Pumped Up in Florida

If you wish to be sarcastic, you could say Richard Paey is “pumped up”—not voluntarily and certainly not painlessly. He’s […]

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If you wish to be sarcastic, you could say Richard Paey is “pumped up”—not voluntarily and certainly not painlessly. He’s the “Prisoner to Pain” depicted on a January telecast by correspondent Morley Safer on CBS’ 60 Minutes. Justly or unjustly, Paey’s plight touches all of us who are disabled and have consistent, perhaps chronic pain.

The horror for this lawyer and 47-year-old father of three began in 1985 in a car crash near Philadelphia. A failed operation left him with metal screws in his spine and unrelenting pain. Later, he was diagnosed with Multiple Sclerosis. Paey says doctors could prescribe painkillers, which worked only briefly. “I developed a tolerance,” he says, “so I needed larger doses to relieve the pain—to be a father, a husband, [in] the community.”

To wit: Paey, in a wheelchair, has a spinal cord injury and is confined to maximum security Tomoka Hills Prison near Daytona Beach for alleged drug trafficking. Siobhan Reynolds, executive director of the Pain Relief Network in New York, which is working with the Paey family for Richard’s release, told Access Press: “He was transferred several months ago from a hospital-type situation at Zephyr Falls to a facility closer to his home.”

The November Coalition (TNC) activist group contends Paey suffers “intractable pain [from] Multiple Sclerosis and failed spine surgery. He is serving 25 years for `illegal prescriptions.’ According to the prosecutor, the prescriptions were illegal because they were written or issued six weeks after Richard’s last medical exam. It was still drug trafficking, the jury was told.” TNC charges that Paey was “moved in shackles to another Florida prison without proper medical care.” Reynolds says the current facility has “no wheelchair access.”

Paey isn’t alone. ScienceDaily reported neuropathic pain generally responds poorly to standard treatment and worsens, causing permanent disability in some people. The National Institute of Neurological Disorders and Stroke—under the National Institutes of Health—says acute pain is normally triggered in the nervous system to “alert you to possible injury. Chronic pain is different. Pain signals keep firing for weeks, months, years. Some people suffer chronic pain in the absence of past injury or evidence of body damage.”

Meanwhile, Minneapolis-based Medtronic Inc. plays a role as a maker of implantable biomedical devices—defibrillators and pacemakers. Among its subsidiaries, Medtronic Sofamor Danek makes spinal implant devices and Medtronic Neurological manufactures drug delivery systems. Medtronic states: “Many people suffer chronic pain because they’re unaware of treatment options. Others have fears which prevent them from talking about pain, which creates barriers to adequate relief. Chronic pain is a major public health issue that results in 40 million doctor visits, 515 million lost workdays, and $100 billion in medical expenses each year. [It] can lead to difficulty holding a job, low self-esteem, strained relationships, and depression.” Reynolds contends Medtronic doesn’t disclose its vested interest in selling expensive pain pumps.

On 60 Minutes’ Safer reported, “[U.S.] doctors tend to under-prescribe painkillers due to their addictive nature and fear of attracting authorities’ attention. Patients are often under suspicion when they try to alleviate unrelenting pain.” Without constant medication, Paey says he is in “excruciating pain that, over time, will literally drive you to suicide,” which he says he tried twice.

Paey’s physician wife, Linda, adds: “We were fearful of addiction. He was afraid to take too many pills.” When the Paeys moved to Florida, getting drugs was the problem. “I was in that medical nightmare zone where you’ve gone through all the treatments, and nothing works. What does work, no one wants to prescribe because it attracts attention.” Paey’s New Jersey doctor, Stephen Nur-kiewicz, agreed to mail and fax prescriptions, even left some prescriptions undated, Safer reported. Convinced Paey might have been re-selling drugs, local police watched him. After two months, “They had guns and ski masks and five or six people ran into the house and half of them took the kids and my mother-in-law; the other one grabbed me,” says Linda Paey. “Rich kept saying, ‘please, call my doctor.’ They said they had.”

