The Agitator is essential reading, one of the best political blogs anywhere. Still, Radley Balko sometimes uncritically parrots libertarian tropes. Government Evil! Liberals Stupid!
For instance, today he posted this libertarian boilerplate:
Alternet publishes article calling for government monitoring of doctors and their pain patients, a crackdown on prescription painkillers, and generally expanding the drug war, all because . . . corporations are evil. And Florida’s governor loves the Tea Party. Or something.
So I followed the link, and the reason the Alternet writer, Kevin Gray, gave ad nauseum for wanting stronger government regulations of pain pills is to prevent accidental deaths. Not because corporations are evil (corporate power is mentioned once). Not because Florida’s governor loves the tea party (again, one mention). This is an article that is clearly and overwhelmingly about deaths caused by prescription drugs. Here, for example, is Gray’s first paragraph:
For the first time in nearly a century, automobile accidents are no longer the nation’s leading cause of accidental deaths, according to a major report released Tuesday by the National Center for Health Statistics. The new number one killer is drugs—not smack, crystal meth or any other stepped-on menace sold in urban alleyways or trailer parks, but bright, shiny pills prescribed by doctors, approved by the government, manufactured by pharmaceutical companies and sold to the consumer as “medicine.” Yet of the billions of legit pills Americans pop every year for medical conditions serious and otherwise, the vast majority of lives are claimed by only a select few classes—painkillers, sedatives and stimulants—that all share a common characteristic: they promote abuse, dependence and addiction.
Gray goes on that for paragraph after trite, overwritten paragraph (“pill mills and doctor shoppers are not just creating a land of bathroom-cabinet addicts—their bodies are packing morgues.”) Balko is either the least competent reader of English in the world, or he just flatly lied to his readers about what Gray’s article was about.
That said, I hated Gray’s article. For one thing, the factoid that he builds his article around — his claim that “The new number one killer is… pills prescribed by doctors” — is wrong. According to the CDC data brief Gray cites (pdf link), in 2008 there were over 41,000 deaths by poisoning, compared to 38,000 auto accident deaths. But “deaths by poisoning,” although mostly pill-related, includes some other deaths; the CDC says that in 2008 there were about 36,500 pill-related deaths, about 1,500 fewer than auto-related deaths.
That’s not a big deal – given the trendlines, pill deaths will soon overtake auto deaths, if they haven’t done so already – but it’s still annoying that Gray couldn’t be bothered to correctly understand the leading statistic in his article, which he wrongly hypes again and again.
What does bother me most about Gray’s article is that he never acknowledges that untreated pain is a serious problem in the United States and worldwide, even while he endorses policies that could make matters worse. For instance, the Florida “pill mill” law:
…mandates the creation of a statewide prescription drug monitoring program (PDMP), delineates narrow conditions to establish a pain management clinic, limits the amount of controlled substances physicians can prescribe, imposes harsh penalties on physicians who violate the law ($10,000 minimum fines, six-month suspensions) and restricts advertisement of pain treatment centers, among other measures.
Gray’s article favors this law, and certainly saving lives is important. But the life-saving aspects of restrictive laws (if they really save lives — I’d like to see some research on that) should be balanced against the loss of freedom involved when the government decides for me how much medicine my doctor can prescribe me; and it should be balanced against the truly incredible suffering caused when people can’t get pain medication they genuinely need.
But you’d never know that reading Gray’s article. Is he even aware that there are millions of people with chronic pain? Does he consider providing them with relief worth even a moment’s consideration? I assume so, but he doesn’t allow any such compassion to come through in his article. And that’s unfortunately typical of how this issue is discussed.
Couple of side notes:
First, I should acknowledge that libertarian writers are a zillion times better than progressive writers when it comes to pain management. If I could put our country’s pain management restrictions under either liberal or libertarian management, I’d opt for the libertarian in a heartbeat.
Of course, the same libertarian whose heart is broken if Lucy is suffering because badly-written laws keep Lucy’s chronic pain untreated, might not care if Lucy’s pain is untreated because Lucy is poor. So although I’d put a libertarian in charge of the restrictions, I’d put a liberal in charge of guaranteeing access.
Second, I’d really like to see those pain-pill-related deaths broken down by cause. Specifically, I want to know what percentage of pain-pill-related deaths are related to liver failure caused by acetaminophen in prescription opiates. Acetaminophen — which is not hard to accidentally take deadly amounts of, and is available without a prescription as Tylenol — should be banned from prescription opiates altogether. No one’s freedom is substantively reduced if they have to take a Tylenol with their prescription pain med rather than having the acetaminophen built-in, and it’s much safer for consumers to be aware of how much Tylenol they’re taking.
Third point: Off-topic, but I was amused by this paragraph of Gray’s article:
“This is just the tip of the iceberg of the prescription drug abuse problem,” says Dr. Margaret Warner, the federal report’s lead author. “The take-home here is, this should be a wake-up call.”
Dr. Warner reportedly went on to say, “if we keep our nose to the grindstone and take the bull by the horns, then when the dust settles there’ll be a light at the end of the tunnel.”