The strange Case and Plight of Richard Paey

This is a subject I feel really strongly about----Pain Control, specifically inadequate pain control. It is probably one of the reasons I still come back to these boards to contribute.

I am a firm believer that opiates are totally misunderstood by patients as well as Doctors
The fear of addiction and demonization of these useful medications is leading to an undertreatment of pain in this country.

Yes you can be physically dependent on a medication without
being addicted and you can be addicted without being physically dependent.
That is something that is very misunderstood.

Yes, addiction in this country is a big problem but not by patients that are appropriately using the medication and
are having their pain sufficiently treated.

And there are addictive personalities that may be problematic given these meds, whether their problem has been alcohol, or cigarettes etc. Weeding out and treating these problematic patients is some Doctor's nightmare.

Anyway enough of my rant. My post is really about the plight of Richard Paey. I'm posting this strange, outrageous story from the Huffington Post. The second article tells how the original charges came to be.
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Cruel and Disgusting: Pain Patient Appeal Denied

Florida's Supreme Court has rejected an appeal from Richard Paey, a wheelchair-using father of three who is currently serving a 25-year mandatory prison sentence for taking his own pain medication. In doing so, the court let stand a decision which essentially claims that the courts have no role in checking the powers of the executive and legislative branches of government when an individual outcome is patently unjust.
Richard Paey-- who suffers both multiple sclerosis and from the aftermath of a disastrous and barbaric back surgery that resulted in multiple major malpractice judgments--now receives virtually twice as much morphine in prison than the equivalent in opioid medications for which he was convicted of forging prescriptions.

He had previously been given legitimate prescriptions for the same doses of pain medicine-- but made the mistake of moving to Florida from New Jersey, where he could not find a physician to treat his pain adequately. Each of his medical conditions alone can produce agony. Paey has described his pain as constantly feeling like his legs had been "dipped into a furnace."

The Ivy-league educated attorney has no prior criminal convictions and weeks of surveillance by narcotics agents did not find him selling the medications.

The Florida Court of Appeals had upheld his conviction-- despite the lack of evidence of trafficking and despite the fact that most of weight of the substances he was convicted of possessing (higher weights lead to longer sentences) was made up of Tylenol, not narcotics. The majority suggested that Paey seek clemency from the governor, claiming that his plea for mercy "does not fall on deaf ears, but it falls on the wrong ears."

In a jeremiad of a dissent, Judge James Seals called the sentence "illogical, absurd, unjust and unconstitutional," noting that Paey "could conceivably go to prison for a longer stretch for peacefully but unlawfully purchasing 100 oxycodone pills from a pharmacist than had he robbed the pharmacist at knife point, stolen fifty oxycodone pills which he intended to sell to children waiting outside, and then stabbed the pharmacist."

But the Florida Supreme Court disagreed, letting the sentence stand, without comment. It released its cowardly decision in the media quiet of a Friday night. As Siobhan Reynolds, founder of the Pain Relief Network points out, "Where Florida stands now is that individuals have no recourse to the courts when the executive and legislative branches behave tyranically." Under the Constitution, the role of the judiciary is supposed to be to check the powers of the other branches-- not simply to defer to them.

Paey's only other alternatives now are an appeal to the U.S. Supreme Court or clemency from Governor Charlie Crist.

Writing in support of clemency, leading academic pain specialist Russell Portenoy, MD, said, "the information available indicates that any questionable actions [Paey] took, actions which led ultimately to his arrest, were driven by desperation related to uncontrolled pain."

He noted that such cases "may increase the reluctance of professionals to treat pain aggressively."

Portenoy wrote that despite the fact that Paey required high doses of opioids, those doses were "clearly in the range used by pain specialists in this country." He stressed that, "The number of pills or milligrams of an opioid required for analgesia says nothing about any of the negative outcomes associated with these drugs-including abuse, addiction and diversion-and reference to the amount of drug as evidence of these outcomes by regulators or law enforcement should not be condoned."

Unfortunately, across the country, pain patients are being undermedicated and doctors are going to prison because the Justice Department refuses to believe this.

People profess to be experts about addiction because they have personal experience with drugs or addicts; they think they know about opioid drugs because they've watched a few episodes of E.R. or been through DARE classes at school. The truth is that opioids are amongst the safest drugs known to humanity-- when given appropriately, they do not kill.

Unlike aspirin, Tylenol, Vioxx, Celebrex, Advil, Alleve and every other known class of pain medications, opioids do not harm any organs and there is no maximum dose once a person has become tolerant to them. People need to educate themselves about the complexities of how drugs, brains and settings interact before making policies about them that send people like Richard Paey to prison.

