Getting Your Fix by Pat Conrad MD


Pain control was never an appropriate area for federal oversight. For all it’s good in easing suffering at the local level, medicine has grown insufferably tiresome as a vehicle for busybodies to crawl up each other’s rear while trying to increase their own importance. Yeah, I just described the AMA, AAFP, et al, who substitute posturing and nosiness for actual achievement. These frauds have been joined by the American College of Physicians, American Psychiatric Association, and American Society of Addiction Medicine in celebrating congressional passage of the Comprehensive Addiction and Recovery Act (CARA) now slithering its way to the president’s desk. The bill is supposed to increase access to naloxone and buprenorphine, fund more addiction services; dump more tax dollars on states for recovery, education and treatment programs, and drug monitoring programs.

Nitin Damale, MD, president of ACP, said, “We urge the President to immediately sign this important bipartisan legislation that helps alleviate the suffering of the thousands of individuals who suffer from these addictions.”

President of AAFP Wanda Filer, MD: “[CARA] will expand much-needed access to care for Americans struggling with substance abuse disorders — a policy long-supported by the [AAFP] and our members”, like any other do-gooder federal program using other people’s money to boss around doctors and patients. R. Jeffrey Goldsmith, MD, ASAM prez is “thrilled…With adequate funding, we believe this bill will help save lives.”

Do you think all of this is a good idea? Then how about “funding for the National All Scheduled Prescription Electronic Reporting Act (NASPER)”? Or the “development of a federal task for that will identify best practices for pain management and prescribing medication for pain”? Or the “expansion of the VA Opioid Safety Initiative [requiring] training for safe opioid prescribing and pain management”?

“But we cannot stop here”, says Saul Levin, MD, CEO of APA, “These programs must be fully funded to be effective. APA looks forward to continuing to work with Congress to curb this epidemic.”

Chair of the AMA Board of Trustees Patrice Harris, MD thinks, “This legislation represents an important step in addressing the public health epidemic of opioid misuse, but it will not be fully realized without new resources to support these programs and policies.” Ah yes, new resources. Remember what I’ve said about accepting Caesar’s coin? The legions always follow.

This newest miracle legislation is from the same compassion-industrial complex that made pain a vital sign, pushed hospitals and docs into overprescribing, and then started fining and jailing them for doing so. Yes, there are plenty of shmucks that took advantage of the climate for a sleazy buck, harmed patients in the process, and were deservedly hammered. But the majority of decent physicians have had to spend more time and energy looking over their shoulder at the G-man in the dark trench coat reading the database in the local pharmacy, spending extra money on mandated e-prescribing and Medicaid-compliant script paper, often prescribing less pain meds than they judged necessary. No, I don’t deny that there is an opioid problem, but it won’t be fixed by even more laws that make me want to work in a micro-brew (and the War on Drugs has been such a success…). I have always tended to be very tight-fisted with the opioids, but that doesn’t mean I trust the medical judgment of an ignorant bureaucrat or blowhard congressman as much as a trained physician. Doctors should be immediately suspicious of anything, ANYTHING agreed to by the AMA, ACP, and AAFP. Doctors should not be grateful to this government for “resources” – they should hate and fear it. This legislation, NASPER, and subsequent steps to fix the problems they will cause will only do for medicine what the TSA has done for flying.

87660cookie-checkGetting Your Fix by Pat Conrad MD