At Trial, Pain Has a Witness Source (NY Times - opiates)

[ovidsen]

http://www.nytimes.com/2007/04/24/science/24tier.html?_r=1&oref=slogin

At Trial, Pain Has A Witness Source

ALEXANDRIA, Va. —William E. Hurwitz, the prominent doctor on trial here for drug trafficking, spent more than two days on the witness stand last week telling a jury why he had prescribed painkillers to patients who turned out to be drug dealers and addicts. But the clearest explanation of his actions — and of the problem facing patients who are in pain — came earlier in the trial.

It occurred, oddly enough, during the appearance of a hostile witness, Dr. Robin Hamill-Ruth, one of the experts who was paid by the federal prosecutors to analyze Dr. Hurwitz’s prescriptions for OxyContin and other opioids. Then, during cross-examination by the defense, Dr. Hamill-Ruth was shown records of a patient who had switched to Dr. Hurwitz after being under her care at the University of Virginia Pain Management Center. This patient, Kathleen Lohrey, an occupational therapist living in Charlottesville, Va., complained of migraine headaches so severe that she stayed in bed most days. Mrs. Lohrey was informed that the clinic’s philosophy “includes avoidance of all opioids in chronic headache management,” according to the clinic’s record.

The clinic offered an injection to anesthetize a nerve in her forehead, but noted that “the patient is not eager to pursue this option.” Mrs. Lohrey was referred to a psychologist and given a prescription for BuSpar, a drug to treat anxiety, not pain. It was the kind of letter Dr. Hurwitz received from people across the country. His office in the Virginia suburbs of Washington was like a Lourdes for people with pain, one of the most widespread health problems. Surveys have found that one in five adults deals with chronic pain, and that it is treated adequately only about half the time. Prescribing opioids was once taboo because of concerns over patients’ becoming addicted. But medical opinion gradually shifted over the past two decades as researchers concluded that high doses of opioids could sometimes be safer and more effective than alternatives like surgery or injections.

Two of the leading pain experts, Dr. Russell K. Portenoy of Beth-Israel Medical Center and Dr. James N. Campbell of Johns Hopkins University, testified without pay as experts for the defense. They said Dr. Hurwitz was widely known as a knowledgeable physician and passionate advocate of giving patients full pain relief, unlike many doctors who were reluctant to prescribe opioids because they feared legal repercussions, particularly when dealing with patients who sometimes used illegal drugs. Read more: http://www.nytimes.com/2007/04/24/science/24tier.html?_

On a personal note....

Dr. Hurwitz was my wife's pain doctor until he was arrested about 6 years ago. He is currently serving 25 year sentence for illegally ditributing drugs like Vicodin and Oxycontin to patients suffering from mind-numbing, paralyzing pain. Like my wife. She suffered 4 fractured vertebrae, including one in her neck, when she was hit by a truck while walking across a street. She's partially paralyzed and on Social Security disability. Her pain since that accident 10 years ago has been torture. Dr. Hurwitz provided her with the medication she needed to live a normal life. Opiate dependent? Yes. An addict looking for high? No. The lengths and expense she has gone through to get the drugs she needs to live a NORMAL life post Hurwitz amaze me. Like a millon other Americans suffering from intense, intractible pain, morphine and morphine derivatives provide relief that no other regime or therapy can touch. She, Dr. Hurwitz, doctors like him and patients like her are being denied the relief they deserve simply because the Bush Justice Department thinks that whomever takes a morphine relted product for more than a few days must be an addict who must be cut off, "rehabilitated" or incarcerated; and the person giving them drugs must be a pusher, even if (as in Dr. Hurwitz's case) he or she is both a licensed MD and an attorney. For obvious personal reasons, I have been following this case closely. I urge others with relatives or friends who suffer from pain that cannot be alleviated by less effective drugs (Tylenol 3, anyone?) to follow this case as well. The health and well-being of you and the people you love may depend on it.

[ms liberty]

1. Important subject. K&R

[annabanana]

2. Happy to give the 5th rec.

Chronic pain is unnecessary today, and it is unconscionable that so many are allowed to suffer.

The whole "church lady, we must protect them from themselves" stance is cruel and not nearly unusual enough.

[ovidsen]

3. Thanks for the kind words

I'd like to see this bumped up and placed on the "best of" page so more people can learn about yrt anoher gaping hole in our health care system.

[CatWoman]

5. I'll do my part

:hi:

:)

[ovidsen]

6. I knew I could count on you!

Thank you, CatWoman O8)

[knitter4democracy]

4. Hubby's followed that case, too.

He prescribes painkillers to his patients at the level they need. He tries to catch the dealers and narcseekers, but he will always err on the side of mercy. Yes, he's caught a few and then cut them off, and he even had a patient forge one of his scrips and have to testify on that. Still, it's not going to stop him from giving people the medication they need.

I think all those dips need to watch House. Like he says in that show, as you did in your comment, opiate dependent does not mean high.

[Mnemosyne]

7. Our doctors have had their hands tied for too long.

I'm so sorry that your wife has suffered so horribly. :hug:

Did you find a good doctor to replace Hurwitz? He sounds like such a compassionate man. Your poor wife must have been devastated when they arrested Hurwitz.

I feel it is criminal to deny adequate pain relief.:grr:

[ClintonTyree]

8. Kick....

as a person who suffers from chronic pain I have first-hand knowledge of the trouble involved in getting adequate pain relief. I've had a spinal fusion (L-4, L-5, S-1) and 2 herniated cervical vertebrae laminectomies. The spinal fusion was only helpful in allowing me to walk on my feet instead of crawling around on my hands and knees, the pain is still chronic and severely limits my mobility.

The rules about opiate distribution are not subject to a Doctor's appraisal. They are carved into stone and they have no leeway in the prescribing of pain relievers. I had to sign a waver saying that I would not "Doctor shop" or I would risk losing the right to pain medication. Rush Limbaugh can apparently skirt these laws but I cannot.

I can get one month's worth of pain meds at a time. Therefore I'm tethered to my pain and symptom management clinic and can't leave the area if it's close to the time to get another prescription. My mother, who lives in Florida, fell and broke her hip last year. I would have liked to have flown down to be with her but I couldn't because I only had a weeks worth of pain meds left. I had to wait until I could get another prescription (which the pharmacy watches like a hawk so I don't get it filled "too early").

The entire system of dispensing pain medication is broke. I know there are a lot of people who abuse these drugs these days but I, nor any other chronic sufferer, can be given any preferential treatment because of those who abuse the drugs.

There's so much more I could go into here but I can't sit at the computer too long because my back starts killing me if I do, I'm sort of a "hit and run" poster because of it.

Kicked and recommended!