NORMAN J CLEMENT RPH., DDS, NORMAN L.CLEMENT PHARM-TECH, MALACHI F. MACKANDAL PHARMD, BELINDA BROWN-PARKER, IN THE SPIRIT OF JOSEPH SOLVO ESQ., IN THE SPIRIT OF REV. C.T. VIVIAN, JELANI ZIMBABWE CLEMENT, BS., MBA., IN THE SPIRIT OF THE HON. PATRICE LUMUMBA, IN THE SPIRIT OF ERLIN CLEMENT SR., WALTER F. WRENN III., MD., JULIE KILLINGWORTH, WILLIE GUINYARD BS., JOSEPH WEBSTER MD., MBA, BEVERLY C. PRINCE MD., FACS., RICHARD KAUL, MD., LEROY BAYLOR, JAY K. JOSHI MD., MBA, ADRIENNE EDMUNDSON, ESTER HYATT PH.D., WALTER L. SMITH BS., IN THE SPIRIT OF BRAHM FISHER ESQ., MICHELE ALEXANDER MD., CUDJOE WILDING BS, MARTIN NDJOU, BS., RPH., IN THE SPIRIT OF DEBRA LYNN SHEPHERD, BERES E. MUSCHETT, STRATEGIC ADVISORS
BY CATHLEEN LONDON MD., 3RD YEAR LAW UNIVERSITY OF MAINE
FULL-TEXT AVAILABLE COMING SOON
The primary narrative driving policy is that the opioid epidemic is driven by overprescribing by clinicians, leading patients to become addicted. This has led to draconian laws that have harmed chronic pain patients and the use of invasive prescription monitoring programs throughout the country.
The black box algorithms mine data and have never been subjected to independent verification. Patients and prescribers alike are flagged as problematic. Although prescribing has dropped dramatically since the introduction of prescription monitoring, overdose deaths have risen dramatically to record highs, driven by the illicit fentanyl market.
Despite this, law enforcement continues to focus on the diversion of prescription medication. The drug prohibition policy set out by the Department of Justice (DOJ) is a misguided attempt to address skyrocketing opioid overdoses. It is their way of trying to fix the issue which was the unchecked distribution of opioids.
The blame for that falls on the DEA (Drug Enforcement Agency), Congress, and lobbyists. This focus on limiting the prescribing of legal opioids has led to an increasingly lethal illicit opiate supply. The DOJ continues to erroneously cite diversion of licit legitimate prescriptions of opioids as the problem.
As a result, doctors have been imprisoned for terms ranging from twenty years to life without parole, all for practicing medicine. Others have had their careers and reputations irreparably harmed.
Undertreated pain is an expensive medical condition, costing an estimated $560-635 billion annually in the United States.
With the current climate of fear and prohibition, and the government’s decision to prosecute doctors who they claim overprescribe, we are in a cycle that started with the Harrison Act in 1914. Drafted as tax law, the Harrison Act required anyone authorized to manufacture or distribute narcotics to register with the Treasury Department, pay a fee and keep records.
Congress sought with this legislation to address the non-medical use of narcotics. Possession, use, and distribution of narcotics were criminalized. Physicians were easier than unlicensed distributors to target and bring to court. A series of Supreme Court decisions transformed narcotics control from tax revenue to a cabining of physician prescribing.
Doctors argued in Linder v. United States to prescribe to alleviate the pain and suffering of withdrawal symptoms. Doctors were first criminalized for prescribing in U.S. v. Moore. Moore also set the language still used today that “registered physicians can be prosecuted under § 841 when, as here, their activities fall outside the usual course of professional practice.”
The combination of the Controlled Substance Act (CSA) and the establishment of the DEA created the War on Drugs that started under the Nixon administration which began with a focus on illicit drugs. Congress criticized the DEA and in 1999 “they sought a new front for the War on Drugs to show measurable results.”
To the DEA, physicians at “pill mills” have morphed from caring, compassionate caregivers to dope dealers in white coats.
A “’ pill mill’ is a term used primarily by local and state investigators to describe a doctor, clinic or pharmacy that is prescribing or dispensing powerful narcotics inappropriately or for non-medical reasons.”
FOR NOW, YOU ARE WITHIN THE