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Debunking The Myths

Common sense in pain management -- read Chronic Pain & Opioids: Debunking the Myths, by Frank B. Fisher, MD -- also available in PDF. And check out this public service ad based on Debunking the Myths.

Physicians are under intense scrutiny because of concerns over prescription drug diversion and abuse. At the same time, they are also under pressure from patients and advocates to prescribe adequate pain medication. It is a difficult balancing act and sometimes, overzealous law enforcement can tip the scales. For more information click here.

The Cato Institute published this tremendous analysis of pain management policy by Professor Ronald T. Libby of the University of North Florida. Download a copy of the full report, and also check out this CSDP public service ad which excerpts the Libby report.

A Michigan study confirms what many patients already know: Pharmacies in minority and low-income areas are less likely to carry sufficient supplies of pain medications. Click here to read more about this study on access to pain medication which was published in the Journal of Pain in Oct. 2005.

Pain management: where healthcare and drug control policies intersect. Click here for more about pain management, diversion, and related items. Also check out this new CSDP public service ad on the federal war against physicians over pain management.

Florida Governor Charlie Crist and his cabinet voted unanimously to grant pain patient Richard Paey a full pardon for his 2004 conviction on drug trafficking and possession charges. For more information, click here.

The re-trial of Doctor William Hurwitz came to an end in July 2007. The doctor's sentence was reduced to less than five years. He was originally given 25 years. For more information, click here.

A federal judge is challenging the plea agreement entered into earlier in 2007 between prosecutors and Purdue Pharma, the manufacturer of OxyContin. For more information, click here.

The New York Times Magazine featured a cover story on pain management issues in their June 17, 2007 edition. Click here to read the story in full.

Purdue Pharma, manufacturer of OxyContin, and three current and former executives were allowed to plead guilty in federal court to misleading the public about Oxy's risks. For more information, click here.

Federal re-trial of pain specialist Dr. William Hurwitz ends – some charges dismissed, acquittal on some charges but guilty verdicts on others. For more information click here.

Commutation Urged After Appeal Fails

Chronic pain patient Richard Paey lost in the appeal of his sentence on drug charges and faces a mandatory minimum 25-year-sentence. For more information click here .

DEA Issues Policy Statement On Pain Management

The US Drug Enforcement Administration has issued a new policy statement on pain management and prescribing practices. For details, click here. Also, a full copy of the notice as published in the Federal Register is available by clicking here.

The 4th Federal Circuit Court of Appeals has granted a new trial to Dr. William Hurwitz of Virginia. Dr. Hurwitz had been accused of drug trafficking for prescribing large quantities of narcotics to patients. For more information click here.

Rightwing talkshow host Rush Limbaugh reached a plea deal with prosecutors – charges to be dropped in 18 months if he completes treatment, avoids re-arrest. For more info, click here.

One of the first physicians in the nation to be charged with the deaths of patients from narcotics abuse was found guilty of one count of manslaughter and five counts of narcotics trafficking in her retrial in Florida. Dr. Asuncion Luyao faces maximum 30 year prison term – an appeal is planned. Click here for more info.

First Annual Opioid Certification Program

Presented by the Opioid Management Society & the Journal of Opioid Management, the conference will be held April 22-23, 2006, at The Conference Center at Harvard Medical, Boston, MA. To register, contact the Opioid Management Society.

The cover story in Harvard Magazine's Nov-Dec 2005 issue is "The Science of Hurt," by Kathleen Koman. Download and read a PDF copy of this tremendous article.

FDA, doctors win versus DEA on question of final approval of new painkilling drugs. Click to read more.

Chronicle AM: UN Decriminalization Drama, Global Undertreatment of Pain Report, More (10/19/15)

A thousand march for marijuana in Dallas, a few dozen in Montgomery; a UNODC document calling for drug decriminalization gets leaked, then yanked; the Global Commission on Drug Policy issues a report on pain, and more.

[image:1 align:left caption:true]Marijuana Policy

Dallas March for Marijuana Brings Nearly a Thousand to the Streets. Around a thousand people joined a march calling for marijuana law reform in Texas Saturday. The march was organized by Dallas-Fort Worth NORML. Click on the link for more.

Dozens Turn Out for Alabama Rally for Marijuana Law Reforms. Several dozen people took to the foot of the state capitol last Friday to call for marijuana decriminalization and access to medical marijuana. Efforts to pass a medical marijuana bill have stalled in the legislature.

Medical Marijuana

Seneca Nation Moving Toward Medical Marijuana. The Seneca Nation of Indians is preparing to vote early next month on whether to authorize the National Council to start drafting laws and regulations to govern medical marijuana. The vote would be only a first step toward the tribe getting in the medical marijuana business. The Justice Department opened the door for tribes to get involved in pot operations with a memo last fall.

