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LETTERS TO THE EDITOR

Pain Doctors: Unfairly Targeted by the DEA?

Thursday, January 8, 2004; Page A22


Regarding the Dec. 29 front-page story "Worried Pain Doctors Decry Prosecutions" by Marc Kaufman:

When will our nation learn to deal in a sane and humane manner with those suffering from chronic or unbearable pain?

A mere four hours before her death, after a protracted battle with cancer, my mother's oncologist denied her request for morphine. He told me over the phone, and I quote, "It is not yet time for that."

Was he worried that she might become "addicted" in the short time remaining to her? Or, as Mr. Kaufman's article might suggest, was he concerned about investigators questioning his judgment regarding the prescription of a narcotic to a terminally ill patient?

Neither concern was of any importance to my mother as she gasped her last breaths without the relief that modern medicine is capable of delivering.

How discouraging that three years later, the situation appears to be worsening.

KENNETH B. HAINES
Beltsville

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Marc Kaufman's article on the persecution of pain doctors by the Drug Enforcement Administration (DEA) raised the question of whether that agency should be regulating physician medical practice. If a physician has to worry whether some bureaucrat from the DEA is going to be looking over his or her shoulder and questioning every dose of analgesic prescribed, a lot of people are going to suffer.

As a person who lost both parents to cancer, I know that control of pain can be the greatest gift a physician can make at the end of life. As a physician who has worked with cancer patients and patients with severe chronic pain, such as sickle cell disease, I know that the control of severe chronic pain can be a difficult clinical challenge. Individual tolerance of narcotics varies, and some people require large doses of narcotics as well as other methods to control pain.

Medical practice is generally the responsibility of the state medical boards. Many state boards, including the District's, require separate narcotics licensing in addition to the federal DEA number. Perhaps the DEA should focus on illegal drug use and refer questions of legal medical practice to the professional boards.

PETER F. BROSS
Gaithersburg

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Marc Kaufman's article about Drug Enforcement Administration investigations of physicians said the DEA is "targeting pain doctors who write frequent narcotics prescriptions." This implicitly embraces the quoted suggestion of an advocate that medical "ambiguity" is being "turned into allegations of criminal behavior." This is not the case.

The DEA does not investigate physicians merely for prescribing large volumes of narcotic drugs. It will, however, investigate when credible evidence indicates that a physician is prescribing in bulk outside established boundaries of legitimate medical practice set by his or her peers.

Second, Mr. Kaufman's story gave little explanation of the compelling reason why such investigations have become an enforcement priority for the DEA: Lives are at stake. The Post itself recently published a five-part series on the rapid growth of drug diversion and fraud it described as "creating a wide-open drug bazaar that endangers public health" [front page, Oct 19-24].

The DEA is committed to effective diversion enforcement and will continue to responsibly protect patients and communities from the costs of narcotics abuse.

KAREN P. TANDY
Administrator
Drug Enforcement Administration
Washington

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