If You Need Pain Pills, Politicians Want To Monitor Your Body Chemistry

Our political leaders envision a future in which high-tech implants snitch about our use of painkillers.

J.D. Tuccille | 9.4.2023 7:00 AM1/2

What if your medical conditions could be monitored from a distance to assess your health and adjust treatment plans based on real-time information?What if the same technology could be used to track your use of medications, such as opioids, to make sure you're not using them in frequencies and dosages frowned upon by bureaucrats who've never met you?You might already have guessed that it's that second implementation of the technology that interests politicians, who want to remotely monitor our body chemistry to stop us from getting high.

Big Brother Will See You Now

"Not later than 18 months after the date of enactment of this Act, the

Comptroller General of the United States shall conduct a study and submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions and the Committee on Finance of the Senate a report on the use of remote monitoring with respect to individuals who are prescribed opioids," reads a small section inserted into the Support for Patients and Communities Reauthorization Act,which has 63 cosponsors in the House of Representatives. The program includes "identification of cohorts of individuals who stand to benefit the most from remote monitoring when prescribed opioids."

What a future our political leaders envision, in which high-tech snitches tell unblinking overlords about our use of painkillers—or any other health data they desire. "A government‐sanctioned study like the proposed one by GAO will no doubt show that, given current or projected technologies, it is possible to remotely monitor how patients use opioids through their physiological responses," warn the Cato Institute's Jeffrey A. Singer, a senior fellow and general surgeon, and Patrick G. Eddington, a senior fellow in homeland security and civil liberties. "With such data in hand, misinformed anti‐opioid crusaders in Congress will then take the next 'logical' step — legislation requiring all patients prescribed opioids for any reason to be remotely monitored (another example of 'cops practicing medicine.')"

"This will intimidate health care practitioners into further curtailing opioid prescribing to their patients in pain," they add. "This simply exacerbates the misery that state and federal opioid prescribing policies have already inflicted on them that is driving many to suicide and some to homicide."

That pain is undertreated is beyond question. Last year, the Centers for Disease Control and Prevention (CDC) acknowledged that opioid guidelines have been inflexibly interpreted. The CDC emphasized that "some policies purportedly drawn from the 2016 CDC Opioid Prescribing Guideline have been notably inconsistent with it and have gone well beyond its clinical recommendations" resulting in "untreated and undertreated pain."

Physicians are leery of prescribing opioids for fear the DEA will target them and deprive them of their livelihoods and their freedom. Patients fear being labeled as drug-seekers and cut off from medication that lets them function. Remote real-time monitoring of body chemistry won't calm anybody's concerns about being second-guessed by bureaucrats. Resentment of and resistance to such intrusive surveillance is guaranteed given that diabetics have already told researchers that such monitoring is unwelcome.

Diabetics Don't Like Big Brother Either

"For people who equate remote digital monitoring with loss of autonomy over their diabetes management, digital health represents a step away from patient-centered care," Theodora Oikonomidi of the University of Paris and the Doctoral Network of the French School of Public Health wrote in 2021 about the results of a large international survey regarding diabetes monitoring. The more than 1,000 people surveyed didn't object to every sort of remote monitoring, but 40 percent of the monitoring scenarios that were presented were rated as "very or extremely intrusive." Respondents especially objected to food monitoring, real-time feedback from a physician, and private-sector data handling.

https://reason.com/2023/09/04/if-you-need-pain-pills-politicians-want-to-monitor-your-body-chemistry/

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"Participants worried that giving their physician access to fine-grain data about their diabetes could lead to judgment and criticism by their physician if the captured data revealed 'poor' diabetes 'control' and nutrition habits," Oikonomidi wrote. "Participants wanted more control over monitoring settings, such as limiting which data they share with their physician."

If diabetes patients don't like feeling judged about meal choices and blood chemistry, imagine how pain patients will feel about constant surveillance of their fentanyl intake.

Nobody likes being put under a microscope over the decisions they make for their own lives, and with pain patients the unseen officials peering through the microscope could impose coercive consequences affecting their health and liberty.

To their credit, the authors of the survey conclude that "shared decision-making could help patients identify the [remote digital monitoring] that best aligns with their values and lifestyle." They recognize that the potential benefits of such monitoring can be best realized if patients aren't pushed beyond their comfort levels. And there is real potential here.

