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Aug 23, 2010

Imagine that one day, after waking up in a hospital with no memory of getting there or being hurt or ill, you learn that you were found wandering down the main street of town, babbling to yourself. It turns out that you’re a diabetic, and it was an insulin problem. It’s a frightening thing, but it can be treated; you don’t have to lose your ability to work or your job or anything else. The solution isn’t perfect – diabetes causes damage, and so does exogenous (from outside the body) insulin, but with proper treatment you have many productive years ahead of you.

Now imagine that some particular group feels “that kind” of drug is wrong – evil. They might be a religious group, or they might have misunderstood a magazine article, or maybe some other thing convinced them that hormones from animals are wrong, evil, or that for some other reason, and I guess “why” doesn't really matter, they think hormone use is bad, and so are the people who use them. Ridiculous, isn’t it? But suddenly, you can’t get the treatment you need because your doctor is afraid to prescribe it! The DEA and the DOJ are prepared to persecute, prosecute and imprison doctors and patients on the basis of unfounded, untrained medical opinions, and maybe opinions from a handful of doctors who also hate the drugs for some reason (doctors are as human and as fallible as the rest of us), or maybe they've found a way to profit from “hating” these drugs - as government witnesses, say. Doctors start losing their practices, their homes, even their freedom, and they will no longer prescribe insulin. Instead, you are given inferior drugs that work poorly if at all, your symptoms get worse, and you don’t know when you might end up comatose, or hallucinating – you’re a danger driving, or even just walking in public. And you yourself are suspected of being a “hormone abuser”, so you could become a criminal in the eyes of the law, which has been altered to accommodate the loudest or wealthiest voices instead of the voices of the informed and of the majority..

You can no longer drive, you can’t work, and it’s very, very hard to qualify for any disability or other treatment. The very problem makes you a suspect the instant a doctor realizes what it is because the instant assumption is that you want the “forbidden drug,” (which of course you do), and that makes you a “druggie” in the eyes of any cop. There is only one medication that will help you, and it has become, if not illegal, something the government is willing to attack people for with the whole power of the government regardless of medical science or the law. Asking for that specific drug instantly makes doctors think you intend to abuse it, or maybe to sell it on the street. You usually get tossed out of any emergency room or doctor’s office with no treatment at all; just another bill. Illegal or not, anyone can be destroyed by a police agency that is unaccountable and has near-control over the courts, and that describes the DOJ perfectly. Then add in the sensation-seeking press, and hope falls even farther. In the local newspaper you find your own story – except that it isn’t. It says your doctor has been caught prescribing these terrible drugs, which are known to have terrible side-effects (nevermind that they can also save your life), and the medical records of all of his patients have been impounded for “further investigation”, which means you can’t even have records with you to prove your history when you look for another doctor – which is called “doctor shopping” and is also considered an indicator of a “drug abuser”. They expect your doctor's patients, who they say were “hooked on these drugs by this irresponsible, needle-pushing doctor”, to come in, register as hormone addicts, go through rehab, and learn to live without these drugs. They want you to admit to being an addict – meaning you will be forever officially recognized as one by the state! And you know that without this medication, you will die – you will die many, many years before you might have with the right treatment, which is inexpensive and readily available – they just won’t give it to you. With the correct medication, you can live an almost normal life if you’re careful. Without it, you can look forward to early amputations, crippling nerve pain, blindness… the list is long and frightening..

Your wife has been reading the newspaper, and has been talked to by the DEA and a doctor of theirs. She thinks you’re weak, and as you slide into worse diabetic symptoms and become ever more sick and helpless, she leaves in disgust, taking your kids with her. She thinks you’re an addict, weak-willed, and she doesn’t want the kids to see you “like this”. You lose the house and end up on the street. Finally, with your own mind suspect due to the disease and worry and lack of rest, with your body falling apart, with nothing of your work or possessions left to you and only worse to look forward to, suicide becomes an attractive alternative..

It really does sound insane, doesn’t it? After all, a treatment that can save your life, that can give you back your life and help keep you alive and healthy and productive for many years is the right treatment no matter what anyone else thinks! It has nothing to do with religion, or strength of will, or even right or wrong. What do these religious fanatics have to do with your life, and why should their foolish and ignorant fears carry more weight than your necessity and that of tens of thousands, even millions, of others? Well, except for the disease and the medication used to treat it, this is a true story! The real disease is chronic pain – pain that never goes away, that you cannot ignore or will away or work at a job and ignore regardless. Pain takes over a person’s life, and takes it away, one thing at a time. You lose the ability to rest, so your ability to think well, and soon just to think rationally, goes. The pain increases, and if it’s ignored by the medical community long enough, it becomes permanent no matter what originally caused it. The nerves learn to transmit pain even without something causing it, so that even if you had an operation done that removed what had been causing you to hurt, the nerves would continue to transmit pain anyway. Your brain will even re-wire itself to overcome treatments that work to some degree so that the pain is treated by the body as a survival-priority alarm.

