Drug Control in the United States - How’s it Working Now?
By Rick Redalen, M.D.
Does anyone ever wonder how our government thinks when it comes to controlling medications? Sorry, that is kind of an oxymoron. Our government thinking?
For years in my early practice of medicine the very best medications we had for weight loss were the amphetamines.
Historically amphetamines, speed, or bennies (a few of the street names used), were prescribed for our armed services members, our bomber and fighter pilots and for many jobs requiring a higher level of alertness and avoidance of fatigue.
Suddenly in 1971 amphetamines were put on a schedule II controlled substances list. Someone, in spite of wide spread use for many years, decided that these substances could be abused.
Multiple countries decided this would be a good ban and medications of this class should be controlled. Of course we all know how that worked out. Now the average kid without a chemistry background can produce “METH” in their kitchen lab. Meth is short for methamphetamine, just one more related stimulant that makes people feel good. As one of my professor friends said at the University of Minnesota one time, “Since when should it be against the law to feel good?”
Well, now we live in one of the fattest countries in the world with obesity now being considered as the largest contributor to premature death in the United States. I guess just recently Mexico took the title away from us, but I think we can win it back if the properly endowed people head north.
So if obesity is one of the greatest killers, why do we outlaw one of the most successful medications ever to hit society to control the problem?
If it is good enough for our fighter pilots and astronauts, isn’t it good enough for us?
Prescriptions and the Law
By Rick Redalen, M.D.
Have you ever wondered why you go into your physician with a pain syndrome of any kind and suddenly they become the long arm of the law?
No sir, or no mam, we can’t give you any pain meds for your broken ankle. You will have to go to a pain clinic for that. But it’s Friday night and we can give you enough pain meds to last until Saturday night and then you can come back on Sunday morning and we can see if you are still in pain. Oh, by the way we are not open on Sunday so just go to your local emergency room and they can make that determination.
How on Earth did we ever get to this point? We now have a cadre of physicians that cannot make even the most basic determinations when it comes to prescribing a medication labeled as a controlled substance by our federal government.
The following excerpts were written by C.E. Terry in The American Journal of Public Health. I cannot find the date but assume it is 1914, the year the Harrison Narcotic Act was passed. Here is part of the reason for some of our troubles today. I am going to paraphrase some of this material from an obviously somewhat hysterical author.
Mr. Terry explains, “It is daily becoming better known that opium, its derivatives and cocaine are being used at alarming rates all over this country.” My following sarcasm is intended. I personally am certainly glad that has changed in modern day.
According to Mr. Terry the main culprit causing this problem seems to be the physician. He feels that the physician has been exempted too much in the Harrison “Anti-Narcotic” Act which went into effect March 1, 1914.
According to Mr. Terry, it has been shown repeatedly that the physician is the single greatest factor in drug addict formation. The physician is worse than the patent medicine man, worse than the criminal druggist, worse than dissipation and vice, whatever that means.
Perhaps it was this type of hysteria that led to the federal government getting involved in the practice of medicine. I am not sure that is entirely the cause. If a physician can blame the government for giving a five day supply of a controlled substance for a chronic condition, isn’t that much better than the physician saying I would like you to come back six times per month so I do not come under scrutiny by the “Federal Drug Marshals.” So please blame them for your six office calls. It is not my fault.
Next time you run into this problem, ask your physician how often he or she has been approached or reprimanded for their misuse of prescribing privileges for narcotics or controlled substances.
The most likely answer is never. The physician beyond question can say, “Yes officer, If someone has a chronic pain syndrome, I only prescribe thirty pills at a time but do it with thirty different office visits. I am beyond reproach. This way I also know if their problem ended on the 29th visit and they do not get an extra unnecessary day of medications.”
Of course I am being very facetious, but I am sure you get the point.