Kansas Silver Haired Legislature to Renew Push for Medical Marijuana. The Silver Haired Legislature, which advocates for senior citizens, is again calling on the legislature to pass medical marijuana. At a meeting earlier this month in Topeka, the group adopted three proposed bills it will push to see passed in the next term. Click on the link for more details.


UN Bid to Urge Drug Decriminalization Foiled. The UN Office on Drugs and Crime (UNODC) has withdrawn a document calling on governments to consider "decriminalizing drug use and possession for personal consumption" after at least one country objected. The document was leaked by Sir Richard Branson over the weekend, and when a journalist violated the UNODC's embargo on release of the document, UNODC walked back the report.

Global Commission on Drug Policy Releases Report on Undertreatment of Pain. The Global Commission on Drug Policy (GCDP) today released its third thematic report, The Global Crisis of Avoidable Pain: The Negative Impact of Drug Control on Public Health. The report was launched by Commissioners, former Swiss President Ruth Dreifuss, UN Secretary General Special Envoy on HIV/AIDS in Eastern Europe and Central Asia, Michel Kazatchkine and former United Nations Special Rapporteur on the right to health, Anand Grover. The report finds that three-quarters of the world's population has no access to pain-relieving drugs and that "the reasons for this have little to do with issues of cost or scarcity of supplies- and everything to do with the prohibition and repressive stand the world has taken on drugs. States are obsessed by the fear that people will use controlled medicines, such as morphine as drugs, thereby neglecting the important medical uses." Click on the title link to read the report.

WOLA Discussion on Impact of Drug Policy on Human Rights in the Americas Wednesday. The Washington Office on Latin America (WOLA) is hosting the discussion in Washington, DC, at lunch time Wednesday. Click on the link for speakers, more information, and to RSVP.

State Department Cuts Some Mexico Drug War Funding Over Human Rights Concerns. The State Department has concluded that Mexico failed to reach some human rights goals in its drug war, triggering the cutoff of millions of dollars of drug war assistance. The move only affects a small portion of overall US drug war aid to Mexico, but does signal growing frustration with alleged abuses by Mexican security forces. Some 15% of aid provided to Mexican security forces is subject to human rights provisions, meaning that Mexico lost $5 million of a total of $148 million in US drug war funding this year. That $5 million was instead diverted to Peru to help finance coca eradication.

Mexico Supreme Court to Take Up Marijuana Legalization Next Week. The high court is set to discuss a legal challenge that could effectively legalize the use and production of marijuana. The challenge comes from a non-profit that filed an injunction against the Mexican health regulatory body COFEPRIS over a 2013 ruling by that body. The hearing is set for October 28.

Norway's Two Largest Cities to Move Toward Giving Free Heroin to Addicts. The cities of Oslo and Bergen are set to begin heroin-assisted treatment pilot programs after the Labor Party won local elections there, but they will have to win approval from the national parliament first. Parliament rejected a 2012 effort to start the programs. Norway has the world's second highest drug overdose rate, after Estonia.

Chronicle AM: MI Forfeiture Reforms Head to Governor, OH Sues Over Toledo Decrim, More (10/7/15)

Toledo's decriminalization is challenged, Florida officials face heat for delays in implementing the state's CBD medical marijuana law, an Illinois panel approves medical marijuana for pain conditions (but will the governor go for it?), and more.

[image:1 align:left caption:true]Marijuana Policy

Ohio Sues Toledo Over Municipal Decriminalization Ordinance. State Attorney General Mike DeWine, joined by the Lucas County prosecutor and sheriff, have sued the city of Toledo in a bid to overturn its decriminalization ordinance. Toledo voters approved the ordinance last month, becoming the first in the state to enact municipal decriminalization. The lawsuit objects to provisions in the ordinance barring police from reporting marijuana crimes to other agencies, making pot trafficking a "negligible" offense, and decriminalizing the possession of small amounts of other drugs. Toledo could become a cartel capital because of the ordinance, DeWine warned: "Absent legal action, it's not hard to imagine international drug rings making Toledo their regional base for operations," he said.

Medical Marijuana

Florida Lawmakers Grumble Over Slow Pace of CBD Medical Marijuana Implementation. At a hearing in Tallahassee Tuesday, lawmakers grilled Health Department representatives over delays in the program. "I mean, it's been almost two years since this bill was passed," said Rep. Greg Stube (R-Sarasota). "And we still don't have any restitution for these children that are trying to get this drug that the legislature recognizes is something needed for the state of Florida," he complained. The department said it was "mindful" of the need to make progress, but still couldn't say when five initial cultivation licenses would actually be issued.

