Policy Analysis No. 545

Treating Doctors as Drug Dealers: The DEA’s War on Prescription Painkillers

By Ronald T. Libby
June 6, 2005

Executive Summary

The medical field of treating chronic pain is still in its infancy. It was only in the late 1980s that leading physicians trained in treating the chronic pain of terminally ill cancer patients began to recommend that the “opioid therapy”(treatment involving narcotics related to opium) used on their patients also be used for patients suffering from non terminal conditions. The new therapies proved successful, and prescription pain medications saw a huge leap in sales throughout the 1990s. But opioid therapy has always been controversial. The habit-forming nature of some prescription pain medications made many physicians, medical boards, and law enforcement officials wary of their use in treating acute pain in non terminal patients. Consequently, many physicians and pain specialists have shied away from opioid treatment, causing millions of Americans to suffer from chronic pain even as therapies were available to treat it.

The problem was exacerbated when the media began reporting that the popular narcotic pain medication OxyContin was finding its way to the black market for illicit drugs, resulting in an outbreak of related crime, overdoses, and deaths. Though many of those reports proved to be exaggerated or unfounded, critics in Congress and the Department of Justice scolded the U.S.Drug Enforcement Administration for the alleged pervasiveness of OxyContin abuse.

The DEA responded with an aggressive plan to eradicate the illegal use or “diversion” of OxyContin. The plan uses familiar law enforcemet methods from the War on Drugs, such as aggressive undercover investigation, asset forfeiture, and informers. The DEA’s painkiller campaign has cast a chill over the doctor-patient candor necessary for successful treatment. It has resulted in the pursuit and prosecution of well-meaning doctors. It has also scared many doctors out of pain management altogether, and likely persuaded others not to enter it, thus worsening the already widespread problem of underrated untreated chronic pain.

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Ronald T. Libby is a professor of political science and public administration at the University of North Florida.