Tuesday, January 2, 2018

The Federal Government Doesn’t Care How Much Pain You’re In

The DEA tried to ban Kratom last year, backing off only after a loud public outcry. 

You can’t buy Vioxx. Merck “voluntarily” withdrew it from the market after it was linked to heart disease. But just try to sell some and tell me who stopped you from doing so. The removal of this class of anti-inflammatory medicines is not exactly “voluntary.” Even granting for the sake of argument that the risk of heart disease is as bad as everyone thinks it is, Vioxx might be the right solution to some people’s pain.

Prescription opioids are tightly controlled, and the DEA has been targeting even legitimate pain doctors for “overprescribing.” This encourages pain patients to shop for a doctor who will actually treat them, which in turn looks suspicious and marks that patient with a red flag, which then makes doctors even less likely to treat them.

Medical marijuana is finally taking off after a very slow start, and attitudes are changing. But the federal government has been a huge obstacle for far too long. We shouldn’t forget that they are still making it hard for growers and distributors. A lot more chronic pain patients would have access if the incredibly conservative drug policy bureaucracy in Washington D.C. would stop fighting it.

I hate to impute nasty motives to people, such as, “They just want you to live in pain.” But I get the serious feeling that these people just don’t give a shit. As I mentioned in a recent post, Trump’s presidential commission on opioids recommended “removing pain as the fifth vital sign.” They are telling us pretty explicitly that they just don’t care if we get adequate pain management or not. If lifestyle changes, ibuprofen and acetaminophen don’t work, too bad? 

There is a downright puritanical paternalism at work here. You can’t be trusted with opioids, cannabis, or kratom because some people might enjoy them too much. Plainly that must be stopped. And you can’t be trusted with pharmaceuticals because you’re too stupid to know what’s best for you and you’ll probably poison yourself. Or maybe the sustained assault on drugs isn’t due to any underlying motive or ideology. It could be sheer inertia. There are government agencies that are invested in keeping drug illegal, because otherwise those agencies would disappear. So they find things to do: analyze some data, investigate some individuals and businesses, ruin some lives, throw some people in jail, and so on. I get the nasty feeling that what I’m observing is just amoral, self-perpetuating bureaucracy at work.  

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