Illinois Panel Approves Medical Marijuana for Chronic and Other Pain. The state's Medical Cannabis Advisory Board voted Wednesday to approve chronic pain, intractable pain, and chronic post-operative pain. The additions must also be approved by Gov. Bruce Rauner (R), who earlier rejected 11 other suggestions for expanding the list of qualifying conditions. The board is also pondering whether to add autism, irritable bowel syndrome, osteoarthritis, and PTSD.

Asset Forfeiture

Michigan Legislature Passes Asset Forfeiture Reform Package. The state Senate Wednesday gave final approval to a seven-bill package that will increase civil asset forfeiture reporting requirements and increase the burden of proof for seizures from "a preponderance" of the evidence to "clear and convincing" evidence the seized items were connected to a crime. The package has already passed the House. Some groups, including the Mackinac Center for Public Policy and the Michigan ACLU, want to see even deeper reforms, including eliminating civil asset forfeiture entirely and requiring a conviction before property can be seized in a criminal proceeding. But this is a start.


Massachusetts Bill Would Block Sending Women to Prison for Drug Treatment. An amendment to a supplemental spending bill would prohibit women from being civilly committed to the Framingham state prison for drug treatment. The bill and its amendments are to be debated tomorrow. It's a move that was recommended by Gov. Charlie Baker's (R) task force on opioid abuse. Baker is looking for $5.8 million in the supplemental budget to pay for women in the prison for drug treatment to be moved to a hospital, most likely Taunton State Hospital.

Chronicle AM: MA Inits Filed, Pill Crackdown Hurts Patients, Yemen War Snarls Drug Trade, More (8/05/15)

Competing legalization initiatives get filed in Massachusetts, pain patients face obstacles amidst the pill mill crackdown, the Yemen war is messing up the peninsular drug trade, and more.

[image:1 align:right caption:true]Marijuana Policy

Two Competing Groups Filed Massachusetts Legalization Initiatives. Both the Marijuana Policy Project-backed Campaign to Regulate Marijuana Like Alcohol in Massachusetts and the local group Bay State Repeal today filed initiatives to legalize marijuana in the state. Bay State Repeal actually filed three versions of its initiative. Click on the organization link to get details on the various proposals.

Medical Marijuana

Leaked Document Shows DOJ Misled Congress on Impact of Medical Marijuana Amendment. In the days before Congress voted to approve an amendment limiting the Justice Department's ability to interfere in medical marijuana states, an internal memo obtained by Tom Angell at shows that the department tried to mislead Congress by falsely claiming that the amendment could "in effect, limit or possibly eliminate the Department's ability to enforce federal law in recreational marijuana cases as well," according to the document. [Emphasis added.] The memo admits that the DOJ talking points were "intended to discourage passage of the rider," but "do not reflect our current thinking." Click on the link for more.

Under-treatment of Pain

Pill Mill Crackdown Hurting Pain Patients. New Hampshire Public Radio has done a lengthy report on the impact of the pain pill crackdown on pain patients. One patient who moved to Florida reports that his pharmacy runs out of pain medications, and the pharmacy owner reported that pharmaceutical wholesalers will no longer distribute the amount of drugs he needs to serve his clients. There's much more there, too; click the link to read the whole thing.


Yemen War Messing Up Arabian Peninsula Drug Traffic. Saudi Arabia's four-month bombing campaign against Houthi rebels is not only killing hundreds, perhaps thousands, of Yemenis, it's also choking off the supply of Middle Eastern amphetamines and hashish that have been being trafficked across the Yemen-Saudi border. Saudi border guards say the war has shut down trafficking, while Riyadh residents complain that supplies are drying up. The article also provides an overview of drug use in the region; click on the link to get it all.

Release: Major Groups Call for UN to Respect Countries That Legalize Marijuana or Other Drugs (5/5/15)


read more

Chronicle AM: NV Pot Init Will Go to Voters Next Year, Dark Web Drug Bust, Saudis Behead Three, More (3/13/15)

Nevada is the first state in line to legalize it in 2016 after the legislature failed to act this week, a controversial Ohio legalization initiative wins a preliminary approval to move forward, there was a major dark web drug bust in Germany this week, and more.

[image:1 align:right caption:true]Marijuana

DC Cannabis Campaign to Host Pot Seed Exchange. The folks behind the Measure 71 marijuana possession and cultivation legalization initiative will be hosting two seed exchanges this month. "This will be DC residents' opportunity to share seeds with other adults and start down the path of legally growing your own cannabis in the safety and privacy of your home," the campaign announced Thursday.

Nevada Will Vote on Marijuana Legalization Next Year. After the state legislature failed to act by a deadline today, marijuana legalization is headed to the ballot next year. Initiative organizers have already taken all the necessary steps for the vote to take place. The legislature could have approved the initiative itself, but instead punted. Read the initiative here.

