Effective Drug Control: Toward A New Legal Framework

many to stay away from the practice of pain management altogether, making it difficult
for patients with severe pain to get the relief they need.
Doctors treating chronic pain are desperate for official guidance so that they may
responsibly treat their patients with as much medication as needed without the fear of
arrest. The Drug Enforcement Administration issued pain management guidelines in
August 2004, prominently displayed on their website as “frequently asked questions.”
These guidelines were negotiated by the DEA and pain management specialists in order
to end the controversy over the arrests of hundreds of pain specialists who prescribe
powerful opiates. However, less than two months after the guidelines were published
they were removed from the DEA website, replaced by the explanation that the document
“contained misstatements” and “was not approved as an official statement of the agency.”
The move came after the legal defense team of Dr. William Hurwitz, a physician accused
of drug trafficking, sought to use the guidelines as evidence. 435
Increases in Drug-Related Harms
Drug prohibition has brought with it impurity of substances, imprecise dosages
and extreme modes of ingestion. 436 Without regulation, the substances are produced by
people who are trying to turn a profit and are often “cut” with other drugs or substances
in order to increase the amount of product. People who use the drugs also tend to use the
highest dosage possible because of the inflated price and the risk they took to get the
drug. A similar phenomenon occurred during alcohol prohibition in the 1920s, as “hard”
liquor was more popular to sell than beer because it could turn a higher profit due to
alcohol content-determined price, it could be hidden and transported easier and it could
be preserved indefinitely whereas beer spoiled easily. 437
With the prohibition on drugs also comes an increase in blood-borne illnesses
such as HIV and Hepatitis A, B and C as a result of needle sharing by drug users, a
problem that is exacerbated by the large numbers of prisoners with these diseases in
overcrowded facilities.