Of Smoke, Mirrors, and Passive-Aggressive Behaviors

Abstract

“What we have here is a failure to communicate.” These are the last words spoken the moment before a Southern prison warden fatally shoots the irrepressible convict played by Paul Newman in the now classic film “Cool Hand Luke.” The first impression an objective, third party might have in reading Dr. Heit's editorial in this issue of Pain Medicine is that a similar failure might explain the precipitous, bizarre, and inexplicable revocation by the Drug Enforcement Administration (DEA) in early October of 2004 of its endorsement of and support for Prescription Pain Medications: Frequently Asked Questions and Answers for Health Care Professionals and Law Enforcement Personnel (hereinafter FAQ), a document that had been unveiled with much fanfare merely 2 months earlier. But closer scrutiny of the chronology of events suggests that the communication breakdown theory is highly improbable. As Dr. Heit points out, the FAQ was the product of years of collaborative effort among experts in the field of pain medicine and representatives of the DEA that worked through no fewer than 20 drafts. The DEA was sufficiently comfortable with the final version of the document that it placed it on its Website, as did another major contributor to the project, the Pain and Policy Studies Group at the University of Wisconsin (PPSG). Nevertheless, 2 months later …