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sent a clear message to the medical community

age of 50--was forced to move in with his

that they need to be sure the controlled sub-

elderly parents.

stances they prescribe are medically necessary. If

doctors have a doubt about whether they could

Conclusion

get in trouble, this case should answer that"--a

statement that implores doctors to err on the

side of undertreatment.160

The government is waging an aggressive,

intemperate, unjustified war on pain doctors.

It isn't hard to see how all of this would

This war bears a remarkable resemblance to

make it more difficult for pain patients to find

the campaign against doctors under the

treatment. "You worry every day that the med-

Harrison Act of 1914, which made it a crimi-

icine won't be available for much longer," one

nal felony for physicians to prescribe nar-

patient told the Village Voice, "or your doctor

cotics to addicts. In the early 20th century,

won't be there tomorrow because he's been

arrested by the DEA."161 One doctor flatly told

the prosecutions of doctors were highly pub-

licized by the media and turned public opin-

the Wall Street Journal, "I will not treat pain

patients ever again."162 Still another told Time

ion against physicians, painting them not as

healers of the sick but as suppliers of nar-

magazine, "I tend to underprescribe instead of

The DEA's

cotics to degenerate addicts and threats to

using stronger drugs that could really help my

renewed war on

the health and security of the nation.

patients. I can't afford to lose my ability to

Since 2001 the federal government has sim-

support my family." The Voice also reports that

pain doctors has

ilarly accelerated its pursuit of physicians it says

many medical schools now "advise students

frightened many

are contributing to the alleged rising tide of pre-

not to choose pain management as a career

physicians

scription drug addiction. By demonizing physi-

because the field is too fraught with potential

legal dangers."163

cians as drug dealers and exaggerating the

out of pain

health risks of pain management, the federal

The most obvious (though least likely)

management

government has made physicians scapegoats

course of action to address these problems

for the failed drug war. In that they are general-

would be for Congress to end the costly,

altogether,

ly legitimate, well-meaning professionals who

regrettable War on Drugs. Barring that, the

exacerbating an

keep accurate records, pain physicians also pre-

best way for law enforcement officials to bat-

already serious

sent a better target than underground, black-

tle the problem of diversion would be to

market drug dealers for a DEA that has been

combat the theft of the drugs from ware-

health crisis--the

subject to increasing criticism from Congress

houses, manufacturing facilities, and en

widespread

and the Department of Justice for its inability

route to pharmacies. More importantly, the

undertreatment

to measurably reduce the domestic drug sup-

DEA, DOJ, Congress, and state and local

ply. Even worse, the DEA's renewed war on pain

authorities should end the senseless persecu-

of intractable

doctors has frightened many physicians out of

tion of doctors and allow them to pursue

pain.

pain management altogether, exacerbating an

whatever treatment options they feel are in

already serious health crisis--the widespread

the best interests of their patients, free from

undertreatment of intractable pain. Despite the

the watchful eye of law enforcement.

DEA's insistence that it's not pursuing "good"

doctors, it isn't hard to see how rhetoric from

Notes

law enforcement officials and prosecutors

would make doctors think otherwise.

The author would like to thank the Cato

Hurwitz's prosecutor, for example, promised to

Institute's Radley Balko for his assistance in edit-

root out bad doctors "like the Taliban."159

ing and researching this paper.

Another assistant U.S. attorney said, upon the

1. Carl T. Hall, "Living in Pain Addiction," San

sentencing of one doctor to eight years in

Francisco Chronicle, April 5, 1999, p. A1.

prison for having worked for 57 days at a pain

2. American Pain Foundation, "Voices of People

clinic: "I believe and I hope that this case has

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