pain that they can never remove alone, completewith cruel spikes to torture them that are hidden where others cant see. They shuffle andlabor from place to place when they must go, and suffer the ignorant judgments, taunts,impatience and abuse of healthy people who move, to them, as though theyre lighter


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than air, as they once moved. Instead of continuing to titrate the medication that helps toa useful dose, doctors too often stop at some arbitrary amount that they are comfortablewith, leaving the patient partially treated, but still in too much pain to do much but holdonto the bare and fraying edge of sanity. The patient is generally told that the medicationisntsupposedto control all of the pain, although why is never mentioned, probably

because there is no real reason, so the patient still suffers along, just a few invisibly tinymilligrams, just thousandths of a gram, about the weight of a penny, of medicine awayfrom real functionality! Sometimes a reason like this is offered: If you max out on theseopiates now, if you ever have an accident or get a terminal disease, the drugs will nolonger help you when you really need them! It sounds perfectly logical, and iscompletely untrue. Again, pure opiate mu agonist drugs have no severe upper limit. Thehandful or less of doctors who have actually believed that and acted on it have foundthemselves holding tearful patients who had forgotten what not hurting was like talkingabout a miracle and have suddenly found themselves looking at the return of a humanexistence they had thought was lost to them forever.

The fears of addiction are being massively exaggerated by Drug War propaganda thateven doctors buy into, and people who could be returned to the work force, or at least totheir families, instead are left in poverty, often homeless, and always sufferingneedlessly. Tens of thousands of them become suicides when they are no longer able totolerate the unending pain and the loneliness, the mockery and abuse of family, friendsand even the medical community day in and day out alongwith the burden of the painand all of its consequences. Addiction only occurs in between one and three and a halfpercent of the population, and it too is eminently treatable, along with the pain. The restof CIPPs are thrown in with addicts by sheer ignorance. Physical dependence on amedication is notaddiction, else people on SSRI's, insulin, statins and many othermedications are also addicts - and everyone knows they are not! People who called these

other patients addicts would be laughed at as fanatic, medical Luddites. This crueltreatment only happens to pain patients, who are stigmatized by perfectly normal andreasonable behavior caused by the terrible need not to hurt anymore. Instead of propertreatment in the face of such need and the reasonable request for help, patients are abusedby being given just enough of what they need to survive, but far too little to thrive.People who do this to animals are thrown in jail for cruelty.

The drug-seeking behavior of a pain patient can be the same as the drug-seeking behaviorof an addict simply because they both want the same medications, but in the pain patient'scase it's behavior that is perfectly reasonable; theyre only asking for the medication thatspecifically treats the medical condition they have. This behavior is called "pseudo-addiction," meaning "false" addiction, and in the medical standard of care doctors arewarned not to mistake one for the other. One way to avoid that error is to watch thepatients reactions. Pain patients, unlike out-of-control addicts, get their lives back onthese medications; the addict loses control of dosing and desocializes, loses job andhome, where the pain patient enters society again, often tries to re-enter to workforce,begins self-care again. The accusation that patients "continue to take the drug even whenit's causing harm" is true in the case of many addicts, but the "harm" people often mistakefor something caused by the medication CIPPs need is actually due to inadequate


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dosing. The patient is the only one who can, with a doctor's help, determine the correctdose. Per the W.H.O., "The correct dose is the one that works." Opiates, unlike manysynthetic and semi-synthetic opioids like meperidine and methadone, have no toxiceffects and used correctly cause no damage. As it turns out, opiates, alone of all othermedications, protect the nerves that otherwise fire non-stop, causing tremendous pain and

in time damaging or even destroying themselves! The protection afforded by opiates cangive those nerves the rest they need, sometimes even allowing them to heal! In otherwords, opiates can be a cure for chronic intractable pain! They do have side-effects,most of which go away after a few days of correct use: itching, sedation, and after sometime using them, increased tooth decay because of thickened saliva, and in men, thedestruction in the body of testosterone, but all of these are easily treated, certainly farmore easily than death, an unavoidable side-effect of non-treatment! The respiratorydepression effect, often cited as a deadly and unavoidable effect of opiates, is also easilydealt with. The tolerance for that effect builds very quickly - within a couple of doses,and it builds much more quickly than tolerance to the analgesic (pain killing) effect, sothat dose increases can be almost geometric, being doubled every second or third dose!