If you’re a chronic pain patient, the drugs they start you on, and try to keep you on if they can, are dangerous, and some, NSAIDS especially (Non-Steroidal Anti-Inflammatory Drugs), like aspirin and acetaminophen (Tylenol) can kill taken in very large doses or for too long. Most of the drugs are pretty much useless, although they can help in small doses if they are used along with the one class of drugs that really does control the pain: opiates, also called narcotics (and opiates are the only drugs that are correctly called narcotics). Over time, you can learn the truth about opiates and addiction: that only a tiny portion of the population are potential addicts, and the rest simply use the drugs for pain, and leave them alone if the pain goes away. Something else that people never consider is that an addict can hurt as much as anyone else, and can safely have the pain treated – it just takes more caution and monitoring to make sure that’s what the drugs are used for and nothing else. To some doctors, if a known addict comes into their ER even with a broken leg, they hesitate to give them anything before they set the bone! People, this is insane! Just how is it better avoid giving an opiate to an addict and allowing the poor patient to suffer in agony?.

To continue the question into a wider realm, why is it better to avoid taking a chance that a patient is an addict or a potential addict and give a patient, say, an aspirin when s/he’s complaining of severe pain instead of something that works? Opiates are the gold standard for pain control, and morphine, despite the bad name it’s gotten through a drug-war-mad government’s propaganda, it is the cheapest, best known, safest and most generally effective medication. It can be used for anything from a sprain to a broken leg to cancer pain, and in the right dose it will work. There are certain types of nerve pain that it doesn’t work for, but in general, it works. It has a few, very well-known side-effects that are easily offset by other medications, and for the first few days, tops, it may cause some sedation, but that goes away. It can cause a very uncomfortable problem with constipation, but that, too, can be handled easily for the most part..

A large part of the problem is that law enforcement agencies get around $60 billion a year (and rising) in funding to fight the War On Drugs, which everyone except a few fanatics in charge knows is a war that can never be won. As long as this fake “war” is being fought, they get all that funding. It means lots and lots of really neat toys like night vision goggles, guns that look like something out of Star Wars, helicopters and things like that, plus something else: power. Even ordinary cops can break into any home in the country without knocking (they get to kick down doors just like in the movies!), and even shoot whoever’s on the other side. If it’s the wrong house, or the person wasn’t armed, or something like that, well – oops. Accidents happen, you know. How can they be expected to make America safe from drugs if they can’t break into the homes of suspected drug dealers (if they wait until he goes out somewhere, which he has to do eventually, they lose a lot of potential funding, not to mention the chance to play Rambo), and then they have to be able to defend themselves, don’t they? Police are almost never held accountable for things like this, or for the bullets that travel through walls to kill the neighbor’s three year old daughter, or whoever. .

They can also accuse a piece of property of being used in selling or manufacturing drugs. Sometimes this is done by paying (often blackmailing and/or bribing) someone who is on parole to “sell” or even just use a drug on the property in the middle of the night when the occupants are asleep. They don’t have to accuse anyone of a crime, and defending the property means finding a way to prove it isn’t guilty, which is all but impossible. Even when, in the rare cases when it has happened and people do manage to get their property returned, it has been trashed, and they get no compensation, so they have repairs on top of legal fees to pay. Often they see a cop’s or city councilman’s girlfriend driving around in what used to be their car before the case is even done, which is illegal, but what can they do about it? The former owners lose pretty much everything, they are never accused of a crime, much less convicted, and sometimes their assets are frozen as “drug money”. Police agencies all over the country use this so frequently, they include it as part of their budgets! .

The War On Drugs is also profitable to the private prison industry, which actually trades on the NASDAQ. The more behavior, harmless or not, gets criminalized, the more criminals there are, and the more of them get put behind bars, so the more money the prison industry makes. It’s all a matter of profit. America now has 2.3 million people incarcerated, with more than seven million people in parole system or otherwise entangled in the legal system. Most of these are for simple possession of a weed. Oddly, the only power the DEA has is based on “interstate commerce” and transportation of goods. The answer to this problem was simple enough: they define any possession of marijuana or any other drug as “interstate commerce” ipso facto, no matter where it came from. Even if you grow it in your own back yard, harvest it and dry it and smoke it in your own home, just having it at all is, by legal definition, interstate commerce, so the DEA has power over it. And over you..

The DOJ has an even better gig. All they have to do is accuse someone, no matter how rich or powerful, and that someone has to plead guilty or be destroyed! That’s why Arthur Anderson, the accounting firm, was destroyed; they chose to fight because they were innocent, but the DOJ can attack forever, and they don’t have to worry about things like double jeopardy, or the Fourth Amendment, or anything else. They can freeze assets, lie to jurors, coerce the judges, and one way or another, no corporation or individual is wealthy enough to fight them – while they essentially have no limits on time or on money they can spend. The accused plead guilty of some lesser charge, or they get nailed with the whole weight of the United States Government, which can nowadays ignore its own laws while attacking someone, and people go to prison for the remainder of their lives, sometimes without even having been convicted of any crime! Dr William Mangino was sentenced to 8 1/2 to 20 years. He was also fined $10,000 in “restitution”, and the only victim mentioned was identified by the government as a Medicaid HMO called Gateway Insurance. Gateway was awarded triple the “damages” for prescriptions filled unnecessarily. The things he was accused of were, perhaps, things a Medical Board should look into, but there was never any crime mentioned, and still, he was declared guilty by a very confused jury who was lied to, deliberately confused, and expertly manipulated. Sound unlikely? Go to : and read it for yourself, along with the rest of this mockery of justice. In essence, the Department of (in)Justice is on a huge power trip, and they can do anything; they can even convict a doctor of nothing at all and sentence him to prison for it! .More than eight hundred doctors can attest to it, if you don't mind visiting or writing to someone in prison.

