Liberal Values Defending Liberty and Enlightened Thought

Culture 11 had a series of arguments yesterday on the drug war. Radley Balko wrote about the collateral damage of the war on drugs. While he dealt with damage in many areas, the one which concerns me the most is the effect on medical treatment:

One final and emerging class of drug war collateral damage is medical treatment. As the drug war has become increasingly federalized, the federal government has at the same time increasingly nosed in on the relationship between doctor and patient.

The most obvious example is medical marijuana, where the federal government has not only told doctors what they can and can’t prescribe to their patients, it has barred research into the possible medical benefits of marijuana (it then dishonestly claims there is no research providing evidence of said benefits), and asserted the supremacy of federal law when it comes to marijuana-related medical policy—a field of policy America has traditionally (and wisely) left to the states…

One more recent area where the drug war is corrupting medical treatment is in the treatment of pain—specifically, chronic pain. By some estimates, as many as 30 million Americans suffer from untreated chronic pain. That number is only likely to rise as the country continues to age. A promising new treatment called “high-dose opiate therapy” has proven successful at keeping chronic pain at bay in many patients. The problem is that as patients build up a resistance, doctors must titrate up their dosages, to the point where some patients can take 40 or more pills per day. These patients don’t get high, and they don’t suffer any ill effects. They aren’t addicted, they’re merely dependent. Take the medication away, and the pain comes back.

Unfortunately, because some addicts use opiate painkillers to get high, the Drug Enforcement Administration has decided to play doctor, determining that no patient should ever need medication at dosages that high, and that any doctor prescribing drugs in those quantities must be dealing (or “diverting,” as it’s called in the white collar world). While it’s certainly possible that some doctors who prescribe pain medication are unethical, the DEA’s aggressive, un-nuanced pursuit of pain doctors has put the fear of prosecution into nearly all doctors who specialize in pain treatment (and scared young doctors from entering the field). Driven by politicians spooked by a spate of irresponsible press reports warning of an OxyContin fad sweeping the country, the DEA’s high-profile pursuit of pain specialists has poisoned the relationship between pain doctors and their patients, and left the country with a dire shortage of physicians willing to prescribe pain medication at the dosages many patients need.

We have drug cops dictating medical policy, and it’s leading to all sorts of unnecessary suffering. Some patients have lost one doctor to a DEA prosecution, spent weeks to find another who will treat them, sometimes miles away, only to have that doctor come under investigation, too. More than a few pain patients have attempted suicide after being unable to find a doctor to treat them.

All just collateral damage. The DEA’s mission is to prevent people from getting high. If it takes an overly broad, overly aggressive, chilling campaign against doctors to do that, leaving millions of people in needless, sometimes debilitating pain, so be it.

Anita Bartholomew had an article on the cost of prohibition and speculated about how Obama will respond to a government program which clearly does not work:

We can’t know yet where an Obama administration will take us but, Candidate Obama gave a few clues about how President Obama may look upon the war on weed. Obama and his spokespeople have said that he would respect the medical marijuana laws passed by local and state governments and end the Clinton and Bush era DEA raids on medical marijuana providers.

It’s less clear how receptive he’ll be to either legalization or decriminalization. Although he backtracked once he became a presidential candidate, Obama agreed with decriminalization in 2004. And, like the majority of Americans polled by Zogby, Obama has called the drug war an utter failure.

It’s a start. Alcohol Prohibition didn’t end all at once. At the dawn of Prohibition, doctors lobbied to retain the ability to prescribe liquor for medicinal purposes. Toward the end, low alcohol content beer was re-introduced. And with economic collapse and bootleg alcohol gang violence out of control, the U.S. reached a tipping point; the 21st Amendment repealed the 18th.

It’s time to reassess marijuana prohibition with clear minds, the way that our ancestors eventually viewed repeal of alcohol Prohibition, to get past the fear-based and moralistic misinformation. Do we really want to keep spending insane amounts of our dwindling government funds on tracking down, arresting and imprisoning the hundreds of thousands of hapless Harolds and Kumars who then can no longer contribute to our faltering economy by overeating at White Castle? Is this where we want to focus our law enforcement resources when we’re entering a deep recession that’s likely to produce an increase in property crime?

Going back to President-elect Obama’s promise to “eliminate spending for programs that don’t work,” it’s clear that the war on marijuana users hasn’t worked. It’s not just a failure, it’s a disgrace, on every level, and it’s time to end it. Not only to save money or to stop punishing non-criminals, but to fulfill a promise made long ago, about inalienable American rights to liberty, the most basic of which is, quite obviously, the freedom to do what you choose with your own body in the privacy of your own home.

David Freddoso presented the counter arguments, supporting prohibition. Ralko and Freddoso also debated their positions on Blogginheads TV (video below):