Political strategies in the war against pain patients

In trying to help pain patients understand that the war against them is not because of drug addicts, doctor-shoppers, or any other group of patients, I’ve used the drug war so we can see the bigger picture.

Just like you can compare the issues in our history of alcohol prohibition to the federal government’s refusal to legalize cannabis, it is interesting to see how the political strategies for the overall drug war have been adapted to the war against pain patients.


In the book, Smoke and Mirrors: The War on Drugs and the Politics of Failure (we urge you to read it if you have not already done so), author Dan Baum explains:

The [Nixon] White House lived by the principles of the southern strategy, and Dent’s office had its own lingo. There were issues that mattered to “our” people, and those that mattered to “their” people. “Their” people were what the White House called “the young, the poor, and the black.” The phrase rolled off the tongue like one word: theyoungthepoorandtheblack. The young were the longhaired student antiwar types for whom the president had open and legendary contempt; the poor and the black were leftover concerns from the Great Society.

Brownell daily read a dozen newspapers from around the country and clipped stories that played on those themes. He looked for stories about badly managed social programs, watched for currents of localized resentment, combed the columns for colorful quotes and juicy anecdotes the presidential speechwriters might use. He particularly kept an eye out for drug stories. Drugs were one thing the young, the poor, and the black all seemed to have in common.

In the old days, marijuana was cheap and used by poor people because of that, but you can’t say that today.  Of course, the amount of disposable income available for luxuries like health care have decreased a lot since the old days.  And if you think that illegal drugs are not part of health care, then you must also think that legal drugs aren’t part of health care.

And I’m not only talking about legal drugs that require a prescription, but also legal drugs like caffeine, sugar, and nicotine.  What, did you think you weren’t self-medicating with every cup of coffee or energy drink?  Do you think you should have to pay a doctor for access to that drug? Should that drug be illegal?  Should caffeine and nicotine be included in the DEA’s drug scheduling list?

Despite Nixon’s assertion to the Disneyland crowd that drugs were “decimating a generation of Americans,” drugs were so tiny a public health problem that they were statistically insignificant: far more Americans choked to death on food or died falling down stairs as died from illegal drugs.

So Brownell was delighted that the media were inflating the story by melding the tiny “hard drug” heroin threat with the widespread “soft drug” marijuana craze. Marijuana, Brownell knew, was a perfect focus for the anger against the antiwar counterculture that Nixon shared with “his people.” Brownell dug out a-recent clip from Newsweek: “Whether picketing on campus or parading barefoot in hippie regalia, the younger generation seems to be telling [the middle-class American] that his way of life is corrupt, his goals worthless and his treasured institutions doomed. Logically enough, a good many middle-class citizens tend to resent the message.” In an article Brownell might have penned himself, Newsweek identified the targets of that middle-class resentment this way: “The incendiary black militant and the welfare mother, the hedonistic hippie and the campus revolutionary.” The young, the poor, and the black. Nixon couldn’t make it illegal to be young, poor, or black, but he could crack down hard on the illegal drug identified with the counterculture.

The federal government cannot make it illegal to suffer from chronic pain, but it can crack down hard on the drug treatments identified with chronic pain.  Working- and Middle-class resentment against those on welfare or disability is nothing new, but now a lot more middle-class people have moved into the working-class and are part of the poor.  So don’t be fooled that these loud voices of resentment contain as large of a group as they did in the old days.

Just like in the overall drug war, the war against pain patients is also about the grief of parents who have lost children to drug addiction and their resentment against the drugs involved, which they blame.  And now those drugs include opioids, many times being blamed as a “gateway” drug to heroin.  Some people still think cannabis is a “gateway” drug to stronger drugs like heroin, but I think the research says differently.  (Besides which, the gateway drug theory isn’t even a theory anymore — it’s more like a joke.)

John Erlichman (of Watergate fame) eventually admitted that the drug war had been dreamed up by Nixon and his team because it was too good not to do so:

Anybody who thinks this is the wrong fight for the NAACP should take a peek at this note from the diary of H.R. Haldeman, President Nixon’s chief of staff, referring to the launch of the war on drugs 40 years ago.

“[President Nixon] emphasized that you have to face the fact that the whole problem is really the blacks,” Haldeman wrote. “The key is to devise a system that recognizes this while not appearing to.”

For the war against pain patients, the system includes the PDMPs, patient contracts, drug testing, pill counts, and the blurring of definitions for dependency, abuse and addiction.  When you criminalize a drug, you criminalize the people who use it.  When you criminalize a medical condition like addiction, you also criminalize the people who might potentially suffer from it. And then a pain patient is automatically guilty (of abuse or addiction) and has to continually prove their innocence (through drug tests, pill counts, checking the blacklist, etc.).

That system turned out to be the War on Drugs, with marijuana being put in the same category as such drugs as heroin and morphine. Nixon’s White House counsel, John Ehrlichman, verified the intention of the War on Drugs in a 1995 interview with author Dan Baum, author of Smoke and Mirrors: The war on drugs and the politics of failure.

For the war against pain patients, illegal heroin is put in the same category as prescription medications.  Meaning, people who use opioids are as “bad” as the people who use heroin.

“Look, we understood we couldn’t make it illegal to be young or poor or black in the United States, but we could criminalize their common pleasure,” Ehrlichman confessed. “We understood that drugs were not the health problem we were making them out to be, but it was such a perfect issue for the Nixon White House that we couldn’t resist it.”
(From, Joining the fight: Not your grandfather’s NAACP, by Larry Gabriel.)

The war on drugs has been a sham since day one. That alone is reason to end it.

Because the war on drugs is a sham (and a failure), then the war against pain patients is also a sham (and will also be a failure).  But it’s taken over 40 years for the drug war to start winding down. How long do you think it will take for the war against pain patients to turn around?

Back in the old days, when the drug war first started, there were a lot of political motivations behind it.  It’s not hard to see the political motivations behind the war against pain patients, but it is hard to count them all.  Since the Great Recession (I don’t know what else to call it), there are now less rich people at the top pulling the political strings. Unfortunately, the amount of money involved only increases as time goes by, even though it’s held by fewer people. Regardless, one of the “people” with the most money will always be the federal government. And the federal government spends a significant portion of its money on the drug war — really, on any and all wars.

Hey, don’t we fund the federal government?  Aren’t we some of the investors in this corporation? Trouble is, we’re only small investors — corporations are really the “people” with all the money. How do pain patients fight corporations?

A strategy for pain patients would be to connect with advocacy groups that have more political clout, like the environmental or gay rights movements.  (I’ve personally tried to find interest in the issues of pain patients from marijuana advocacy groups, but received no response.)  But first, we would have to make up a big enough group for other groups to take us seriously. And I guess we would also need funding — good luck with that.

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