This is the biggest reason there is a War On Drugs, which has become a war on doctors and helpless, desperate patients whose only “crime” is that they are in pain: because it gets almost unlimited funds and power into the hands of greedy, power-hungry government agencies that have become medically and socially unaccountable, destructive engines of devastation to millions of sufferers, doctors and others.

People in unending pain who are refused the necessary medication lose the ability to work, the ability to rest, to sleep, to think straight a lot of the time, and in time, of course, being unable to work or do much of anything, they eventually lose everything else. This is attributed to the drugs, rather stupidly, as they generally can’t get and don’t have the drugs. Their bodies begin to age rapidly, certain parts of their brains especially. Naturally, people who hurt enough for long enough go from one doctor to another trying to find help. This is called, again, “doctor shopping”, and is considered a sign of addiction. They go from clinics to emergency rooms to doctor’s offices – anyplace they might get help, even if it’s just one small prescription. That one prescription is a few days relief from the pain, a few days and nights when they can rest, eat, maybe de-toxify the place where they live (if they’re not on the street by this time). Over the years, people learn which drug helps them the best and has the most acceptable side-effects. This too is considered a sign of addiction: the patient asks for a “drug of choice”.

Frequently, a doctor who doesn’t know how to treat chronic pain - which is different from acute pain and requires a different approach to treatment, even though the same drugs are involved – and writes a small, low-dose prescription for the drug that helps. If you tell him it won’t last very long, he says to make it last, to wait until you’re ready to scream before you take a pill. (Could a diabetic make too little insulin last?). That’s wrong, for a chronic pain patient too. So the choice is to take it as prescribed and get no relief from it, or to take it in the dose that helps and keep taking it that way until it runs out, getting relief, rest and maybe a few clothes and dishes washed for that short amount of time. It takes more of the drug to overcome the pain that has been allowed to build up, so either way, you run out too soon, but you actually run out faster letting the pain build before you take it. And it makes no sense at all to take such a small dose that you get no relief at all; you may as well flush it down the toilet. So, when you call back and ask for a refill, the doctor says no, and tells you never to call or show up again.

Chronic pain uses a different part of the nervous system than acute pain does as well as passing through the systems involved in depression, and when the opiate is taken for pain, it goes to the receptor sites where it attaches, just like the body’s own version of the drug, which is inadequate to control too much pain, and instead of getting the patient “high”, it just controls the pain. The chemical molecule that hits the receptors on the nociceptive (pain-transmitting) nerves in the dorsal horn of the spine and stops them from firing continuously and destroying themselves is the same molecule created by the human body for the same purpose – it’s just that in a chronic pain patient that system is broken. Tolerance can build, mostly in the early stages of treatment, but once the correct dose of the correct medication is found, it usually stays stable except for instances when the pain becomes greater due to too much activity or some other cause that make the pain greater temporarily. This is called “breakthrough pain”, and breakthrough medications, or “rescue doses” are usually prescribed for it, in proper treatment, anyway. The only other reason usually to increase the dose is because the condition has worsened, which such things do as we get older. In general though, chronic pain patients generally remain on the same dose for years at a time.

There is propaganda out there, oft repeated and as usual, totally wrong, that “opiates were never meant to be taken long-term.” Who is it that created them and only “meant” them for the short term? God? The fact that this flower, the opium poppy, actually makes the same molecule the human body makes to control pain is, it seems to me, one of the best proofs of a caring supreme Being I can think of! And again contrary to the propaganda, this absolutely natural substance causes no lasting organ damage! No other medication on the market that I’m aware of can make the same claim! No matter how long someone uses it, If the pain goes away enough that opiates are no longer needed, almost always the patient can simply be titrated down – taking a smaller and smaller dose – until s/he’s no longer taking it, and there in no damage from the drug! Quite often, if the patient is left alone by the DEA and allowed to continue mitigating the pain as needed, the pain does go away, too – it can often be cured! Patients in this circumstance notice they have pills left at then end of the month more and more often, and more and more pills because they no longer need that high a dose. The nerves, instead of being destroyed by continuous firing, have been allowed to rest and heal. Sadly, this rarely happens because the doctor gets scared and refuses to prescribe any longer, or the DEA attacks, or something else happens and the patient is cut off. And that, happening too often, is a frequent cause of suicide. Patients describe it as “having the rug pulled out from under them.” It’s a good analogy.

When the patient ends up with chronic pain, s/he loses a mate, the children, the job, the car, the home, health, medical insurance, self respect and self image – sometimes literally everything is taken away by it except life itself, and too often the patient does that. It happens at least 20,000 times every year. Think about it: how many times would you be willing to start over from scratch? How many times would you be willing to be put through catastrophic withdrawals which can, in and of themselves, sometimes kill, especially as the patient gets older and the damage from poorly or uncontrolled pain gets worse? It’s outright torture for no reason at all, or so it seems to the patient. The fact that it adds to corporate profits and unaccountable agency power (especially valuable as America switches over from a Republican government to fascism) is no comfort. Poverty, agony that never ends, mockery, sneering disdain, humiliation for asking for help, being labeled a “filthy addict” because of the need for medication – should these be the penalty for daring to have a disease? “Should be” or not, it is the penalty here in Puritan-descended America. And it is first creating and then killing the weakest, poorest and most helpless sector of our population; there are now an estimated seventy-five million chronic pain patients who are untreated or under-treated. They are not the vague criminal class called “filthy addicts” either – they are our parents, our relatives, many of whom were injured in the war, whichever war it was that their generation had to contend with. Parents, spouses, friends who were injured in deregulated workplaces that removed the safety regulations to speed things up, then fired people for daring to get hurt on the job. They are the people who raised us, or taught us in school, raised our food or served it in the restaurants, who built the buildings around us. They are ordinary Americans, and they are in pain, pain that can easily be treated well enough that many if not most of those people can return to work.

