The Hurwitz verdict is going to scare even more doctors off of chronic pain management. Patients lose yet again:
By prosecuting Hurwitz for drug trafficking because some of his patients abused or sold painkillers he prescribed, the Justice Department reminded physicians throughout the country that they are expected to be cops as well as doctors. If they fail to reconcile these irreconcilable roles, if they do not treat their patients like criminals as well as customers, they can be convicted of felonies punishable by decades in prison, as Hurwitz was last week.Hurwitz was a bad cop. He believed his patients when they said they were in pain. He gave them the benefit of the doubt when they asked for early refills, which could indicate diversion but also could indicate inadequate doses. He continued treating their pain after they tested positive for cocaine. He hesitated to abandon problem patients he knew would have trouble getting treatment elsewhere.
Related posts:
- The sad plight of William Hurwitz
- Chronic pain and drug pushing
- Hurwitz verdict: "The jurors were confused by the law"
- The Hurwitz jury: "I went into this blind and came out wishing I was"
- Chronic pain and the troops
- Chronic pain
- Migraines and the stigma of chronic pain medication use
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{ 7 comments }
Gallant egalitarianism, in this case masquerading as utter gullibility, is no excuse for the massive gate keeping failure that Hurwtiz represents. Before we see the usual cadre of “circle the wagons he is one of us” defenders line up, let us take a moment for consideration. As a gatekeeper it is the job of the provider to ensure that his/her patient is not becoming a conduit for the transference of scheduled drugs into the general population. This is an incumbent duty. It is the people such as Hurwitz that make the rest of the field appear to be nothing but wholly unsavory. Then again, just like the PI world, believing in the stories told by whatever dope fiend or litigant that walks in through the door is a system that is bound for fraud and failure.
Doctors shouldn’t have to be police. If some drug addicts get their drugs from doctors, who cares?
Doesn’t the medical community have enough politcal clout to tell lawmakers and the DEA to butt out? I guess not.
“It is the people such as Hurwitz that make the rest of the field appear to be nothing but wholly unsavory.”
Bull. As the United States progressed from OTC morphine and cocaine to the Hurwitz prosecution, only one thing ever made a dent in drug overuse: listing the ingredients on the label. Everything else is crusading busybodies and dominance games.
It is the doctor’s job to “ensure” that there is no diversion???? How are they to “ensure”. That is silly. We can not ensure that other than to never prescribe. We can only take actions that reduce the risk. Each action taken which reduces the risk of diversion will also increase the risk that patients will be denied the treatment they need. Or to put it another way:
Every doctor who prescribes has some of the Rx diverted or abused. If he is rigid in following certain rules, then less. Every doctor who sometimes denies Rx because of concerns about diversion, will sometimes deny patients treatment who are not diverting. It is a continuum of risk-benefit and, I think, a matter of medical judgement and not criminal liability.
Some people who use marijuana, have criminal histories, and are unreliable with follow up suffer chronic pain. In fact, they are the people most likely to get injured and have poor recovery. Do I prescribe controlled drugs for them? Hell, no. I am a coward and am scared of the government. Only middle class, record free, drug screen clean, compulsively punctual people with no tell tale signs of redneckism get scheduled 2 drugs in my practice. Is that good? Regardless, more are going to join me now.
Hurwitz has no room to complain here. He played in traffic and was completely flattened by the 18 wheeler that is the Federal government. If Hurwtiz in specific and clinicians in general are either unwilling or unable to do hand the privilege of controlling the prescription pad then they need to be removed from the position of responsibility or we need to rethink the whole “gatekeeper” concept and decriminalize the whole lot.
“The gatekeeper concept” is NOT fundamental to the physician role but rather is one imposed by the state in it’s expansion of control over personal lives over the last hundred years. As this verdict shows, all doctors who prescribe controlled drugs are playing in a highways of eighteen wheelers. But they did not got there. The highway was built where they already were for thousands of years and must be in order to do their job. By your analogy, doctors should just not prescribe the chemicals the feds choose to designate “controlled” or they deserve whatever they get.
I have had chronic pain for years and I am not on opiates because my doctors are too afraid of losing their license.I will suffer the rest of my life.I have no intention of living with this until I’m 90.I will take steps to end my life when I feel that enough is enough. The ironic thing is..I will probaly use pills I can get on the street very easily.So thank you to all who have decided that I have no right to be properly medicated. “Anonymous too”
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