Who is served by the incarceration of Richard Paey? Certainly not his family, certainly not the taxpayers and absolutely not the image of America as a decent, humane country. Certainly not the interests of pain patients or even drug addicts-- neither of whom benefit from viewing drugs as a criminal justice issue. Not one child will be deterred from taking drugs, nor one mother saved the horror of an overdosed teen because we lock up those who need opioids to relieve their pain.

Governor Crist, please, do the right thing and send Richard Paey home.
Cruel and Unusual: 25 Years for Taking Own Pain Meds

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Dec 6, 2006
By: Maia Szalavitz
Huffingtonpost.com

In a mind-boggling act of sadistic legal legal buck-passing (I can't bring myself to glorify it with the word "reasoning"), the Florida District Court of Appeals upheld a 25 year mandatory minimum sentence for a Florida man convicted of "drug trafficking" for possessing his own pain medication.

Richard Paey is a wheelchair-bound father of three young children.

He has no prior criminal record– in fact, he's an Ivy League law school graduate. He has not one, but two extensively documented and excruciatingly painful chronic disorders: multiple sclerosis and chronic back pain due to an injury suffered in a car accident that was treated by a surgery that made matters worse. (This surgery was so egregiously misguided that TV exposes and numerous large malpractice judgments resulted). Paey has already been in prison for three long years.
In prison– a place not exactly known for medical kindness– he has been given a morphine pump, which now daily gives him similar or higher doses of medication than he was convicted of possessing illegally.

So why is he serving 25 years? Tipped off by a pharmacist ignorant of pain management, Florida authorities decided that the doses of painkillers he was receiving were so high that he had to be selling the drugs, not taking them. They found no evidence of this, however, even after putting him under surveillance for months.

But they did manage to convince his New Jersey doctor– who Paey claims authorized his prescriptions– to testify that, in fact, Paey was forging them. The doctor was told that he would face a similarly lengthy prison sentence for trafficking if he'd authorized such high doses for a patient who had moved from New Jersey to Florida. (See here for why he had reason to fear, despite prescribing legitimately and appropriately).

To add to the exquisite ironies of the case, the reason Paey qualified for such a lengthy sentence was due largely to his possession of acetaminophen (Tylenol), not opioids. Paey was taking pills that included acetaminophen and oxycodone– but the state counted the weight of the acetaminophen towards the weight of illegal drugs when it determined the charges that led to his sentence.

In upholding his sentence, the majority argued that it was not so "grossly disproportionate" as to be "cruel or unusual" under Florida's constitution. It is the legislature's role, they said, to determine the appropriate laws based on harm done by drugs to the community and prior case has law upheld lengthy mandatory minimums for drug crimes.

Essentially, since Paey's sentence wasn't death or life without parole, it was OK, even though it was a nonviolent first offense committed by a person suffering extreme pain without evidence that he was actually planning on selling drugs. Paey's family– who had been hoping he'd be home for Christmas– will have to wait.

The bottom line, for the majority, was that the law had been applied appropriately. Because the outcome was unjust in this particular case, Paey should seek clemency from the governor, not appellate court relief. Noting that the facts of the case "evoke sympathy" for Paey, they concluded that "Mr. Paey's argument about his sentences does not fall on deaf ears, but it falls on the wrong ears."

The only glimmer of hope was the thundering dissent by Judge James Seals. He gave hypothetical examples of situations in which an innocent person could be similarly convicted of drug trafficking by dint of simple possession of large quantities of drugs. He then concluded:

I suggest that it is cruel for a man with an undisputed medical need for a substantial amount of daily medication management to go to prison for twenty-five years for using self-help means to obtain and amply supply himself with the medicine he needed…

I suggest that it is unusual, illogical, and unjust that Mr. Paey could conceivably go to prison for a longer stretch for peacefully but unlawfully purchasing 100 oxycodone pills from a pharmacist than had he robbed the pharmacist at knife point, stolen fifty oxycodone pills which he intended to sell to children waiting outside, and then stabbed the pharmacist…

It is illogical, absurd, cruel, and unusual for the government to put Mr. Paey in prison for twenty-five years for foolishly and desperately pursuing his self-help solution to his medical management problems, and then go to prison only to find that the prison medical staff is prescribing the same or similar medication he had sought on the outside but could not legitimately obtain. That fact alone clearly proves what his intent for purchasing the drugs was. What a tragic irony.

In a letter to the governor requesting clemency, Paey's attorney, John Flannery, wrote, "In more than thirty years of practice as an appellate law clerk in the US Court of Appeals for the Second Circuit and a federal prosecutor and as a practicing appellate and trial lawyer, I have never seen an opinion such as this in which the Court agreed the sentence was wrong but could not agree on how to correct it."

This is a sorry time for justice in America– and an even sorrier time for the media, which continues to ignore the ongoing disgrace of our drug laws and their enforcement. (For more information and to help support Paey and others caught up in the war on pain doctors and their patients, visit the Pain Relief Network.)

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