I have seen people who had been incapacitated by pain who, when they were suddenly treated right, returned to work, or at least got off the couch, or out of the wheelchair, or put down the cane. I’ve seen these silent, lonely, abandoned people become human beings again, begin to socialize again, pick up a musical instrument again, start dating again. And I’ve seen them after someone complained to the medical board that “My sister is being turned into a damned addict by that pill-mill doctor!” The doctor, who simply cannot afford yet another law suit that, true or not, will cost another fifty thousand, hundred thousand or more dollars. Some patients, rather than live as a suffering ball of pain consigned to the couch or that hated wheelchair again, choose to die. I’ve also actually heard those complaining relatives say things like, “Well, no, he can’t work any more; he had to quit. And he can’t walk very far – just bedroom, bathroom and back. But at least he’s off those filthy drugs!” And then there’s “Damn you, you coward! Man up! Get up and move, so something, nevermind the pain – you always hurt! So what? Everybody has some pain!” Sorry folks – it’s simply not physically possible. The pain is real. So is the damage it causes: loss of brain mass, cognitive impairment (which the opiates, used for pain, do NOT do), type II diabetes, lupus, chronic fatigue syndrome, Reflex Sympathy Dystrophy, hypothyroidism, hypercholesterolemia, Arthritis (yes, chronic pain causes arthritis) - it’s a long, long, miserable list. And the human body treats pain as a survival-priority signal: it will reroute nerve signals, alter the physical structure of the nerves themselves, do whatever it has to do to re-establish that all-important pain signal until the cause gets fixed. Except sometimes it can’t be fixed, so the pain never stops. It does, however, spread as those nerves recruit others.

Another crock of male bovine alimentary end-product that pain patients have to put up with is being accused of faking the pain for “secondary benefits.” That means free money so they don’t have to work, Food Stamps, lots and lots of sympathy, people coming over to help out and so on. Sorry, but there is no such thing. Social Security is sometimes just enough money to rent a glorified cardboard box someplace where the old friends don’t like to go unarmed. Sometimes it isn’t even that much. Food stamps always require copies of documents that they can’t find or can’t get, and any small additional income they manage to find takes away from that with the excuse they “make too much money now.” Say someone’s wife dies and he gets a “Widower’s Benefit” of $75 a month from his wife’s check. That pushes him over some limit that no one bothered to mention, so he loses $190 in Food Stamps. Also though, Medicaid stops paying two Medicare premiums, so that’s another, oh, $220 or so taken out of his check before he ever sees it. So that $75 he was so glad to get loses him almost $400 and suddenly he can’t pay both the power bill and house payment, though even that house payment is less than half what he’d have to pay anyplace else. As for sympathy: “Well, I just hate seeing him this way; he used to be so active! And all he does is sit there on that couch – he doesn’t want to go out, do anything.” How strange.

Chronic pain patients quickly learn not to show the pain. They take positions they can avoid squirming in and stay there. They get and up and down as little as possible, and when they do, they use exactly the right angle, the right support, and they move slowly so they don’t make any mistakes. They school their faces to a blandness they don’t feel, they don’t grunt when they have to get up, don’t or moan, or grimace. The pain is still obvious, but a bit less so. People do not know how to act around the suffering; they don’t know what to say, and they feel obligated to ask if there’s anything they can do. God forbid the patient should take them up on it though; they tend not to show up. In fact, they tend not to show up regardless after a while. “He’s always in pain – it’s been years!” As though it was a bad habit their old friend should just give up on and get on with his life. And then the patient is left with another problem: the doctor sees no signs of pain, especially not pain as bad as the patient describes. The patient is now in the position of having to pretend to be in the pain s/he’s really in! Once you learn not to let your face or position or body mechanics or voice give away the fact that you’re in pain, you can’t just turn it off. Not only that, but it just doesn’t occur to the doctor that no one can moan and groan and writhe around for years or even decades on end.

Doctors are as human as anyone else, and they are not trained to diagnose or to deal with chronic pain! They only know acute pain – which is when you slam your hand in the car door or something like that. It can reasonably be expected to go away fairly soon. Doctors are only taught to dose for acute pain, which is almost always a significantly lower dose than chronic pain. There is also usually a “threshold dose,” which means that anything below that dose doesn’t do anything at all. All too frequently the doctor prescribes a dose below that threshold dose, and if the patient follows it, s/he may as well use it for Wrist Rocket ammo for all the good it does. On the other hand, if they take at least the minimum dose, it means that they will run out too soon, and this is classed as “drug abuse.” It’s actually patient abuse. Doctors are also as subject to propaganda, conditioning, or brainwashing if you prefer, as anyone else is. While they know a lot, they cannot know everything, and chronic pain is a specialty – one that medical schools, because of DEA attacks, DOJ railroading, theft of assets and Bush-era judges who want to be Drug War heroes too like the cops - advise their students not to go into.

