I broke my back when I was nine years old. That sentence explains more about this article than the politics ever will.
I have spent most of my life learning what pain does to a person, what relief can give back, and what happens when people who do not live inside your body acquire the authority to decide how much suffering you should be expected to carry. I am not writing this as a man defending intoxication. I do not particularly like being high. I am writing it as a man who has repeatedly found that medicine was available only after somebody else had decided what kind of person I was, what I was allowed to use, what I had to submit to, and how obedient I needed to appear before relief could be considered.
That is the real subject here. Marijuana is part of the story. Opioids are part of the story. Pain management is part of the story. Oklahoma’s medical marijuana program is part of the story. But underneath all of them is an older question about authority: when a person has harmed no one and is trying to manage suffering inside his own body, who exactly owns the decision?
I did not arrive at that question from theory. I arrived at it through doctors’ offices.
Before Medicine Became Management
Around 2005, give or take a year, I went to the primary-care doctor I had been seeing since high school. He knew me. He knew my history. He knew I had smoked marijuana when I was younger because I told him. I have always believed that if I am asking a doctor to treat me, the least I can do is tell him the truth.
My back was getting worse. He asked whether I was smoking marijuana for the pain. I told him I was. He said good.
That matters because people have very short memories about medicine. There was a time, within my adult life, when a doctor could know that a pain patient used marijuana, understand why he used it, prescribe pain medicine, increase that medicine when the injury demanded it, and still treat the patient like an ordinary man trying to function. Marijuana was not automatically proof of bad character. Needing pain medicine was not automatically treated as evidence against the person asking for it.
Eventually I was taking six Lortabs a day and three muscle relaxers and still hurting badly enough that my doctor told me something deeper was wrong. He was right. I needed surgery. I had it, did well for about a month, then hurt myself badly roughhousing with my brothers. My surgeon believed the operation itself was sound. I was still hurt. I went back to the doctor who knew me, and from there I was sent into pain management.
That is where the character of medicine changed for me. I still needed a doctor. What I increasingly encountered was a system.
The Handler in the Room
There is a difference between being treated and being handled. I have tried to describe that difference elsewhere because it is one of the hardest things to explain to someone who has never needed long-term pain care. A simple no can hurt, but at least no is honest. The stranger experience is sitting in a medical room while the conversation moves away from what is wrong with your body and toward a process that was already waiting for you before you arrived.
The first pain-management doctor did prescribe medicine, but relief came attached to a sequence. Injections. Ablation. Physical therapy. Procedures. Things the practice wanted tried before other things could be considered. Some of those treatments hurt me badly and did not help. Physical therapy became almost absurd: I was told that movement was important while the pain preventing movement was treated as something I was expected to overcome first. Every individual step could be defended. That is part of what makes the structure so durable. An injection can be defended. A referral can be defended. A urine screen can be defended. A contract can be defended. Another appointment can be defended. The trouble becomes visible only when all the defensible pieces accumulate into one damaged life.
The institution sees the pieces. The patient lives the whole.
I left that practice and started looking for another doctor. Today the phrase doctor shopping can make that sound suspicious before anyone asks why the person was looking. I was looking because I hurt and because the arrangement I had been offered was not working. I found an older doctor in downtown Oklahoma City who had a reputation for not treating marijuana use as a moral failure. He was kind to me. He knew I used it. He prescribed a small amount of pain medicine, around three Lortab 5s a day, and for a short time I felt like I had found a doctor again instead of another checkpoint.
Then I arrived for an appointment and the receptionist told me I could still see him, but I would not be receiving medicine. They took me to his office instead of an examination room. He was behind his desk and a lawyer was standing beside him. He told me he could no longer treat me and that he was leaving Oklahoma for California. I remember fear in that room. I remember believing that this doctor thought continuing to practice the way he had practiced could get him into serious trouble.
I told him he could not simply cut me off. The lawyer told me they could refer me to a pill mill down the street where, as I remember his words, I could get all the OxyContin I wanted and it would kill me. I was taking three Lortab 5s a day. I was offended. I told him to keep the referral, walked out, sat in my car, and cried.
I also remember that lawyer telling me by name to thank Tom Coburn. I have never claimed that one sentence proves that Tom Coburn personally caused what happened to me. It does not. It is part of my memory of that day, and I preserve it for exactly what it is: something said to me while I was losing another doctor. That distinction between a record and a conclusion matters to me now far more than it did then.
Beggars Are Not Choosers
I went back to the doctor who had known me since I was young and begged him to help. He sent me elsewhere. One doctor wanted to know whether I thought I was depressed or mentally ill. Another said he would consider helping me after I saw a psychiatrist. The psychiatric appointment was weeks away, and getting back into pain management would take longer still. This is one of the peculiar cruelties of pain care: institutions can schedule suffering as though pain itself keeps office hours.
Eventually I went to an emergency room. They did not solve it. I returned again to my old doctor and told him that if he would not help me, he needed to find someone who would. I did not know whether he had any legal duty to do that. I was desperate and speaking like a desperate man. I remember him calling doctor after doctor. I remember twelve.