To the Drug Enforcement Administration (DEA) component of the U.S. Dept. of Justice, Reynolds says Dr. Nurkiewicz admitted mailing Paey undated prescriptions and, when pharmacists called, verified prescriptions. Shown evidence Paey filled 200 prescriptions within two years for 18,000 pills; the doctor claimed all the prescriptions were forgeries. Dr. Nurkie-wicz wouldn’t talk to 60 Minutes, Access Press found his telephone number unlisted, and Reynolds claims he cut a deal with the DEA and “faces no criminal charges.”

Florida assistant state attorney Scott Andringa acknowledged to Safer that Dr. Nurkiewicz’s statements were “inconsistent and contradictory,” but said Paey took advantage of his doctor’s inattention to detail. “It’s a crime to forge prescriptions, and it’s a crime to use a forged prescription you stole to get drugs from a pharmacy, which is what he did,” Andringa says. Paey claims he never sold drugs. The Washington Post has reported: “An extensive effort to ease tensions between physicians who specialize in treating pain and the [DEA] over the use of morphine-based painkillers has backfired—leaving many pain doctors and patients more fearful than before that they could be arrested for practicing what they consider good medicine.”

Under Florida law, having one bottle of painkillers obtained illegally is considered drug trafficking, with a higher penalty than trafficking in much larger amounts of cocaine. Andringa’s office offered Paey a plea bargain: no jail time if he admitted the crimes. Paey says “I would have found it near impossible to get any medication. I didn’t want to plead guilty to something I didn’t do.” The jury convicted Paey of 15 counts of prescription forgery, unlawful possession of a controlled substance, and drug trafficking. The judge had no alternative but to sentence him to 25 years. Paey expected to win in court. When he was convicted, he and his wife were shattered by the verdict.

The Mayo Clinic contends chronic pain can develop for no apparent reason—“that doesn’t mean the pain doesn’t exist. [A] Doctor may not be able to link it to an identifiable physical cause. X-rays and lab tests can’t ‘see’ pain. Even subtle damage to nerves can cause severe pain. Years of research have failed to uncover the precise physical causes of a variety of painful ailments.” Dr. David Martin admits: “Some people don’t know what is causing their pain. Others know the source, but search for an effective treatment.” An anesthesiologist and pain medicine specialist at Mayo Clinic in Rochester says “in the vast majority of cases, we can determine a cause; in some cases we [have] an explanation but we can’t eliminate it. Not all abnormalities cause pain and not all pain is associated with abnormality.” He claims that when “patients tell me about their pain, I believe them.”

Dr. Martin notes patient-controlled analgesia (PCA) is “often used to control pain after surgery. The machine will ignore the request if you push the button too frequently. Only the patient should push the button.” He emphasizes some pain medications “pose no risk for addiction. These include anti-inflammatory drugs, anti-depressants, and anti-epileptic medications. Opioids, such as morphine and codeine, have some risk of addiction; when taken as directed by a physician, the risk is very small. When your body adapts to a drug, eventually you may need a higher dose to get the same relief.”

60 Minutes talked to Dr. Russell Portnoy, chairman of the Dept. of Pain Medicine at New York’s Beth Israel Hospital, who said, “People are literally able to take industrial strength doses without sustaining any problem at all. There’s a very deep concern [in] the medical profession that the authorities don’t know anything about pain medicine; and are so afraid of prescription drug abuse that they tend to investigate or go after prescribers on the basis of very weak evidence.”

Now inject irony: Paey had a pain medicine pump inserted surgically before he went to prison, Reynolds noted, and now Florida pays for the constant stream of medication delivered directly to Paey’s spine. That provides him with pain relief at doses more powerful than the drugs he was taking when he was arrested.

To contact Richard Paey or to learn more about his appeal visit www.PainReliefNetwork.org

Herb Drill writes and edits www.notaccessible.com and is a charter member of the Society of American Business Editors and Writers.

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