The “Medical Standard of Care” is what the textbooks, which are written by the real experts, say to do. This is as opposed to “usual practice,” or what most doctors actually do. The MSC says it makes more sense to begin with opiates; they’re safer than NSAIDs when taken as prescribed, and they are far more effective. NSAIDs are Non-Steroidal Anti-Inflammatory Drugs like aspirin, Aleve, Motrin, Naprosyn, Tylenol (which actually isn’t an NSAID but it’s usually thrown in with them) and some others. Tylenol, taken in too large a dose in a 24 hour period, can almost literally “melt” the liver. NSAIDs all act as anticoagulants, also called “blood thinners.” They can cause bleeding, and tend to be responsible for a lot of ulcers and other problems, including some strokes. At last count (that I’m aware of), they killed 16,500 people year. Chronic pain patients are not good patients to give NSAIDs to; they are not well rested or thinking very clearly, they are desperate for relief, and they can lose count of pills that aren’t helping, or sometimes just take more hoping for just a little bit of relief, which at pain levels like that just isn’t generally going to happen with NSAIDs. So the MSC is to start with morphine.

Watching a chronic pain patient trying morphine for the first is like watching Jesus at work – it’s a miracle when the dose is right. To quote a doctor friend, “They pick up their beds and walk!” Unlike aspirin or Tylenol or other “ain killers,” morphine goes right to the nociceptive nerves in the dorsal horn of the spine and turns them off. No more pain! At the very least, if the dose is over the threshold dose, the pain is diminished substantially. Instead of becoming “groggy” or “acting drugged,” a pain patient actually becomes more alert, more awake, stops moving like Frankenstein’s monster – stiffly and carefully so as not to make the pain worse. If it’s the right dose of the right opiate, they start talking about vocational rehab, or they just go do laundry they haven’t been able to get to for weeks, or months. They wash dishes and do other chores. Maybe they go out for coffee with a friend. They get their lives back. Until someone else takes them away again.

I was Hospital Corps during Vietnam, though the only war zone I got sent to was East Oakland. That was the choice of the military; I joined up during wartime, like both parents and my brother, after grandparents, uncles and other relatives and ancestors in Korea and WWII. I worked in a med/surg ward (this included oncology), an ortho ward, ob/gyn and nursery, a toxicology lab doing extractions for gaschromatography (and thin-layer when the gaschromatograph died, which it did a lot) and radioimmunoassay. I worked crash call at the airfield and emergency on watch, ran x-ray, ran Industrial Med for a time after the doctor had a heart attack (I ran yearly and entrance physicals, sewed up people’s heads after they stood up to fast under aircraft and so on). I was also an EMT-1, then a Paramedic Neonate Transport Tech when neonatology was a new. I worked ambulance after I got out of the military off and on for a decade. I kept up my reading in medicine, and after I got hurt for the last time and the pain never stopped, I studied everything I could get my hands on regarding pain treatment, medications and general medicine. I want you to know that while I am not a doctor, I am also far from medically ignorant.

That last injury was going on 28 years ago. If the doctors had not assumed that I was “in for drugs,” if they had listened and done the diagnostics I was asking, then begging for and had then done the indicated operation before the pain became permanent, or if they had simply treated the pain correctly, I could have been working this past almost three decades! Instead I’ve had no choice: I’ve been on Social Security Disability, Medicare, I’ve been homeless more than once, I’ve had six back operations, two of them six weeks apart, and once before, for eight years, the VA was treating me almost correctly, and I was able to play music on weekends, I got married to the love of my life and shopped, cooked, kept house (okay, I was never that great a housekeeper, but I tried) took care of twelve permanent feline residents and uncounted ferals in feeding them to keep them close and out of trouble, doing trap, neuter, inoculate and return. In other words, I had a life. I had also had to tear out the bathroom and rebuild most of it, help with the plumbing, and watch from a safe distance while the house got rewired – not enough, but it’s better than it was – after the 60 year old system ran 220 volts through the whole house system. That was when my wife caught her fourth case of pneumonia.

Up until then I had a life. I was a husband, and I was busy, and I had a life! Then my wife developed a nearly fatal complication, we spent ten days in ICU, and I had a patient to care for when we got home. It was COPD and it got worse. Fast. I also had to have back operation number six shortly after she got home; I made dinner the night of the day I had the operation. About the time my wife became bed-ridden and we knew she was dying, the VA went Drug War crazy and handed me over to a fake, lying and abusive “Board Certified Pain Management Specialist” who was not board certified or a specialist In pain management, and he destroyed the regimen that had allowed me to function almost normally for eight years. The VA outright lied to me, and led me to believe I either saw him exclusively for the pain or I would lose all pain care. This fake specialist chose not to believe me when the pharmacy screwed up on my meds, he tried over and over to force me in to the clinic almost fifty miles away just for piss test “to make sure you’re taking your medications right,” which I wasn’t and had already told him (I had told him at the time he wrote the script the dose was below my threshold dose and he ignored me) - if I had taken that dose I would have been crippled, as I was when it ran out far too early, but at least I had some food cooked and stored. I had told him repeatedly though that my wife had choking fits and I could come home to find her dead – she needed someone there at the time because she was increasingly helpless! Once during a short store trip – I tended to hurry those – she fell off the bed reaching for the TV remote I’d messed up and left out of her reach and fractured her shoulder. The doctor wouldn’t listen. He took away more and more meds that worked and tried harder and harder to force me to take medications I knew didn’t work or that might well incapacitate me when I could not afford it – my wife couldn’t afford it. He very nearly drove us both to suicide. A week before we would have gone to a beloved place in the woods to die, I found just enough help that we decided to live. I was alone in caring for her though for over a year and a half. My weight dropped from 210 to 143; I’m six foot two.

