No good deed goes unpunished when a private citizen is up against the federal drug warriors--those members of the Department of Justice who have been seeking, with increasing success in recent decades, to effectively control the practice of pain relief medicine. But a current drama being played out in federal court in Kansas portends an even darker turn in the DOJ's war--a private citizen is being threatened with prosecution for seeking to raise public and news media consciousness of the Feds' war against doctors and patients.
The current contretemps in Wichita has its roots in 2002 when Sean Greenwood, who for more than a decade suffered from a rare but debilitating connective tissue disorder, finally found a remedy. William Hurwitz, a Virginia doctor, prescribed the high doses of pain relief medicine necessary for Greenwood to be able to function day-to-day.
Yet when federal agents raided Hurwitz's clinic in 2003 and charged the pain management specialist with illegal drug trafficking, Greenwood's short-lived return to normalcy ended. He couldn't find another doctor willing to treat his pain--the chances were too good that the "narcs" and the federal prosecutors who work with them would assert impossibly vague federal criminal drug laws. Three years later, Greenwood died from a brain hemorrhage, likely brought on by the blood pressure build-up from years of untreated pain.
Greenwood's wife, Siobhan Reynolds, decided to fight back. In 2003 she founded the Pain Relief Network (PRN), a group of activists, doctors and patients who oppose the federal government's tyranny over pain relief specialists.
Now, the PRN's campaign to raise public awareness of pain-doctor prosecutions has made Reynolds herself the target of drug warriors. Prosecutors in Wichita have asked a federal grand jury to decide whether Reynolds engaged in "obstruction of justice" for her role in seeking to create public awareness, and to otherwise assist the defense, in an ongoing prosecution of Kansas pain relief providers. The feds' message is clear: In the pursuit of pain doctors, private citizen-activists--not just physicians--will be targeted.
For Reynolds, the script of the Kansas prosecution has become all too familiar: The feds announced a 34-count indictment at a December 2007 press conference. Local media dutifully reported the charges with minimal scrutiny and the accused--Dr. Stephen Schneider and his wife, Linda, a nurse--were convicted in the court of public opinion before their trial even began.
In such an atmosphere, it is very difficult to make the point that physicians engaged in the good faith practice of medicine are being second-guessed--not by fellow physicians, but by the federal government--and punished under the criminal law for administering what the Drug Enforcement Agency (DEA) of the Department of Justice considers more narcotics than is necessary to alleviate a patient's pain.
When pain doctors administer too much of a controlled substance, or do so knowing that they will be diverted to narcotic addicts, they are deemed no longer engaged in the legitimate practice of medicine. But the dividing line is far from clear and not subject to universal agreement even within the profession. Any patient in need of relief can, over time, develop a chemical dependence on a lawful drug--much like a diabetic becomes dependent on insulin. And, once a treatment regimen begins, many patients' tolerance to the drug increases. Thus, to produce the same analgesic effect, doctors sometimes need to increase the prescribed amount, and that amount varies from person to person.
It is notoriously difficult even for trained physicians to distinguish an addict's abuse from a patient's dependence. Nonetheless, federal narcotics officers have increasingly terrorized physicians, wielding the criminal law and harsh prison terms to punish perceived violators. Since 2003, over 400 doctors have been criminally prosecuted by the federal government, according to the DEA. One result is that chronic pain patients in this country are routinely under-medicated.
The litany of abusive prosecutorial tactics could fill a volume. A "win-at-all-costs" mentality dominates federal prosecutors and drug agents involved in these cases. After a Miami Beach doctor was acquitted of 141 counts of illegally prescribing pain medication in March 2009, federal district court Judge Alan Gold rebuked the prosecution for introducing government informants--former patients of the doctor who were cooperating to avoid their own prosecution--as impartial witnesses at trial.
Improprieties galore marked the prosecution of Dr. Hurwitz. Before his trial in federal court in Virginia in 2004, the DEA published a "Frequently Asked Questions" (FAQ) pamphlet for prescription pain medications. In a remarkable admission, the DEA wrote that confusion over dependence and addiction "can lead to inappropriate targeting of practitioners and patients for investigation and prosecution." Yet on the eve trial, the DEA, realizing that Hurwitz could rely on this government-published pamphlet to defend his treatment methods, withdrew the FAQ from its Web site. Winning the case proved more important than facilitating sound medical practice. Hurwitz was convicted.
In Kansas, it appears that zealous prosecutors are targeting not only the doctors, but also their public advocates. When Reynolds wrote op-eds in local newspapers and granted interviews to other media outlets, Assistant U.S. Attorney Tanya Treadway attempted to impose a gag order on her public advocacy. The district judge correctly denied this extraordinary request.
Undeterred, Treadway filed on March 27 a subpoena demanding a broad range of documents and records, obviously hoping to deter the peripatetic pain relief advocate, or even target her for a criminal trial of her own. Just what was Reynolds' suspected criminal activity?
"Obstruction of justice" is the subpoena's listed offense being investigated, but some of the requested records could, in no possible way, prove such a crime. The prosecutor has demanded copies of an ominous-sounding "movie," which, in reality, is a PRN-produced documentary showing the plight of pain physicians. Also requested were records relating to a billboard Reynolds paid to have erected over a busy Wichita highway. It read: "Dr. Schneider never killed anyone." Suddenly, a rather ordinary exercise in free speech and political activism became evidence of an obstruction of justice.
On Sept. 3, a federal judge will decide whether to enforce this subpoena, which Reynolds' lawyers have sought to invalidate on free speech and other grounds. The citizen's liberty to loudly and publicly oppose the drug warriors' long-running reign of terror on the medical profession and its patients should not be in question. Rather, the question should be how the federal government has managed to accumulate the power to punish doctors who, in good faith, are attempting to alleviate excruciating pain in their patients.
