In her fourth in a six-post series for Points, Siobhan Reynolds reviews the policies and judicial precedents that leave doctors unwilling to prescribe opioids to patients in pain. Reynolds focuses in particular on how federal control of the medical profession undermines the political structure of the United States and the opportunities for freedom and experimentation federalism provides.
In an earlier blog post I suggested that I would explain the reasons why physicians are loath to treat pain with opioids despite their noted efficacy; I’ve mentioned that medical professionals don’t like to admit that they are afraid to prescribe these medicines, preferring instead dole out far more dangerous non-controlled drugs on the grounds that opioids are “bad” in some special way having nothing to do with their actual utility or safety profile. In this post, I will examine how the profession developed such a seemingly irrational blind spot where opioids are concerned. This blind spot has its roots in the interpretation and enforcement of the Harrison Narcotics Tax Act of 1914 and the more recent Controlled Substances Act (initially passed in 1970).
Years ago, when I sat at my computer in my kitchen in New York City, wondering how in the world it was that doctors simply refused to effectively manage their patients’ pain, I researched the law myself.