Ohio Attorney General Approves Petition Summary for Responsible Ohio Legalization Initiative. The attorney general's approval means ResponsibleOhio now goes to the Ohio Ballot Board for its approval. Their meeting will take place in about 10 days. Read the ResponsibleOhio initiative here. If the Ballot Board approves, ResponsibleOhio must then gather 305,591 valid signatures of registered Ohio voters from at least 44 of 88 counties to get the measure on the fall ballot.

Medical Marijuana

Federal Medical Marijuana Bill Gets New GOP Cosponsor. A second Republican senator has signed on to the Compassionate Access, Research Expansion and Respect States (CARERS) Act (Senate Bill 683). Sen. Dean Heller (R-NV) joins fellow Republican Sen. Rand Paul (KY) and Democrats Cory Booker (NJ) and Kirsten Gillibrand (NY).

Georgia Senate Passes Restrictive CBD Cannabis Oil Bill. The Senate passed Senate Bill 185, which would allow parents bringing CBD cannabis oil into the state to treat their children with epilepsy to be exempted from criminal prosecution, but would not allow medical marijuana in any other form and would not let adults or children with other diseases use it. The House has passed a broader CBD bill; the Senate Health Committee chair has promised it will try to reconcile the two bills.


China Withdraws UN Motion to Make Ketamine a Controlled Substance. After lobbying from Canadian researchers and others who said ketamine is a crucial anesthetic for poorer countries, China today withdrew its motion before the UN Committee on Narcotic Drugs to schedule the drug. The Chinese said they would defer their resolution for another year so ketamine can be studied more.

Germans in Major Dark Web Drug Bust. Police in Leipzig announced yesterday that they had raided 38 locations and arrested seven people, as well as seizing more than 700 pounds of cocaine, ecstasy, LSD, amphetamines, marijuana, and hash. The bust was of only one seller on the dark website Evolution, but the Deep Dot Web blog, which closely tracks the online narcotics trade, calls the law enforcement operation the biggest Dark Web drug bust ever. Still, the vendor busted represented only a fraction of the 20,000 drug listings on Evolution, and that's just one dark web drug sales site.

Saudi Arabia Beheads Three For Drug Smuggling. A Yemeni, a Syrian, and a Saudi national were executed in the kingdom this week for smuggling amphetamines and hashish into the country. That makes about 20 drug executions so far this year in the county, about half of the 43 executions reported so far.

The Drug Enforcement Administration worked with pain management specialists to develop pain prescription guidelines so that law enforcement could do its job and physicians could do theirs. A month later, DEA pulled the guidelines.

In a letter, 30 state attorneys general take DEA to task over withdrawal of pain management prescription guidelines. Check out this public service ad on the letter.

OxyContin has been the center of controversy as pain management has moved to the front of the public consciousness. Much of what's been reported is exaggerated. Click here for more news and information about Oxy and pain management issues.

Excerpts from Cato Institute Analysis*:

"The government is waging an aggressive, intemperate, unjustified war on pain doctors."

"By demonizing physicians as drug dealers and exaggerating the health risk of pain management, the federal government has made physicians scapegoats for the failed drug war. Even worse, the Drug Enforcement Administration's renewed war on pain doctors has frightened many physicians out of pain management altogether, exacerbating an already serious health crisis - the widespread undertreatment of intractable pain."

"Experts agree that tens of millions of Americans suffer from undertreated or untreated pain ... According to one 1999 survey, just one in four pain patients received treatment adequate to alleviate suffering."

"The medical evidence overwhelmingly indicates that when administered properly, opioid therapy rarely, if ever, results in 'accidental addiction' or opioid abuse."

"Pain specialists make an important distinction between patients who depend on opiates to function normally - to get out of bed, tend to household chores, and hold down jobs - and

addicts who take drugs for euphoria, and whose lifestyles deteriorate as a result of taking opiates, instead of improving. The DEA makes no such distinction."

"The relationship between a doctor and his patient is crucial to the proper assessment and treatment of the patient's condition. The DEA's aggressive investigative procedure poisons the doctor-patient relationship from both sides."

"The DEA continues to lower its evidentiary standards, making it nearly impossible for many doctors to determine what is and isnít permitted."

"Large quantities of narcotics routinely go missing en route from manufacturers to wholesalers and from wholesalers to retailers. The DEA itself acknowledges this problem. Given the poor job the DEA is doing of monitoring the narcotics it's charged with overseeing ... DEA's attempt to blame physicians for the drugs' street availability seems arbitrary, unjustified, and capricious."

Common Sense for Drug Policy,

H. Michael Gray, Chair; Robert E. Field, Co-Chair

* "Treating Doctors as Drug Dealers: The DEA's War on Prescription Painkillers" by Professor Ronald T. Libby, June 16, 2005.

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