Adam Blatner

Book Review: Pain control and drug policy : a time for change, by Guy B. Faguet, M.D. Santa Barbara CA: Praeger / ABC-CLIO, LLC, 2010.
    This excellent book offers a careful, scholarly analysis on the war on drugs—taking a stance that challenges the hysteria associated with this policy. I especially resonated with something I encounter frequently now that I live with other elderly people in an active senior retirement community (i.e., Sun City Texas)—i.e., people complaining that the medicines they’re given to control pain don’t really help enough! This scares me! I confess my bias towards wanting adequate pain control if either I or a loved one becomes sick with a painful disease, and I don’t want my doctors to be afraid to give it to me in adequate doses.

There have been many challenges to the war on drugs since I gave a talk for my community’s lifelong learning program several years ago, now posted on my website, but the bone-headed policy continues. Some people are foolishly afraid of drugs—and so biased against medicines that can alleviate pain that they stifle good medical practice. This fear is pandered to by people who make a living off of that fear.

This book reviews the history of opiates, mainly. The author is not blind to the trouble caused by certain kinds of drugs that have no medical implications, such as the practice of smoking crystallized methamphetamine (aka, “ice,” “crystal,” etc.). Dr. Faguet does note the almost absurd permissiveness about alcohol and tobacco—the overprotective government doesn’t seem ready to take on big business and lobbyists, and local government still protects its own “good ol’ boy” networks.

The book has an excellent history of medicine review of the use of opiates, and a further history of the way several regions of the world have been politically corrupted by the prohibition of drugs. I want to add a mention of one of surgery’s greatest practitioners and innovators, William S. Halstead, who became stabilized on morphine at regular intervals. (There was a period of great instability when he also used cocaine before that.) He remained alert and did excellent, meticulous surgery. This is resonant with how some few people can live quite well on methadone. The problems of continued tolerance and escalation often do not happen.

In 2004 I gave a talk to our senior lifelong learning program and posted notes on my website. Let’s raise our voices, speak to our state and national representatives, shift consciousness about this waste of resources. We can’t afford it and the present policy not only is ineffective, but actually is harmful