Systemic Suicide and Personal Pain

Image by David Paul Ohmer via Flickr

“All will be done again as it was in far-off times”
http://www.newstatesman.com/south-america/2009/10/british-world-essay-mexico
Surveying the fragments of an obliterated civilisation at the British Museum’s Moctezuma exhibition, Tom Holland is haunted by the parallels between our vulnerable globalised world and that of the doomed Aztecs .Perhaps it is the very definition of a successful civilisation that it should balance an aptitude for violence with a deep inner conviction that its morals are superior to those of everyone else. The Persians and the Romans, the Chinese and the Arabs: all of them blazed this trail. Where the west has been exceptional, however, is that both its greed and its ethical presumptions have been so destabilising to other civilisations that they have served to transform the entire world.

Can Narcotics Turn Free Speech Into Obstruction of Justice?
http://painreliefnetwork.org/blog/can-narcotics-turn-free-speech-into-obstruction-of-justice
Tanya Treadway, an assistant U.S. attorney in Kansas, is trying to bully pain treatment activist Siobhan Reynolds into silence by threatening to prosecute her for “obstruction of justice,” based on Reynolds’s advocacy work for a local physician accused of writing inappropriate painkiller prescriptions. In a Forbes.com column published today, civil liberties lawyer (and Reason contributor) Harvey Silverglate offers some damning details about Treadway’s harassment:

When Reynolds wrote op-eds in local newspapers and granted interviews to other media outlets, Assistant U.S. Attorney Tanya Treadway attempted to impose a gag order on her public advocacy. The district judge correctly denied this extraordinary request.

Undeterred, Treadway filed on March 27 a subpoena demanding a broad range of documents and records, obviously hoping to deter the peripatetic pain relief advocate, or even target her for a criminal trial of her own. Just what was Reynolds’ suspected criminal activity?

“Obstruction of justice” is the subpoena’s listed offense being investigated, but some of the requested records could, in no possible way, prove such a crime. The prosecutor has demanded copies of an ominous-sounding “movie,” which, in reality, is a PRN-produced documentary showing the plight of pain physicians. Also requested were records relating to a billboard Reynolds paid to have erected over a busy Wichita highway. It read: “Dr. Schneider never killed anyone.” Suddenly, a rather ordinary exercise in free speech and political activism became evidence of an obstruction of justice.

A federal judge is expected to rule tomorrow on Reynolds’ motion to block the subpoea as a violation of her First Amendment rights.”

http://www.reason.com/blog/show/135848.html

When Cops Play Doctor
http://painreliefnetwork.org/blog/when-cops-play-doctor

politicians are calling for greater power to monitor doctor-patient relationships in order to fight the “epidemic” of prescription drug overdosing.

But maybe the real epidemic is underdosing. Countless Americans suffer with severe chronic pain because doctors are afraid to treat them properly.

Michael Jackson’s death unleashed a flurry of media stories about all aspects of the pop star’s life, including his alleged prescription drug abuse. On the same day countless millions watched Jackson’s star-studded memorial service, reason.tv interviewed another musician.

Seán Clarke-Redmond, a man who enjoyed an active life before the neurodegenerative disease ALS, often referred to as Lou Gerig’s disease, rendered him nearly immobile—he can no longer even play the piano.

The disease also left him in almost constant pain. Redmond is prescribed some medication, but not nearly enough to keep his pain under control. Dr. Frank Fisher says Redmond’s case is an appallingly common one.

“Chronic pain in America is an enormously under treated disease,” says Fisher, a Harvard-trained physician. “It’s a public health disaster.”

Pain specialists like Fisher and patients’ groups like the Pain Relief Network battle law enforcement officials who are forever on the lookout for “pill mills” and patients who misuse pain medicine. Fisher notes that the same medications so often associated with celebrity addiction are the same medications that combat pain most effectively.

Fisher has treated his patients with high doses of opioids-that is, until a swat team raided his clinic and threw him behind bars.

“They were trying to give me 256 years to life,” says Fisher who argues that fear of prosecution often prevents doctors from treating chronic pain patients effectively.

What allows doctors’ medical decisions to be overruled by police?

“What we’re dealing with is a mass insanity,” says Fisher. “We call it the war on drugs.”

Chronic Pain in Primary Care
http://painreliefnetwork.org/blog/chronic-pain-in-primary-care
Inadequately treated acute pain also may lead to adverse physiologic changes, including cardiac dysfunction, impaired immunity, and the development of chronic pain.[6] Increased activity in peripheral and central nociceptive pathways can lead to plastic changes in neural circuits that perpetuate such acute pain symptoms as allodynia (painful responses to normally nonpainful stimuli) and hyperalgesia (increased sensitivity to painful stimuli), often after the initial insult has resolved.[7]
Pain remains undertreated, especially in the primary care setting. Even when patients make the decision to visit a healthcare professional, inadequate training and resources may prevent proper assessment of their condition.[2] Deficiencies in pain management related to patient gender, race, and socioeconomic status have been reported.[8]

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