The big drug database in the sky: One firefighter’s year-long legal nightmare
arstechnica.com
arstechnica.com
It would be a huge understatement to claim that the US has a strange obsession with so called prescription narcotics. Sending doctors and patients alike to jail for supposed overuse or over-subscription.
Look, yes, there is a public interest case where someone is known to be selling or allowing others to be selling such medications onto the black market. But in many of these case (most?) that isn't really the case, or at least they have no evidence of that.
So, again, what exactly is it they're trying to accomplish? Why is the victim? Why do they care?
On a related note, I have a family member (in the US) who works in a clinic, the sole purpose of this clinic is to get people with chronic or in some cases even terminal conditions off of narcotic painkillers. These people provably are in pain, but the system in the US is such that they'll kick people off of painkillers who actually need them simply because of some kind of "narcotic painkillers are bad" circular logic which nobody can explain to me.
I'd really like someone to explain to me why the prescription of painkillers isn't a matter best left to patients and doctors in most cases where there is no suggestion of resale or other corruption. It just boggles my mind that the police are getting into people's personal treatment plans and calling their painkillers illegal.
Children, spouses, parents, family, and friends of people whose free will is compromised by their addiction to prescription drugs? It's a "victimless crime" only from a very narrow perspective of what constitutes social harm.
Addiction does not follow from treatment with narcotics. What you think of as harmful addiction follows from the junkie subculture created by criminalization
The harmful effects of drug addiction are in fact a result of severe criminalization of narcotics. If you suffer from debilitating pain, you will go out of your way to suppress it. If no one will sell you pain killers legally, you will get them illegally.
Indeed, if doctors could legally prescribe opiates for chronic pain sufferers, most of the illegal market would disappear. There would indeed be no crime. People in pain would get their medication for a few dollars and go on having normal lives. Calling these people addicts really is a way of ostracizing them, which only hurts people. True, they might be addicted to their medication. Their pain is now manageable too, really a fair trade off I think. Even more so when a daily dose costs just pennies.
Pills can make you feel good. You aren't supposed to just be able to feel good without doing some sort of "work" to "earn" it. So the pills are cheating. We'll give you a concession if your circumstances make you feel extra bad, but only until you reach the normal level of "feel-good" that should be afforded to you by your station in life.
The whole "war on drugs" exploits this involuntary tic in popular opinion.
http://www.huffingtonpost.com/2012/10/08/annika-eriksson-swe...
I'm very much a libertarian kind of guy and part of me wants to say "well so, its their life, let them do what they want". But these deaths have serious societal repercussions: the removal of an otherwise productive body and the orphaning of children.
I don't like shades of gray, but this seems like the government overreacting to a problem. I don't think people should go to jail because of substance abuse, I do think that people in legitimate pain deserve to be relieved from that pain, but I also think the government has a legitimate role in regulating these drugs.
I've been working on this theory harm I tentatively call "moral environmentalism". It is actually very similar to anti-abortion or anti-homosexual stance: some people feel that certain behaviors taint the "moral environment", and this constitutes real harm to them personally. The mechanism of harm is usually, but not always, predicated on the existence of an enforcing deity. The idea is that if you don't work to stop harm (even self-harm of others) that you are somehow culpable.
A deity is not required, however: some claim the these morally 'dirty' actions will result in other wrong actions that do have victims. (it's usually a cover for a deity, though). You see this in the anti-drug (and anti-alcohol, historically) movement, with claims that legalized drugs will cause an orgiastic violent apocalypse.
The same is true if someone wants to be gay. They have the right to choose that lifestyle for themselves. I don't agree with abortion, however. Not because of some societal impact, but because it steals away the agency of another. I think people have every right to choose for themselves, but no right whatsoever to chose for another; including the unborn.
This really irks me. People do not wake up one day and go "oh gee, let's see, i'll be attracted to a different gender from now on!" It's this attitude that, unchecked, does things like killing Turing.
[abortion] steals away the agency of another
This is retarded too, i'm very sorry, but somebody has to say it. So this clump of cells that was created entirely by the actions of the parents suddenly has rights, but the host, whose body it is (and nobody else's, mind!), doesn't get to choose? Why this sudden flip? On day 1 this person (non-pregnant woman) has full agency according to you, then on day 2 once pregnant, she has magical incubator-only-no-agency restrictions?