The twelfth was a woman. She agreed to see me. I sat in that examination room thinking I had finally reached the end of the line and that this woman might be my last real chance at relief. Then the door opened and she came in pointing at me, telling me I had three strikes and had already used all three. I had barely met her. She told me what I was going to take: three-quarters of a strip of Suboxone and three Lortab 5s a day.
I said okay.
Beggars are not choosers. That sentence should never describe medicine, but it described the position I was in perfectly.
At the time I was not taking opioids. I had already been without them. What I had was marijuana. She put me on Suboxone anyway and forbade marijuana. There was no long conversation about why marijuana had once been treated as acceptable by doctors who knew me and was now forbidden as a condition of receiving something else. There did not need to be. The arrangement was simpler than the explanation: take it or leave it.
After a few weeks I began hearing what sounded like mumbling behind me. It became noticeable enough that I would turn around to see whether someone was speaking. I called the doctor and told her what was happening. Her answer, as I remember it, was essentially that she did not care whether I took the medicine or not because I was not getting anything else from her.
So I left it.
The Patient Who Disappears
I stopped looking for help. That is different from getting better.
There was a period after that when I came dangerously close to killing myself. I am not suicidal today, but I was then, and I will not clean that part of the story up for the comfort of people who prefer public policy in neat categories. A person can be counted as successfully removed from opioid treatment while his life is quietly collapsing somewhere outside the clinic. The prescription number goes down. The institution records less risk. The patient disappears.
This has become one of the central questions in my work because government is very good at counting the things it has decided to fear. It can count prescriptions, pills, doctors, pharmacies, overdoses, suspicious orders, registrations, and dispensing rates. What is harder to find is the clean national number for the person who was already injured, already in pain, lost lawful treatment, went home, and eventually could not carry the suffering anymore. That absence does not prove every suicide involving chronic pain was caused by denied medicine. It proves something narrower and more important: the cost of restriction is not counted with the same administrative precision as the risk of prescribing.
That imbalance has followed me ever since. If a medicine harms someone, the event becomes evidence for more control. If the absence of medicine harms someone, the event can disappear into a larger category where no institution has to own it.
They Called It Addiction. I Called It a Last Resort.
Cannabis became what I had. I self-medicated. Other people were free to call that addiction if they wanted. I called it a last resort. I do not particularly enjoy sitting around high, and I never built an identity around marijuana. I used it because I hurt and because the lawful system had repeatedly demonstrated that relief would come, if it came at all, on terms I did not control.
For much of my adult life I have probably functioned at a fraction of what I might have been capable of with adequate treatment. I survived that. Survival should not be confused with proof that the treatment was unnecessary. That is one of the uglier tricks hidden inside pain policy. If the patient survives without medicine, his endurance is treated as evidence that he never truly needed it. Look at him. He is still here. The restriction must have worked.
No. Sometimes all you proved is that the person was capable of suffering longer than you expected.
There was another contradiction that became impossible to ignore. Marijuana had once been something a doctor who knew me could acknowledge as useful for breakthrough pain. Later, marijuana in a patient’s system could become a reason to deny opioid treatment. Then Oklahoma legalized medical marijuana and built an entire licensed system around the same substance. The medicine did not change. The patient’s pain did not change. What changed was the institution standing between the two.
When Oklahoma Sold Permission
When Oklahoma legalized medical marijuana, I did not experience the moment as liberation. I experienced it as the government deciding that something I had already used for pain could now be lawful if I paid for permission, remained inside the approved channel, and paid again when I bought the medicine.
The State of Oklahoma calls the additional charge an excise tax. Under State Question 788, retail medical marijuana is subject to a seven-percent excise tax in addition to applicable state and local sales taxes. That is not my interpretation; that is how the state describes the tax.
I call it a sin tax because that is what it represented to me. Oklahoma had finally agreed that this was medicine for licensed patients and then placed a special tax on the medicine at the point of sale. I looked at that arrangement through the eyes of a man who had already been told to use marijuana for pain, later been told marijuana could disqualify him from other treatment, and then been told that marijuana was acceptable again once the state had created the permission structure around it.
That pissed me off.
The insult was not merely the money. The insult was the category. A person who hurts is already forced to explain himself constantly. Why do you need it? How bad is the pain? Are you depressed? Are you addicted? Are you compliant? Did you use the right pharmacy? Did you take the right amount? Did you use marijuana? Did you sign the agreement? Did you provide the sample? Did you complete the procedure? Did you follow the process?
The questions accumulate until sickness itself begins to resemble a character investigation.
What was our sin? Being in pain? Using the medicine doctors themselves had once suggested? Wanting to sleep? Wanting to work? Wanting enough relief to get off the couch and remain useful to our families? A person can argue about the prudence of any particular drug. That is medicine. A person can argue about dosage, interactions, risk, dependency, and whether the treatment is helping. That is medicine too. But once the question becomes whether a harmless adult has demonstrated enough obedience to deserve consideration, medicine has crossed into something else.