The W.H.O. reports doses as high as threegrams being effective and well tolerated, andthere is a long list of historical luminaries who used opiates all of their famous and veryproductive lives, including a founder of Johns Hopkins hospital and the originator of themodern surgical paradigm.

The Drug Waritselfis the cause of many if not all of the problems erroneously blamed ondrugs: the illegal and very dangerous street trade of drugs, the high street prices, theavailability of powerful medications to younger and younger children, and the frequentoverdosing or poisoning of users by unregulated manufacture of drugs by the untrained -all of the criminality associated with drugs, in fact - can all be laid at the doorstep of theWar On Drugs. Now, unable to show any progress in the Drug War afternine decades of

criminalization, the DEA has taken to loud and flashy show-trials of compassionatedoctors who dare try to treat people in unending pain correctly, with legal medications.They have used sheer muscle and a convenient (for them) interpretation of the ControlledSubstances Act (CSA) to destroy medical doctors who are doing exactly what theyresupposed to do treating patients with compassion and knowledge, helping them toreturn to their lives, their jobs and their families, and the patients are caught in thecrossfire. This weakest, most desperate demographic that is stuck in agony and povertyneedlessly is also being casually destroyedby federal cops who have literally taken overthe medical field of pain management! Too often, patients who have been totallyabandoned by the medical community, sometimes in their hundreds orthousands whenthe DEA destroys another pain clinic or doctor, have only two choices: to buy the drugsthey need to keep working or to simply stay alive illegally on the street if they can, or tolose everything job, money, family, home, even their lives. And course when theyrecaught, which happens often because these are notcareer criminals who know the ins andouts of the street trade, all of the blame is placed on theirshoulders, and on the drugsthemselves as if they can make choices. Ask yourself this, though: if you were a diabeticand some religious fanatics managed to get insulin made illegal, would you allowyourself to die due to this ignorance, or would you buy your insulin anywhere you couldget it? The obscene profits generated by the Drug War to corporations and government


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agencies leads to the refusal of the government and these other entities to recognize thatliterally all of the problems that are supposedly caused by the illegal drug industry, plusthe horrendous suffering and waste of the entire seventy-million soul population ofchronic intractable pain sufferers who range from very young children to older people,can be corrected overnightby the simple expedient of following the Constitution and

removing or correcting the Controlled Substances Act and by decriminalizing drugs andleaving them to the states to regulate as was done until the war on our own sick andinjured was morphed by PR (which stands here for propaganda) hacks into the mislabeledbut well-hyped War On drugs. As things stand, private prisons trading on the NASDAQ,the Prison Guard's Unions, politicians looking for a safe plank for their platforms andfinding it in the Drug War, the DEA looking for tangible results to justify their ever-increasing funding of what is over $20 billion a year (though Drug War total costs runover $60 billion) and their unaccountable power to steal property (civil forfeiture isincluded in their and in police department's budgets!) and abuse ordinary, harmlesscitizens with no accountability, the DOJ uses unethical and too-often illegal tactics tomanufacture high-profile cases out of ordinary doctors who are just doing their jobs.

States and private prisons that get federal funding grants for warehousing harmless,nonviolent populations of prisoners whose crimes had no victims, the addictiontreatment industry which is backstopped by the forced treatment of pain patients who arenot addicts and who cannot be "cured" by anything except the treatment of their paingiving the industry an unending stream of patients who are forced to endure "treatment"for the wrong condition ... There are simply too many agencies, industries andindividuals who gain too much sheer profit and power for them to just give it up willinglyand walk away from it. The money and power granted to the "Drug Warriors" to fightthis false and unwinnable War On Drugs will neverbe released voluntarily, as the PrisonGuards Union in California demonstrated when they spent $2.5 million to defeat aproposition in California that would have stopped the incarceration of nonviolent drugoffenders and released millions now in prison for victimless crimes, which have nobusiness being made into crimes at all.