She died in my arms never having had to leave the home she grew up in, both of which I had promised her. That fake pain doctor at the VA, which I had to leave and have not returned to, crippled me because he decided I was a liar and besides my home problems, probably exaggerated, weren’t his problem. A specialty hospital I was trying to take my wife to said they could help her, and she might still be alive today if it wasn’t for him; I was too damaged, crippled up by pain and exhausted to get her there. That’s another debt I intend to do my damndest to pay. Now I have to recover after almost killing myself in caring for her. I am back on a better regimen, though somewhat less than perfect, but I may end up homeless again what with the dwindling benefits, the house and almost everything in it falling apart and the rising costs of everything. I could also lose that regimen at any time if the DEA decides to attack my doctor, or if almost anything else goes wrong, my fault or not. He’s doing nothing illegal, but as with so many other agencies these days, the DEA ignores the law and makes it up as they go. I’m not at all certain that I’d choose to live if they take it all away yet again.

A dear friend, who is a mother of three teenagers and wants desperately to live is going to die in agony because the Medical Manager on her case who is also the Administrator of Human Services for a city in Kansas which administers their own medical insurance has, per reported comments of hers, decided that my friend would be “better off going through detox and getting off those filthy opiates.” She raised my friend’s co-pay to 50% - about $4,000 a month, totally out of her reach. Her doctor sent a letter explaining that only keeping the pain under control had kept her healthy and alive for twelve years, the point at which 80% of people with her autoimmune disorder are dead; he also said that altering her medicine regimen at all would cause her to suffer “severe consequences up to and including death.” This woman, the Medical Manager, forced her to try “a drug that’s just as god but cheaper.” My friend threw four clots and almost died; she lost the use of her left arm and she and her kids spent the Christmas holiday in ICU waiting to see if she would live. After this proof of what her doctor said, the City refuses to budge. After being a very active mother, she is now almost bed-ridden and in terrible pain. She has maybe a month to live, and her kids, traumatized and scared, are terrified and angry. She WILL DIE, too. No one who could help will touch her case.

Seventy-five million Americans are in situations like these, or in situations so similar it makes no real difference. Seventy-five MILLION. It’s getting harder and harder to find a doctor who will treat chronic pain – correctly. Having found one, a minor miracle, it’s getting harder and harder to keep one. After it becomes impossible, I suppose we all just become another statistic in the “elites” depopulation program. Did you even know about this? No, not unless you or a friend or relative has chronic pain, and chances are you didn’t understand the real situation. You still don’t, but you know more than you did. Whoever you are, you are one accident at work or on the highway, one botched operation or other mishap from becoming another modern day leper, loathed by all.

If you have the ability to feel compassion, if you have any empathy or sense of justice, this should anger you as much as it does me! People get angry and leap into action when they hear about a dog that was abused; okay,I'm showing you seventy-five million human beings here who are being abused! To repeat, there’s a cure for many, maybe even most chronic pain patients – they’re just not allowed to have it! If the Medical Standard of Care is followed long enough without being taken away or without the doctor being forced to lower the dose to uselessness, it allows the nerves that were being destroyed by constant, nonstop firing to rest – and heal! Without realizing it, pain patients have cut back on their own doses of opiates simply because they had begun needing less and less. Some quit entirely. When the doctor who discovered this tried to find how prevalent this was, however, the DEA attacked, and all of his patients were thrown back to square one. As usual, some chose to die rather than go through it all again, and of course those deaths too were blamed on the doctor. Further testing has not been - encouraged.

Pain patients are such great targets because for the most part they are too poor to mount a legal battle. They don't shoot back at cops, and they certainly can't fight physically. They cannot go stand or march in protest; too many can’t make it to the store for groceries they need, or can’t afford to buy those groceries if they could get there. They are people who worked hard all their lives, and they are children – and mothers, fathers, grandparents – people from all walks of life, of all ages and skin colors. What they have in common is that they are one of the most helpless groups in the country, too weak, unrested, unfed, unable to work and often unable to get disability – and they simply hurt too much. Many are hard-pressed to get from one room in a house to another, those that have rooms, a home, a place to live at all. It isn't called "life-destroying pain" without reason; that's what it does, especially with all that help from an out-of-control DEA, abetted by the DOJ. They’ve all contributed – or could have. Now they desperately need help, because they simply cannot fight for justice alone. They haven’t the resources - physical, often mental (you try not sleeping for eight days), financial, transportation, health, you name it.

So what are you going to do?

Ian MacLeod August 13th, 2010 Oregon Links to articles; "A Modern Understanding of the Etiology of Chronic Pain" in, Chronic Pain in Veterans; Testimony: House Committee on the Judiciary, Subcommittee on Crime, Terrorism, and Homeland Security; Alex DeLuca; PRN; 2007-07-12. Posted: 2007-07-15; Revised: 2007-07-16. A Modern Understanding of Chronic Pain and Opioid Therapy Chronic Pain is a Medical Emergency War On Doctors/Pain Crisis The ‘Bounds of Medical Practice’ and the ‘Standard of Care’ - Alexander DeLuca, M.D., MPH

Visibility: Everyone
Posted: Monday August 23, 2010, 8:25 pm
Tags: abuse medical pain treatment chronic [add/edit tags]

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Surunatik WTF (38)
Tuesday August 24, 2010, 12:24 am
An impassioned piece, and yes long! But it needs to be said. Have you sent this to the ACLU? or? It's time there was challenge to the judicial thumb upon us, and it's time we demanded True Justice!