I'm sorry, this has nothing to do with you being religious or not (as you rightly point out), but your views don't correspond with a place i would like to live in.
/sarc
I'm not even sure if you're disagreeing, sarc-tag or not :)
People with long term pain need an early referal to a pain management clinic. They need short term pain meds to allow them to do physiotherapist guided exercise.
Long term use of pain meds doesn't work for most people. This is not about some moral panic over heroin; it should be about the unsuitability of ineffective and risky medication.
When someone with long term pain takes opiate meds for that pain they start needing to increase the dose; this puts them at risk of harm from toxic doses.
Short term pain is different; use opiates for that.
Here's a programme with interviews with people at pain clinics. These people had active addictions to opiate pain meds; they were taking huge quantities of pain meds; but importantly they were not getting adaquate pain relief.
The common mechanism for dose increase with morphine and similar opioids that act on mu-opiod receptors is their upregulation of NMDA receptors. NMDA upregulation increases pain sensitivity. Wash, rinse, repeat - the patient is on the dose escalation escalator.
The opioid methadone is an NMDA antagonist (along with ketamine, memantine, and dextromethorphan, for example), making it much less likely to induce dose escalation when prescribed for otherwise intractable chronic pain.
Methadone has a bad reputation because of 1) its association with treatment of heroin addiction and 2) its pharmacokinetics. The latter means that its blood concentration increase (and decrease, on cessation of the drug) changes slowly (think a week or so). When it's prescribed, it takes awhile to titrate for effect. If the process is rushed, it's possible to get lethal levels following several days after dose increase. It's basically a PID controller problem with a long phase lag between control input and effect.
In a clinical setting that doesn't involve the difficulties of multiple drug abuse, it's a very useful medication for otherwise intractable chronic pain.
Long way of saying that the opiate dose escalation issue is complicated.
I'm sure it had nothing to do with his attorney filing an appeal, showing he was ready to fight a law that was far too lenient towards police access, which might get the law overturned and make other, easy convictions suddenly impossible to get.
The Third Party Doctrine needs to go.
I'm also curious if they caught the original perpetrator. Tampering with narcotics would be tough to pull off in our agency... To get access to the narcs you have to swipe a ProxCard and enter a pin to access a safe (logging a timestamp attached to your identify), which gets you to a locked metal box and a numbered seal (which is checked twice daily). Any tampering would be caught within ~12 hours, and would be easily traced back to the card and pin number of the person who accessed it.
As I understand it, generally:
If, in the course of executing a warrant, you find items that meet the description in the warrant but which provide evidence of a different crime than the one that motivated the warrant, you can seize them and use them for future prosecution.
If, in the course of executing a warrant, you discover items that are not what is described in the warrant but which would provide evidence of another crime, you generally, IIRC, cannot seize them, but your discovery of them during the execution of the warrant can support an affidavit for a new warrant identifying them.
But when you extract just the factual statements from the article there's a whole different picture. The police was investigating a pretty serious crime. One of their tools in this investigation was checking medical records of employees of the fire department to find irregularities that might point to someone with motive to steal opiates. Instead of finding a direct motive they found out a person was committing fraud with prescription drugs. The person was charged, but eventually the charges were dropped because they couldn't round out the evidence, the reason is unclear.
Did this person really commit prescription drug fraud? Did he make money off that? Is that the sort of crime that should throw a wrench in an adoption process?
I obviously don't know the guy, but it seems a bit weird to me to just disregard the idea that the authorities have hard evidence of him circumventing a law. Using the properties of that guy that make him seem like a stand-up guy just to make a larger point about privacy feels a bit disingenuous.
Further, these are medical records. You know, things that we all get HIPAA notices for every time we go to a doctor. I have to go through a pain in the ass process every time I want to get two of my own doctors to talk. Police could just bypass that, without any probable cause (Feds still can).
Phone record searches require probable cause. Financial and personal records require probable cause. Prescription records? Wide open to the police to comb through any time they like.
As a person who has had different controlled substances prescribed by three doctors this year, this is frightening as hell.