The War On Drugs is, in the end, regardless of the denials of politicians who count onhyping it for votes, a war on the weakest and most vulnerable of our citizens: the old,those who are too damaged to work and can find no treatment in our strictly for-profitmedical system, those abandoned by understandably frightened physicians, or those whoare ignorant and misinformed by the entire propagandized and victimized medical systemwhose physicians are attacked by a Justice Department that is now so powerful that to beaccused is to be destroyed, as Arthur Andersen was, guilty or innocent. Any agency thatbrags about a 98% conviction rate has to know that they are imprisoning a hugepercentage of people who are totally innocent! Nonetheless, they continue to lie, spin,blackmail, misinform and attack our own helpless and desperately ill citizenry. There'sjust no place else where they can gain that kind of money and sheer, almostunaccountablepower. The verdict is clear, and is increasingly being shown in study afterstudy: we can't win the War On Drugs, but we can lose it. We are losing it - bycontinuing to permit the cruel and utterly needless destruction of millions of lives for theprofits and power of paramilitary police agencies and an often complicit judiciary whoonly misuse it, creating an ever-widening circle of misery, suffering, poverty and death.


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The money being spent of the War On Drugs would buy the treatment of all of thoseseventy million people who suffer in unnecessary pain, as well as most, and maybe all, ofour other citizens who have been trying desperately not to get sick because the costs ofmedical treatment and medication would lose them what insurance they have, or wouldplace any treatment totally beyond them simply because ordinary people generally dont

have fifty- or a hundred thousand dollars for out-of-pocket expenses; it would pauperizethem, likely leaving them and their children homeless. These are horrible choices forpeople to have to make, but they are left to us this way because they are dictated bysoulless corporations and government agencies whose sole motive is profit or morepower. These organizations are so large, layered and complex that the blame for thesuffering and deaths they cause never sits on any one particular pair of shoulders, but theresults bow the shoulders and crumple the already-damaged backs of the innocentseventy million or more who are dying slowly, suffering all the way, for lack of care.

Truly, we clearly, demonstrably cannotwin the War On Drugs, but we can lose it. Andwe are. We have. Its long past time to do something else.

More information on the failed and destructive War On Drugs can be found on Dr.Alexander DeLuca's site and on the old PRN site at http://www.doctordeluca.com/ andhttp://www.painreliefnetwork,org/ respectively. There is also an organization ofcourageous retired and active police from various departments and agencies who haveseen the futility and the terrible destructiveness of the War On Drugs, and have dedicatedthemselves to fighting for the end of this war against our own citizens, called L.E.A.P. Law Enforcement Against Prohibition, at: http://www.leap.cc/cms/index.php on the Web,which I add here for any DEA or DOJ people who have doubts or want to know more.There is a terrific amount of information available on these sites.

References on the medical standard of care:

1) Fine PG, Portenoy RK. A Clinical Guide to Opioid Analgesia. The McGraw-HillCompanies. Healthcare Information Programs. revised 2004. (Available:http://www.stoppain.org/pcd/content/forpros/opioidbook.asp)

2) Chronic Pain I and II by Brookoff (written in a Fam Pract journal:Brookoff , D. Chronic Pain I - A New Disease? Hospital Practice;Volume 35; Issue 7; 2000. (Available:

http://www.doctordeluca.com/Library/Pain/CP1NewDisease2K.htm, and,Brookoff , D. Chronic Pain II -The Case for Opiates (Available:

http://www.doctordeluca.com/Library/Pain/CP2CaseForOpiates2K.htm) bothin Hospital Practice; Volume 35; Issue 9; 2000.

3) An Ethical Analysis of the Barriers to Effective Pain Management. Ben A. Rich;Cambridge Quarterly of Healthcare Ethics, 9: 54-70, 2000.