Great share Ian!

Cam V. (417)
Tuesday August 24, 2010, 1:54 am
Ian, this is a profound piece. You should consider submitting it to a magazine. Excellent work! I would like to pass it on! Well done my friend. Very, very well done!

Past Member (0)
Tuesday August 24, 2010, 3:42 am
Thank you Ian for your most valuable share.
You are master of word.
May your experience assist many others in pain.
And give them hope and confidence.
And I wish it will achieve sufficient impact at sources, responsible.

Carole Sarcinello (338)
Tuesday August 24, 2010, 4:39 am

Thanks for sharing this, Ian!

Gregory Hilbert (422)
Tuesday August 24, 2010, 10:31 am
Ian, the best way I know to express what I think of your Sharebook article is to say this:

I am most proud to call you friend.

Ian MacLeod (79)
Tuesday August 24, 2010, 11:38 am
Thank you, all! When I was with the Pain Relief Network, Siobhan Reynolds got between the DOJ and an intended victim/doctor. That's actually still dragging on in Kansas. The DOJ tried a couple of illegal attacks, then with the help of a Bush era complicit judge fined PRN out of existance and baggared her. Not sure how she's getting by, OR staying out of jail, but the government does NOT want to give up this power or income for 75 million "lives unfit to be lived" like me. Right now I'm seeing a doctor who helps, but that's ALWAYS a delicate situation. The closer to correct the treatment is, the omore iffy it is.

Northern, I have no idea HOW to submit to a magazine. Last time I made a serious effort they wanted to talk to my "agent," my lawyer, etc. It's like music - I write that too. No agent, manager, lawyer, etc. Just me.

Anyhow, thanks for reading and commenting! You're welcome to pass it on, quote or whatever!


Robert S. (115)
Tuesday August 24, 2010, 4:15 pm
Perhaps I can best tell you of your arguments impact on me by telling you of a conversation I had after reading it. I, once getting started, began to get quite animated exclaiming, " they don't call a diabetic who needs insulin an addict or addicted to insulin, do they? Ian, you eloquently, rationally expose a cruel injustice and got me mad about it. That ain't hay. Well done. I suggest shorting if I dare and sending far and wide to those in Gov. It could sway someone of influence away from the ignorance that grips the way pain is treated.

Ian MacLeod (79)
Wednesday August 25, 2010, 4:31 pm
Robert, not sure what you mean by "shorting ," but if you want to send this anywhere at all, please do! In whole or in part, so long as you don't change the meaning. I HAVE sent similar things to a great many agencies and individuals. Mostly I get no response; sometimes I get told that it's "just sour grapes from a deprived junkie" or something like that. That's the VA's take, anyway. I'm glad if this moved you! There is a genuine crisis in American around medical care to begin with, but government lies have rendered pain treatment almost forbidden! And as I said in the article, pain is now a disease in and of itself, and it KILLS. Even so, you'll hear doctors say, "Pain never killed anybody."

I beg to differ.


Ian MacLeod (79)
Thursday August 26, 2010, 5:32 pm

I'm not sure who it would have to sway to have a useful result. There are too many agencies and industries making too much profit in money and power from things the way they are. That ignorance is due to deliberate propaganda.


Dandelion G. (383)
Sunday August 29, 2010, 11:54 am
So what are you going to do?

Ian, I don't know what I can do.

I hold no law degree, no medical degree, I hold no position in public office, heck I don't even know anyone who is important to have sway over anything. I'm just one of the masses who see all the various injustices going on and feel that the statement, "hell on Earth" is very much real for many of the human beings that Walk upon her.

Coming from a native mind, we were taught that for every disease of the human body, there is a plant that was put upon the Earth by the Great Spirit to help. So I personally feel, that one Human Being does not have the right to forbide another that they can not have that which the Great Spirit placed for all to use in their time of need.

But we are controlled by those who take over the control, they make money by it, and they play God with that control. Is why they didn't want the First Nations people to get their ideas across to the masses, how could these Theives make money off of those concepts of sharing, balance, no hoarding, and all are equal and the world is to be shared also equally within a self sustaining balance of our Earth.

We do not have that nor even what the original ForeFathers had tried to do. That the protection of one persons rights, or a minority, was what this society was to strive and protect. To have the right to be out of pain, despite how others might view it based on their ideas of what that person is going through, should be protected. But it is not.


Today the chronic pain sufferer is told they can't have what they need, tomorrow it may be the insulin you speak of, or the blood pressure medication. Those who are not perfect will be weeded out. Maybe not in gas chambers, but denial of needed medications will have the same affect and will cost less. The disease kills them or they kill themselves.

To me, it all goes back to the head of the snake, the year 1913.....when total power was turned over to the Elites with the Federal Reserve. Loss of our rights have gone steadily away with it.

FACT: Morphine became a controlled substance in the US in 1914, and to have the drug without a prescription was a criminal offense.

Think about it......1914 the year after 1913.

Sorry Ian took me so long to read and respond but I fight chronic bronchitis so my brain was fuzzy for awhile, gets me down pretty bad. This was too important of a share by you so I wanted to give it my most thoughtful response. I'm truly sorry for all that you suffer and am blessed to consider you among my friends on here.

