Have folks seen this?
The New Panic Over Prescription Painkillers
The article starts off listing reports of rising pain killer overdoses, then:
But at the same time, studies also consistently show that chronic pain is tragically undertreated in the U.S. (and around the world). Last June, an Institute of Medicine report called undertreated pain a "public health crisis" that affects 116 million Americans, and costs the economy around a half-trillion dollars per year in medical bills and lost productivity. The same month, three pain-related articles in the Lancet focusing on post-operative, cancer related, and non-cancer related pain, respectively, found mass undertreatment in all three areas. The journal ran an an accompanying editorial pointing to another study from Human Rights Watch showing that the problem is global, and more because of bad policy than because of a supply. In one recent study of 40 countries, 27 didn't consume enough opioid drugs to treat even 1 percent of patients with terminal cancer or HIV/AIDS. " Furthermore," the editorial added, "in 33 of 40 countries, governments had imposed strict restrictions on prescribing morphine, beyond the requirements of UN drug conventions to prevent misuse."
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But the reason so few painkillers are prescribed by pain specialists is likely that after a decade of policies targeting doctors with costly investigations and criminal charges, there simply aren't many conscientious pain specialists left. In his paper for Cato, Ron Libby includes multiple warnings from palliative care specialists that this was exactly what was happening. In 2003, for example, David Brushwood, who is both an attorney and a professor at the University of Florida College of Pharmacy, told the Decatur News that physicians once had a cordial relationship with drug cops--that if a doctor suspected a patient was diverting, he would cooperate with the police to turn in the patient. But for the DEA, doctors became high-profile targets, and thanks to asset forfeiture, lucrative targets as well. Since the DEA campaign, Brushwood said, the cops "watch as a small problem becomes a much larger problem . . . [then] they bring the SWAT team in with bulletproof vests and M16s . . . with charges [of] murder and manslaughter."
After a series of high-profile prosecutions of doctors, one pain specialist told the Wall Street Journal in 2004, "I will never treat pain patients again." Another told Time, "I tend to underprescribe instead of using stronger drugs that could really help my patients. I can't afford to lose my ability to support my family. The Village Voice reported in 2003 that medical schools had begun advising students, "not to choose pain management as a career because the field is too fraught with legal dangers."
Article is longish and I haven't read the whole thing.