Chronic Pain — 19 January 2013

bigstock-American-Drugs-4379874By Mark Maginn, Columnist

Recently New York City announced troubling new measures to fight the city’s growing opioid addiction and associated violence.

There is no doubt that opioid addiction rates have climbed in the last few years across the country and in New York. The addiction and associated deaths are a very real problem and city officials should be congratulated for addressing the problem.

Two measures aimed at fighting addiction are limiting the number of opioid painkillers a hospital can prescribe in emergency rooms and the NYPD calling on drug makers to use nanotechnology to track individual pills. Unfortunately, these measures are repressive.

The first policy change announced by Mayor Michael Bloomberg mandates hospitals to prescribe only a three day supply of opioids to discharged patients — enough for them to secure additional medicine through their own physicians.

Secondly, the NYPD is asking opioid manufacturers to investigate ways to use nanotechnology that can be placed in every pill so that law enforcement can track individual pills in ways similar to global positioning systems. The police brass stated that no one will be tracked except in case of suspected theft. How reassuring.

My general criticism of these measures is that they restrict much needed medicine for pain patients – a practice that is imbedded in the overall strategy of the failed War on Drugs Addicts already face a daunting medical problem that should not be exacerbated by the damage of the mindlessness of the perpetual War on Drugs.

A three day supply of opioids to hospital patients seems on the surface to be a wise choice, but on closer inspection it is fraught with difficulties.

The NYC public hospitals serve 1.3 million patients a year, with 475,000 of them uninsured.

Not all of these patients can see their physicians within three days, which will result in increased pain and the misery of withdrawal that could precipitate another emergency room visit.

Furthermore, many patients who have no insurance or who lack financial resources often rely on city hospitals for health care, including prescriptions to treat their chronic pain. Once again, we will witness the needs of the least powerful being trampled by the most powerful in their zeal to abolish addiction.

This initiative will either delay treatment for pain patients or make opioid treatment impossible for the poor.

While wealthier pain patients with health insurance will continue to have access to opioid medicines, those with limited income or no health insurance will be unable to afford pain relief.

One has to look at the wider consequences of reduced prescriptions for people with limited financial or community resources. Untreated patients may not be able to work, their relationships with their families and communities may suffer disruption, and those with untreated constant pain could be more likely to choose suicide over endless suffering.

Hydrocodonebtibu75200Tracking Pain Pills

The second measure, using nanotechnology to track opioid pills to enhance law enforcement efforts to stop diversion and theft, has wider consequences for our rights to privacy.

This measure requires us to look at the growing surveillance state burrowing ever deeper into our country.

Over the last generation, it has become nearly impossible to walk down any city street, go into any store or bank and not be watched by ubiquitous security cameras tracking our movements. These cameras, like all efforts to “protect” us from this or that crime wave, have been installed under the premise that the average citizen will be safer and only criminals will have to worry.

Additionally, after 9/11 and the slap dash passage of the Patriot Act, the National Security Agency (NSA) was given the authority to intercept phone calls and emails, significantly and worryingly intruding on the privacy of citizens. We now have a huge governmental apparatus spying on us.

Earlier this year, William Binney, a former official with the NSA, stated that domestic surveillance has increased under President Obama with trillions of emails and phone calls collected from us by our government. Binney stated that the NSA is building a 2 billion dollar storage facility in Utah to house all the information they have collected on us.

Along with data mining, collecting and collating our personal data to look for patterns of suspiciousness; cameras and domestic spying by both the government and private industry have gained public acceptance. These measures are a quiet, secretive assault on our civil liberties and do real harm to people with pain.

I see the placement of nanotechnology tracking in our legal medicines to be yet another step in limiting our freedom by repression and oppression of those merely seeking relief.

And now, the NYPD, infamous for its oppressive stop and search of minorities under the guise of fighting crime, is proposing yet another repressive measure, aimed at patients living with constant agony.

Tellingly, most governments know an opportunity when they see one. If you strip away the stated reasons for these measures and look at their consequences. While these measures might reduce theft to some degree, they once again afford the power grabbing authorities the cover to bring down the full force of the government on some of the least powerful people in our society.

Governmental repression is always sold to the people as a means to protect them from a perceived internal or external threat. In this instance, it’s opioid addiction.

The surveillance state has steadily encroached on us over the last generation, a period in which the consolidation of wealth by the plutocracy is dividing the nation into hothouses of anger and suspicion while legitimizing governmental efforts to spread control over ever larger sections of society.

These repressive measures need to be opposed not only by people with pain but the larger body politic. Once again, we need to eject the government from our relationships with our caregivers.

Mark-MaginnMark Maginn lives in the east bay of San Francisco where he is a poet, writer and social justice activist. Mark suffers from chronic pain and was a longtime volunteer with the American Pain Foundation. His blog can be found here

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About Author

Mark Maginn, Columnist

Mark is a poet, writer and social justice activist. Mark suffers from chronic pain and was a longtime volunteer with the American Pain Foundation.

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