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Interviews with local doctors confirm that patients should, as one physician stated, "talk to their doctors while the FDA decides what to do." However, "Many patients are nervous that tried and true drugs might go off the market, leaving them struggling to manage pain." The physicians who spoke with the Dispatch stressed that patients should not worry excessively but rather "take acetaminophen seriously, read labels, and understand that it's fine as long as it's not taken in excess." Moreover, the Dispatch's sources reached the consensus that "it would be a mistake to take Vicodin and Percocet off the market." Sources at the FDA stated that "Changing dosing regulations on Tylenol would take years [...], and the agency is well aware of the concerns of people who rely on Percocet and Vicodin." FDA spokesperson Karen Riley suggested that "this will be a measured response [...], adding that labeling changes would be an option that could happen relatively quickly." When federal prosecutors served activist and Pain Relief Network president Siobhan Reynolds with an excessively broad subpoena in March of 2009, the unrelenting pain patient advocate hit back with her own motion to quash the order, which she filed on April 9, 2009, according to a May 15 feature in that week's Drug War Chronicle ("ACLU Backs Pain Activist's Effort to Quash Subpoena Issued in Kansas Case").
US Assistant Attorney Tanya Treadway has, since 2007, stopped just short of litigationally harrassing Reynolds as a result of advocacy she performed on behalf of pain management physician Steven Schneider, who - along with his wife, Linda Schneider - was arrested in late 2007 after federal agents raided the couple's pain clinic and home in an attempt to prosecute them for "unlawfully prescrib[ing] pain medications." Treadway's most recent subpoena "demands that Reynolds turn over all correspondence with attorneys, patients, Schneider family members, doctors, and others related to the [...] case," as well as "bank and credit card statements showing payments to or from clinic employees, patients, potential witnesses and others, including virtually every attorney Reynolds knows." The Chronicle states that the "subpoena is supposedly part of an obstruction of justice investigation aimed at Reynolds," who "became a thorn in Treadway's side" after she traveled to Kansas to aid the Schneiders, "whom she sees as being hounded by overzealous federal drug warriors." Treadway, on the other hand, views Reynolds' advocacy as evidence of her "sycophantic or parasitic relationship" with Steven and Linda Schneider; the prosecutor claims that Reynold's activism constitutes an attempt to "further the Pain Relief Network's political agenda and her own personal interests." However, according to the ACLU, which stepped in to assist Reynolds with her legal battle, "the subpoena should be withdrawn because it threatens Reynolds' First Amendment rights and amounts to little more than a 'fishing expedition' aimed at finding out information about the Schneider's defense." The civil liberties group filed an amended motion to quash the subpoena in early May of 2009.
ACLU attorneys claim that the prosecution's actions "constitute an abuse of the grand jury process [and] would have 'a chilling effect' on Reynolds' constitutionally protected speech." Additionally, the ACLU contends that the subpoena represents further "misuse of the grand jury process because it is aimed at invading the defense camp of the Schneiders." In lay-speak, Reynolds' ACLU advocates have argued not only that the defendant simply exercised her right to free speech in her Schneider-related advocacy efforts but also that the prosecution is attempting to illegally snoop around for clues about the Schneiders' legal strategy.
David Perry, director of the Pharmacology Graduate Program at George Washington University warns that "the presence of acetaminophen is toxic in high doses." However, Perry also cautions readers that "anything could be toxic" including Vitamin C and "even so-called natural products." Doctors' largest worry, however, appears to relate to the lack of alternatives available for treating pain.
The Chronicle feature provides a more detailed account of the case's history - particularly where Reynolds' and Treadway's involvements are concerned.
Many of the legal documents - including Treadway's Reynolds-aimed subpoena, Reynolds' initial motion to quash the grand jury subpoenas, and the ACLU's amended motion to quash them - are also available for public online viewing. Brinkema was a setback for federal prosecutors, who were seeking a life sentence for William E. Hurwitz, 61, a former pain specialist based in Mc Lean, was a key target of a far-reaching investigation into doctors, pharmacists and patients suspected of selling potent and addictive painkillers. District Court in Alexandria convicted Hurwitz on 16 counts of drug trafficking in April.
Jurors acquitted him of nine counts and deadlocked on three.
Before the second jury got the case in April, Brinkema dismissed the counts involving the patient who died and the two who were seriously injured.
Activist and president of a pain patient advocacy group, the Pain Relief Network, Siobhan Reynolds has "filed a complaint with the Justice Department alleging prosecutorial misconduct in a grand jury investigation of her role" in an ongoing legal battle involving Dr. Reynolds is being assisted by both her own organization and the American Civil Liberties Union, which filed an amended motion to quash a March 2009 subpoena that the parties claim infringes upon Reynolds' right to free speech and represents a gross misuse of the grand jury system. As CNN reported on June 30, 2009 ("FDA Advisors Vote to Take Vicodin, Percocet Off Market"), an FDA advisory panel voted in favor of "eliminating prescription drugs that combine acetaminophin with narcotics -- such as Vicodin and Percocet -- because of their risks for overdose and severe liver injury." The panel also "advised the FDA to lower the maximum daily dose of acetaminophen in over-the-counter and prescription medications, and to address the formulations and dosing recommendations for children." Among other recommendations, the panel suggested that, if the FDA chooses not to remove the aforementioned medicines from pharmacy shelves, it could "lower the amount of acetaminophen" in drugs that combine acetaminophin and narcotic painkillers and "take some action to ensure that subscribers and patients are aware of the potential liver damage posed by taking these products." Although it typically follows advisory committee recommendations, CNN informs readers that it "is not required" to do so.