Abstract: http://www.doctordeluca.com/Library/Pain/EthicalAnalysisBarriersPainTx2K.htmFull text PDF:http://www.doctordeluca.com/Library/Pain/EthicalAnalysisBarriersPainTx2K.pdf

The Distortion of Medicine, the Standard of Care, and Medical Community Norms;Dr. Alex DeLuca; War on Doctors/Pain Crisis; 2008-12-30.
http://www.doctordeluca.com/http://www.doctordeluca.com/http://www.leap.cc/cms/index.phphttp://www.stoppain.org/pcd/content/forpros/opioidbook.asphttp://www.doctordeluca.com/Library/Pain/CP1NewDisease2K.htmhttp://www.doctordeluca.com/Library/Pain/CP2CaseForOpiates2K.htmhttp://www.doctordeluca.com/Library/Pain/EthicalAnalysisBarriersPainTx2K.htmhttp://www.doctordeluca.com/Library/Pain/EthicalAnalysisBarriersPainTx2K.pdfhttp://www.doctordeluca.com/Library/Pain/EthicalAnalysisBarriersPainTx2K.pdfhttp://www.doctordeluca.com/http://www.leap.cc/cms/index.phphttp://www.stoppain.org/pcd/content/forpros/opioidbook.asphttp://www.doctordeluca.com/Library/Pain/CP1NewDisease2K.htmhttp://www.doctordeluca.com/Library/Pain/CP2CaseForOpiates2K.htmhttp://www.doctordeluca.com/Library/Pain/EthicalAnalysisBarriersPainTx2K.htmhttp://www.doctordeluca.com/Library/Pain/EthicalAnalysisBarriersPainTx2K.pdf


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http://doctordeluca.com/wordpress/archive/distorted-confused-med-standards/NOTE: These are offered as companion pieces that delineate

how the ethical practice of medicine has been distorted by the invasion of theregulation of medicine by a police-mentality that is only trained to

see criminality with reference to drugs, and is not suited to dictate to physicians how to

treat their patients, or to states how to run the practice ofmedicine!

4) From Dr. Alexander DeLuca: The Reasonable PhysicianStandard. While drugwar prosecutors invariably attempt to confuse juries and journalists, and usually succeed,regarding this crucial difference between the medical standard of care and communitynorms of medical behavior, that difference is in fact very clearly drawn, as a matter ofboth medical ethics and precedence in criminal law. As Ben Rich explains in MedicalCustom and Medical Ethics: Rethinking the Standard of Care (citation/abstract-full textPDF):

When credible evidence has been presented that not just a particular physician, or anisolated, retrograde group of them, but a majority of the profession has failed to adoptpractices that would materially reduce patient suffering, courts may properly conclude, inthe tradition of great justices like Holmes and Hand, that a reasonable physician wouldnot practice in this way6emphasis mine)

Ian MacLeodAugust 27th, 2009Activist PRN, Nonprofit, Nonpartisan, 501(C)(3) Corporation.

Veteran, Disabled, Chronic Intractable Pain Patient, 25 yearsOathkeeper.Primum, non nocere!Illegitimis non carborundum!
http://doctordeluca.com/wordpress/archive/distorted-confused-med-standards/http://journals.cambridge.org/action/displayAbstract?aid=274995http://journals.cambridge.org/action/displayAbstract?aid=274995http://doctordeluca.com/Library/Pain/MedCustomEthicsStandCare05.pdfhttp://doctordeluca.com/Library/Pain/MedCustomEthicsStandCare05.pdfhttp://doctordeluca.com/Library/Pain/MedCustomEthicsStandCare05.pdfhttp://doctordeluca.com/wordpress/archive/distorted-confused-med-standards/#fn:6http://doctordeluca.com/wordpress/archive/distorted-confused-med-standards/http://journals.cambridge.org/action/displayAbstract?aid=274995http://doctordeluca.com/Library/Pain/MedCustomEthicsStandCare05.pdfhttp://doctordeluca.com/Library/Pain/MedCustomEthicsStandCare05.pdfhttp://doctordeluca.com/wordpress/archive/distorted-confused-med-standards/#fn:6

the war on drugs can’t be won – but it can be lost

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