April 18, 1998

President William Jefferson Clinton
The White House
Washington, DC

Dear President Clinton:

RE: “Civilian casualties of the war on drugs.”

As the Executive Director of the National Foundation for the Treatment of Pain, it is my duty to inform you of a healthcare crisis that is presently affecting thousands of citizens, which if left unchecked threatens to destroy the quality of life for millions of Americans suffering in pain. There have been landmark scientific breakthroughs in the medical treatment of pain in recent years, so that average citizens may now, with appropriate care, lead relatively normal lives free from the debilitating tyranny of chronic, intractable pain. The medical and scientific communities unanimously agree on safe, reliable treatment with oral pain medications. Yet, certain governmental policies, and the agents who enforce them, today prevent reasonable medical treatments for legitimate pain patients.

This crisis is nothing less than a medical tragedy in our nation. It destroys the quality of life for patients who should be leading productive lives. At the same time, humane, caring physicians have had their medical licenses revoked, their fiscal well-being imperiled, and their practices and families destroyed by senseless, outdated policies that do not hold up to the light of international medical wisdom. We cannot understand how this can happen in America today, and we are asking your help to investigate and correct these injustices before millions more lives and dollars are squandered and lost.

As the information in our files amply document, a calamity continues in this nation concerning the treatment of pain. Not only is the inadequate treatment of both cancer and non-cancer pain a tragic crisis, since 1995 more than 1500 qualified, scientifically and medically enlightened physicians have lost their right to practice medicine while attempting to legitimately treat pain patients with medically accepted prescription medicine therapies. We are not talking about illicit drugs, or drugs prescribed falsely to drug abusers. Without exception, these cases involve physicians with clinically diagnosed patients who received protocols universally accepted within the medical profession.

If any other single cause had resulted in the disappearance of 1500 physicians, it would have been considered a public disaster. But, because this has happened one doctor at a time, each in an isolated, astronomically expensive legal process, the disaster has gone largely unnoticed by the public and the media. We are writing to draw your attention to the fact that nearly 1 of every 400 doctors in the United States has suffered disgrace and tragedy at the hands of the Drug Enforcement Agency and State Boards of Medical Examiners, while attempting to practice humane and legitimate medicine.

We do not believe that this deplorable loss of medical professionals has been a conscious decision on the part of your administration. The preponderance of evidence indicates that doctors who prescribe Schedule II drugs on a regular basis are presently perceived, categorized, regulated, processed and prosecuted by the same agents of the DEA that trap and arrest major traffickers of illegal drugs. In fact, the Administrator of the DEA himself recently made this bold comparison while testifying before the Senate Judiciary Committee in documented proceedings. These agencies simply do not recognize the profound distinction between the legitimate medical treatment of intractable pain, and criminal drug abuse. The result of this situation is a living nightmare for legitimate patients in pain, their families and the physicians who care for them.

The line has to be drawn, and we are asking for your help before another life is lost, or another physician suffers further public humiliation and is lost to the patient community.

Guidelines for the treatment of intractable pain abound.Recommendations have been advanced by virtually every agency, including the World Health Organization, the United States Government per the National Institute of Health, the American Medical Association, the American Academy of Pain Medicine, the American Pain Society, and a multitude of states and other organizations and entities. Regardless, in the USA today, any physician who prescribes three Percocet a day to any patient for more than one month, automatically becomes the object of surveillance. It is commonplace for the DEA to send undercover agents, trained to feign illnesses, into the offices of doctors to attempt to entrap them into prescribing pain medications. We have documented cases where agents have lied to federal grand juries to secure indictments against doctors. This is a misuse and abuse of power, where medical professionals are policed by agents without medical training.

The fear of regulatory persecution has reduced the number of physicians who are willing to practice the treatment of pain. We respectfully, and urgently, request that you appoint a high-level member of your administration to take the lead in bringing this situation into the light of day, and resolving it appropriately. We therefore request that the treatment of intractable pain be included in your proposed Patients' Bill of Rights. The National Foundation for the Treatment of Pain is a not-for-profit organization which seeks to accomplish comprehensive and effective medical treatment and social justice for all who are involved with legitimate medical pain. We are committed to ending this nightmare. We will assist you in any way possible.

We respectfully await your response.

 

J.S. Hochman, M.D.
Executive Director
The National Foundation for the Treatment of Pain

Mark Gordon
National Communications Director
(408) 655-8812 • Fax (408) 655-2823 • email: markgordon@paincare.org
207 Herrmann Drive, Monterey, CA. 93950

cc: Vice President Gore, Hillary Clinton, Senator Tom Daschle

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