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March 1, 2006 - Des Moines Register (IA)

Pain Patient: My Drugs Are My Business

By Tony Leys, Staff Writer

Return to Drug War News: Don't Miss Archive

John Grim is tired of staying quiet about his pain and the medicine he takes to control it. He's fed up with the stigma surrounding the thousands of patients like him who use narcotics for legitimate reasons. And he's outraged that state regulators want to set up a computer database that would track every prescription he fills.

"I'm worried about scrutiny from people who have no business snooping into my medical issues," he says.

Grim is sitting at a cafe table near his home in Des Moines. He leans forward onto his forearms, grimacing as he shifts weight off his ruined back. "Do I look like a junkie to you?" he asks.

He looks like a typical Iowan. He is 47, and he used to be a corrections officer in the state prison system. He was placed on disability after rupturing a disc in his back while restraining an inmate nine years ago. He's undergone nine surgeries, and he expects more. He clutches a gray, plastic remote control for an electronic implant that helps block pain signals from traveling up his spinal cord.

Every four hours, he takes narcotic pain relievers. He is not an addict, he says. He gets no high off the pills. "I'm physically dependent on them - just like a diabetic is physically dependent on insulin."

Grim says he takes no pleasure in talking about these things publicly, but someone has to step out of the shadows and show how normal a pain patient can be.

He has been following closely a proposal to have the Iowa Board of Pharmacy Examiners set up a computerized system, which would automatically track every order pharmacists fill for addictive medications.

The idea was approved last spring by the Iowa House, but it bogged down in the Senate amid privacy concerns raised by doctors' groups. Now the proposal is back before legislators after supporters altered it to address some of the complaints.

Under the revised plan, government officials could not perform random searches for patients who were buying unusually large amounts of drugs. Officials could look at the registry only if they could show "probable cause" to suspect that a specific person was doing something wrong.

Supporters of the computer system say it mainly would be used by doctors and pharmacists, who could check it to see whether patients were duping multiple physicians into prescribing the same drugs.

Grim is not mollified by the changes in the proposal. "I have no faith," he says. "There's no way they can convince me that law enforcement isn't going to find a way to peruse these records."

His main concern is that the system would make doctors wary of prescribing narcotics, because they would fear being targeted by regulators and police.

He recalls how his first surgeon refused to give him anything stronger than Tylenol 3 . "All he would do is pat me on the shoulder and say, 'God bless you. I'm sorry I can't carry your cross for you.' "

Grim agrees with registry supporters who say some drug addicts "doctor shop" to obtain excessive amounts of narcotics. But he doubts the problem is widespread, and he says if addicts couldn't get a fix that way, they would find another source. Meanwhile, he says, the registry could make life harder for law-abiding people like him.

He likens the proposed system to a computerized registry that would track how Iowans spend their money. Such a system could spot people who make foolish, unaffordable purchases, he says. But why would that be the government's business?

"Who are they going to pick on next, that's what I want to know."

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