In June 1971, President Richard Nixon delcared a “war on drugs” and pronounced drug abuse to be “public enemy No. 1.” Two years later, in July 1973, Nixon created the Drug Enforcement Administration (DEA) and charged them with coordinating the efforts of other federal agencies in the war on drugs.
In May 2009, nearly four decades later, Gil Kerlikowske, the new director of the White House Office of National Drug Control Policy (ONDCP), declared the war on drugs to be over. He said he felt that even though the war on drugs was meant to be a war on a product (drugs), it was perceived as being a war on people. Now, rather than treating drug abuse as primarily a criminal justice issue, Kerlikowske wants to emphasize prevention and treatment.
Although the main purpose of the ONDCP remains curbing drug abuse, they also say they want to make sure their policies don't increase physicians' fears about prescribing needed opioid medications for pain patients. In a recent interview with the Journal of the American Medical Association, A. Thomas McLellan, deputy director of ONDCP, discussed some of their plans to ensure that pain patients are able to receive the medications they need for pain control:
- Develop a consensus on standard pain management protocols that protect patients
- Educate patients about opioid use
- Encourage physicians to use treatment agreements
- Encourage physicians to sit down with their patients and explain the patient's responsibility regarding the appropriate management and storage of their medications
- Integrate prescription drug monitoring into electronic health information systems
- Create clear guidelines to give physicians and patients confidence while clarifying the role of law enforcement
The ONDCP will be working closely with the Department of Health and Human Services, the National Institute on Drug Abuse, the US Food and Drug Administration, and the four largest primary care medical societies to develop these strategies.
In My Opinion...
Every war has casualties. Sadly, the casualties from the 40-year war on drugs have been chronic pain patients. Legitimate pain patients have been treated like the enemy – suspected of being war criminals. Instead of being presumed innocent until proven guilty, patients are often presumed to be drug abusers until they can somehow prove to their doctors that they are not.
I sincerely hope this new emphasis on education, prevention and treatment with the promised de-emphasis on criminalization will help to allay doctors' fears so they will be more comfortable about prescribing opioids when their patients need them.
One of the things that concerns me, however, is that the DEA was not included on the list of agencies working with the ONDCP. Until the DEA eases up and stops conducting armed raids of doctors offices followed by highly publicized prosecutions, physicians will continue being reluctant to prescribe opioids. – Please continue to the next page to see an important video.
I came across this excellent video by ReasonTV that illustrates the problem so much better than I could. (Please scroll down to see the video.)
“When Cops Play Doctor: How the drug war punishes pain patients”
In late March Kerlikowske said that the “ONDCP and Federal partner agencies have developed a plan to curb prescription drug abuse, which includes expanding prescription drug monitoring programs and educating healthcare providers and patients about the danger of abusing prescription drugs." He doesn't explain what “expanding prescription drug monitoring programs” will entail. While Kerlikowske and the ONDCP say they want to make sure pain patients receive the medications they need, I fear an expansion of prescription drug monitoring programs will only make it more difficult.
What the end of the war on drugs means for chronic pain patients remains to be seen. We need to continue to seize every opportunity to make our voices heard in Washington DC so we don't continue to be casualties of war – especially a war that has supposidly ended.
Kuehn, Bridget M. Treatment Given High Priority in New White House Drug Control Policy. JAMA. 2010;303(9):821-822.
National Drug Intelligence Center Relaeass National Drug Threat Assessment 2010. PRNewswire. March 25, 2010.
Published On: April 11, 2010