As Cato's Singer and Eddington point out, "technologies to remotely monitor blood pressure, EKGs, oxygenation, and more are either already available or soon will be. Private technology companies, funded by venture capital, continue to develop these devices, responding to the growing market for telehealth services."

Cops Practicing Medicine Taint Both Cops and Medicine

But that's not what politicians have in mindwhen they contemplate remote government monitoring of patients prescribed opioids to treat their pain."The wording of the study language is too broad,"point out Singer and Eddington. "It doesn't talk about remote monitoring for treating opioid use disorder or dependency, but just remote monitoring of patients on opioids." The implication is that every pain prescription will come with a requirement akin to the world's nosiest ankle bracelet, tracking not just location but medication use, with every popped pill second-guessed by a drug warrior at the other end of a telemetry chain.

Drug warriors threaten not just privacy, bodily autonomy, and doctor-patient relationships with such intrusive schemes; they also threaten the further development of promising medical technology. With diabetics already skittish about remote data monitoring and drug warriors potentially turning such monitoring into explicit surveillance of the most private areas of our lives, the whole field may become tainted as a manifestation of Big Brother in a lab coat. Cops practicing medicine can fuel resentment of not just cops, but also of medicine.

People need pain medication. And if some people use the same or similar medications for recreational purposes, or flat-out abuse such drugs to the detriment of their health, that's just part of life and probably unavoidable.As the CDC acknowledges, we have a problem with the undertreatment of pain. It's not worth exacerbating that problem, or turning the country into a medical surveillance state, in the vain hope that somehow the government will stop people from getting high.

https://reason.com/2023/09/04/if-you-need-pain-pills-politicians-want-to-monitor-your-body-chemistry/

(old article, but it shows a pattern for courts and police)

Jail Officials Refused To Give Him His Heart Transplant Medication. Days Later, He Was Dead.

A lawyer for the family speculates that jail officials balked at the medication's high price.

Emma Camp | 5.25.2023 3:55 PM

Dexter Barry was arrested last November following a dispute with a neighbor. Five days later, he was dead, after jail officials refused to give him necessary medication for his heart transplant.

According to The Tributary, a news outlet based in Jacksonville, Florida, Barry was arrested on November 18, after a neighbor reported him to the police for allegedly threatening to "beat him up" following an extended dispute over Wi-Fi. While the two never physically fought, Barry was nonetheless arrested on a simple assault charge.

During his time in police custody, Barry—who had received a heart transplant in October 2020—frequently insisted that he needed to take specific daily medications to prevent his body from rejecting his new heart. According to body camera footage of the incident, Barry told one police officer at least seven times that he needed this medication to survive.

When Barry appeared in court the morning after his arrest, court transcripts show that he once again requested access to his anti-rejection medication.

"I am on medication," Barry told Judge Gilbert Feltel. "I just had a heart transplant, and I haven't taken my medicine all day since I have been locked up, and I take rejection medicines for my heart so my heart won't reject it, and I'm almost two years out…. And the medicine that I am taking, it's like 30-day prescription that's like $2,400."

"OK. Here's what I will do, Mr. Dexter," replied Feltel. "I am going to simply set a bond in your case of 503 and add the additional condition of no violent victim contact." While Barry was released on November 20, his son and a lawyer for the family say that Barry never received his medication while in jail. By the time he was released, he had missed at least five doses.

Despite resuming his medication, Barry's health declined over the next few days, and he died on November 23, just three days after being released. A pathologist hired by Barry's family reported that his cause of death was his body's rejection of his heart transplant.

Andrew Bonderud, the family's lawyer, speculated that jail officials didn't obtain Barry's medication due to its cost. "Records from jail will likely show they made a note of it," Bonderud told The Tributary. "[The Jacksonville Sheriff's Office (JSO)] recognized it's an extremely expensive medication and how disgusting if it turns out that this was a business decision for the JSO, that they would rather not pay for the medication. They would rather risk death over a business decision. It's one of the most outrageous cases I've ever seen in this city of JSO misconduct."

While the pathologist declined to blame Barry's death solely on jail officials' refusal to obtain his necessary medication, it's clear that JSO officers were, at best, reckless with Barry's health—and at worst, contributed to his avoidable death.

"The police officer could've gone inside and got his medication," Barry's son told The Tributary. "This man is telling you, my heart needs those meds. A two-minute walk would've saved his life."

https://reason.com/2023/05/25/jail-officials-refused-to-give-him-his-heart-transplant-medication-days-later-he-was-dead/