Ian MacLeod (79)
Sunday August 29, 2010, 6:58 pm

I have no degrees either. I just read a lot - always have - and I have LOADS of experience with pain; twenty-seven years worth. Almost three decades during which I could have been working, contributing, living my life. Three decades, gone.

Native Americans are who inspired a lot of the thinking of Thomas Paine, Thomas Jefferson and others of the Founders, especially around things lie personal liberties, the sacredness of freedom, and not trusting one individual with too much power. The Iroquois, I think, were one of the main tribes he spoke with.

I agree about natural medicines as well. I understand that there was once a plant that was a perfect contraceptive; it's extinct now. Between over-picking and the Church destroying it everywhere they found it, it no longer exists. For that matter, the opium poppy provides the EXACT SAME MOLECULE our own bodies make to control pain! We can't grow it, we can't buy it or own it without their approval. People like me could grow them in our own yards, and control our own pain levels despite the fact that our internal systems are now broken, generally because of medical ignorance and abuse, but we're not allowed. It would deprive the pharmaceutical companies.

Yes, the creation and illegal (which it still is) empowerment of the Federal Reserve was the beginning of the end for America, as it was intended to be. If our "own government" would get out of the way - their favorite place to be as far as I can tell - ordinary Americans WOULD get rid of it, and the parasites who own and run it. But the parasites in our government would lose far too much money and power; they could no longer convincingly call themselves our "betters."

What America needs to do is to clean house, getting rid of the parasites FIRST. The ones in charge of everything, the ones who've come to own everything, including us (they think) I mean.

"Ordinary people" just tend to take care of business, do what needs doing with no fuss, and go on to the next thing. We help those who need help, build what needs to be built, and most of us are careful about natural resources, gentle with animals. Farmers didn't abuse the animals they raised for food 'way back when, or put poison on the crops they were going to sell to friends, neighbors and family. It took government regulations written by lying corporations and finally factory farms to do that. There's a bill that's VERY near to being passed "unanimously" on the QT as soon as Congress gets back that has been fought down over and over again, SB 510, that will impose the expensive regulations that are, at some some are, needed by factory farms, on organic farms and even on backyard truck gardens that will guarantee that everything we put in our mouths is poison. No matter HOW many times we've managed to block it, someone owned by the corporations, this time a Congresswoman whose husband works for Monsanto, slides it back in somewhere. Eventually we'll miss it, or be unable to get enough people to write and call in to their Senators, and it will become law, and we will ALL begin dying - of starvation, or of malnutrition, or of the poisons inherent in GMO frankenfoods. And no, the bill doesn't say all that - exactly, but it CAN be (and WILL be) interpreted and enforced that way. I plan on planting a garden the first chance I get, whether it gets passed or not. If we ALL do that, they'll have to put every citizen alive in prison, and THAT may be a problem. Hell, I may even start a flower garden.


AniMae Chi (436)
Thursday September 2, 2010, 3:51 am
so deeply touched Ian, hard to find words to express what i'm feeling... i understand You... Oceans of LOVE~LIGHT~PEACE

Ian MacLeod (79)
Thursday September 2, 2010, 7:14 am
Wado, tohiju.



. (0)
Tuesday September 7, 2010, 2:22 pm
Thank you Ian for inviting me to read this! I understand every word..all truth. It's about the game they play..there is a Muslim Pharmacist..compounds all his own things a block from me and he explained to me that for example xanax..if people no longer produce seratonin..which is manufactured in the gut and not the brain..then they can take a very large dosage of xanax and feel perfectly normal..for me? I can only tolerate one forth of a .01 dose! But my daughter can take three 5 milligram ones and be perfectly normal. Thus proving his point. All you are saying is true. Actually.. you must write a book Ian! It would be a great income and a best seller..your life is fascinating..we would all purchase it... and you certainly have all the knowledge, experience, info..etc might have to go into hiding however!...books about these things have been written..truth is dangerous! But necessary! Thank you for being a survivor of our society ... you have taught us all much here..Salam Alaikom Ian..arij

Ian MacLeod (79)
Tuesday September 14, 2010, 9:32 pm

Shukran! Well, you make about twenty-some people now just in the past month who think I should write a book. Guess I'd better get working on it! :>) Actually I have been working on several for some years; I just don't have the contacts, agents, managers, degrees, etc. I'll keep at it though.I do get pretty bent out of shape about what's been happening lately, and that story about the woman in Kansas is entirely true. Thank you again!

To all of you who've read and commented, I thank you. Northern, I hope you've had luck in passing it on to others. Robert, glad I could offer you some ammo in an argument! People like me need all the help we can get! Dandelion, I know how a physical condition gets in the way of cognition, believe me. I'm glad you found it worth the effort. Carl, again, thanks for reading and commenting! Carole, thanks you also - I wish I could get this out to a truly wide audience. Just don't quite know how. Maybe one day... Gregory - a compliment indeed! Sioux - thank you, too! What you folks have read here came to me one long, slow and usually lonely night at a time, one ten-hour ER wait at a time, one insulting, sneering comment from a doctor or nurse at a time... I cam by this knowledge the hard way, for certain. It's good to see it appreciated when I AM able to offer it.

Take Care, All!



Ian MacLeod
male, age 59, married, 8 children
Madras, OR, USA
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