iStock_000014428222_MediumA fascinating legal action hit the news recently, involving the responsibility of physicians and clinics for patients who become addicted to prescribed painkillers.

Will the court find that those who prescribed or supplied the opioids were also accountable for the addiction that often resulted? We’re talking about legal responsibility now, and that can run far afield from conventional moral judgment.

In one sense, of course, this is a continuation of other legal actions related to fixing liability for the consequences of various substance disorders. Cigarette smoking is the common example, but there’s also the recent suit (still pending, I believe) on behalf of retired NFL players seeking compensation for addiction to pain meds that they insist were provided, encouraged, and even required by the team. An update on that.

In the late 80’s, a case that had to do with eligibility for certain VA benefits made it all the way to the Supreme Court. That’s where I first encountered the term “willful misconduct” used with respect to  alcoholism. The Court ruled that despite the persuasive evidence for a disease, the drinker retained enough control over his actions that they could be considered largely voluntary– and that allowed the VA to exclude him from certain benefits. The case made the cover of Time. An article from around then.

In this most recent West Virginia case, the target is the pain clinics and the doctors who staffed them. In particular, one clinic that grew from a friendship between a former prison doctor and a former inmate. Together, they seem to have created a classic ‘pill mill’ in the heart of the Mountain State. Now, of course, they’re blaming one another.

A recent book described another case, this time from the Pill Mill capital of Palm Beach, Florida, involving a chain of pain clinics that appears to have been a criminal enterprise from the very beginning.

I’m afraid most of the legalities have yet to be resolved by the Courts. Could be awhile before they’re sorted out.

I find myself remembering the street wisdom: when it comes to drugs and human behavior, “if it can be done, it will be done.” Which makes me think that somebody else is busy right now, thinking up a whole new set of issues to occupy the legal system in the future.


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