As for Mr. Pyle, "Firefighter Ryan Pyle had also been dealing with chronic back pain, and after a five-day stint in the hospital for an infected tooth, was also prescribed painkillers on several occasions. Police saw these prescriptions in the database and charged Pyle with one felony count."[1]
The assumption of guilty until proven innocent (and he must be guilty if the police were looking at him, right?) is revolting. The ability of police to peruse records at a whim and destroy people's lives is even more so.
1. http://www.kutv.com/news/features/local-news/stories/Utah-39...
Where does it say that? All I see is this:
Pyle had been prescribed short-acting and long-acting opiate-based painkillers for years after being diagnosed with an inoperable mid-back disc herniation from a dirt-bike accident.
If that counts as evidence of fraud sufficient for criminal charges to be filed, I think we have a problem.
On one hand, a nice guy has had his life upended during the most stressful phase of parenthood.
On the other hand, having a sympathetic defendant has paved the way for meaningful reform of third-party doctrine.
Whether or not you agree this should be a crime (see UnoriginalGuy's comments), current laws do make this a crime.
And it's hard to imagine how the doctors could be implicated in that crime--essentially, they are the ones being duped.
At a higher level, let's assume for a moment that 3rd party data should not be protected by the 4th amendment. That does not mean the database maintainer is obligated to hand over records to the authorities. It just means they can if they want to without violating a persons rights. The DB owner is certainly allowed to say "come back with a warrant" with will of course require probable cause.
It's not like third party records did not exist in 1791. The framers, being lawyers and businessmen, would have been intimately familiar with the concept of entrusting their person information to the documents of third parties. Had the framers intended "secure in their persons, houses, papers, and effects" to actually mean "secure in their persons, houses, papers, and effects [and their doctors' or accountants' or lawyers' concerning them]" they could have written the text that way. They didn't.
Also the idea that the framers could have seen anything like digital data collection is preposterous. Just because they had records doesn't mean they had any sort of access to the monitoring of your documents like we do today. The scale just want there.
There is an episode on true detective where one of the detectives goes through old case files. He has stacks of then and has to search them onelaw at a time. Compare that to a key word search or a elastic search.
Could the third party law apply to Dropbox or Google drive. Those are my documents, but stored by a third party. I sure hope warrants are needed for officers to go through my files on Google servers.
We need to look at the constitution with new eyes and re work it for a digital age.
Sorry for any Grammer issues I'm on my phone.
Re: Google docs. Third party doctrine definitely should apply. If a Google engineer doesn't need a warrant or your permission to dig through your files on Google's servers, they should be fair game for a subpoena compelling them to turn over those documents. No different than how subpoenas can compel accountants to disclosure financial documents pertaining to their clients.
Well, individual engineers working for Google can't access the files of customers, partly because of incidents in the past where Google employees abused this access. Does that alter how the law should treat them?
The law needs to reflect society's expectations because most people are not criminals by the default of having laws reflect what is normal in society. Break that, and you end up with people not caring about any laws ("in for a penny, in for a pound", and all that). In this case, the Third Party Doctrine fails miserably (but then, so do a lot of other laws).
A problem is that the Constitution has become the secular equivalent of a religious document as a result of the US culture wars, and is now referenced in dogmatic rather than pragmatic fashion. As a result, any politician that goes on the record in favor of a constitutional overhaul is denounced as a tools of shadowy political interests; thus the political fringe have become rabid defenders of the constitutional status quo by piling on to frustrate any efforts at reform.
-- Ninth Amendment to the Constitution
In keeping with that intent, the phrase "their papers and effects" is not precisely defined. I think it's up to us to hash out the appropriate meaning for our day and age. Pace Rayiner, I don't think it's at all unreasonable to imagine that that phrase was not necessarily intended to encompass only papers and effects that happen to be within one's house.
I agree. It isn't outdated, it's just wrong - and it's been wrong all along.
> they could have written the text that way. They didn't.
Most likely because it seemed self-evident to them. Keep in mind, the Framers, as brilliant as they were, were hardly perfect, and their language has been ambiguous in more than one place. In fact, you could argue that the Constitution is riddled with holes and contradictions. Look at the language around the 2nd Amendment. Look at how their is an enumerated powers clause, but also a "necessary and reasonable" clause, and all the consternation that has caused. Heck, consider the 3/5's Compromise, which does not exactly show the Founders in terribly good light.