The Approved Hand
The longer I studied the history of drug control, the clearer the structure became. The modern drug war is usually imagined from the street inward: contraband, traffickers, raids, arrests, fentanyl, heroin, cartels. That world is real. But lawful medicine has its own machinery. The government does not have to outlaw a medicine completely in order to control access to it. It can establish the approved hands allowed to manufacture it, distribute it, prescribe it, dispense it, possess it, and document its movement. It can leave the medicine legal while making legality itself conditional on remaining inside the chain.
Once you see that, a pain-management contract stops looking like an isolated piece of office paperwork. It becomes the point where the larger system reaches the individual patient.
Contract for Care Comes First
I want the marijuana excise tax gone. I do. I think the idea of placing a special tax on medicine bought by licensed patients deserves public scrutiny. But it is not the first fight because it is not the deepest mechanism.
Contract for Care comes first.
The contract is where the patient learns that access can be conditioned on submission to a private system of monitoring and behavior. One prescriber. One pharmacy. Drug screens. Pill counts. Refill rules. Procedure requirements. Appointment rules. Restrictions on other substances. Terms written by the institution and presented to a person whose alternative may be untreated pain. Any one of those provisions can be defended in isolation. The deeper question is what kind of consent exists when the thing being withheld on the other side of the signature is relief from suffering.
I am not arguing that a doctor must prescribe whatever a patient demands. I am not arguing that controlled medicine has no risks. I am not arguing that deception, diversion, reckless prescribing, or dangerous combinations should be ignored. Responsibility belongs on both sides of a medical relationship. If I lie to a doctor, I have damaged the trust that makes judgment possible. If a doctor acts recklessly, the doctor should answer for his own conduct. Consequences should remain attached to the person who earned them.
What I reject is the transfer of everybody else’s wrongdoing onto the harmless patient before he has done anything wrong.
That is why the contract matters. It formalizes a presumption that would be unacceptable almost anywhere else in ordinary life: because some people misuse a thing, everyone who needs access to it enters under supervision. Because some prescriptions are diverted, the compliant patient becomes a diversion risk before his own conduct has established it. Because institutions are afraid of consequence, the cost of that fear is moved into the body of the person already suffering.
That is not merely paperwork. It is a theory of authority.
The Right of the Harmless
This is where my argument finally becomes very simple.
The Right of the Harmless is not something I believe government created for me. It is a natural boundary on government itself. If my conduct harms another person, another person’s rights have entered the question. If I assault someone, defraud someone, poison someone, steal from someone, or drive into someone, I have created a claim beyond myself. Government has a legitimate reason to act because another person exists on the other side of my conduct.
But if I am sitting in my own house trying to relieve pain in my own body, who exactly have I harmed?
That is the line. The question is not whether every choice I make is wise. It is not whether a majority approves of it, whether a doctor would make the same choice, whether a regulator thinks the risk is acceptable, or whether somebody considers the act unhealthy, foolish, sinful, or offensive. The question is whether my peaceful conduct has crossed into another person’s rights. If it has not, then the burden should remain mine because the body is mine and the consequence is mine.
Freedom without responsibility is childish. Responsibility without freedom is submission. I am arguing for both.
I Would Take the Medicine
I also want something said plainly because pain patients are too often forced into false moral positions. I am not proud of going without medicine because I think suffering makes me noble. It does not. Pain is not a virtue. I would take effective pain medicine today if it were lawfully available to me under terms I could live with.
What I will not do is buy pills from the illicit market. The street supply has become too dangerous for me to gamble with, and I have no interest in becoming another number used to justify the same system that helped create the desperation in the first place. So I endure more than I should have to endure. I can do that. Not everyone can.
That distinction matters. Public policy should not be written around the assumption that every person will absorb unlimited suffering quietly and remain standing. Some people disappear from care. Some lose work, sleep, mobility, marriages, patience, faith, and the ordinary structure of a life. Some seek dangerous substitutes. Some die. A system that counts only the danger of medicine and not the danger of forced pain is not measuring the whole problem.
What the Sin Tax Really Means
The seven-percent marijuana excise tax is not the whole problem. It is a symbol of it.
It represents the same instinct I have encountered throughout modern pain care: relief is permitted, but only after authority has arranged the terms. The patient may receive medicine, but through approved hands. He may use cannabis, but after licensing. He may receive controlled medicine, but under monitoring. He may seek relief, but inside the process. What looks like access from the outside can feel very different from the chair where the patient sits.
That is why I no longer begin with the drug. I begin with the structure around it. I ask who has authority, what that authority actually says, where the rule came from, what evidence supports it, what consequence follows, and who carries the cost when the institution is wrong. That is what Seeds of Vice has become for me: not a place to complain about power, but a place to identify it clearly enough that it has to answer.
The first target is Contract for Care because that is where the question becomes personal and immediate. The patient walks in with pain. The institution places terms between the person and the possibility of relief. The signature is then called consent.
I have lived long enough on the other side of that desk to know the difference between agreement and surrender.
So when I ask what our sin was, I am not asking for sympathy. I am asking for the line of authority. What did the harmless patient do that justified turning his medicine into a permission system, his treatment into supervision, and his suffering into leverage?
If there is an answer, put it in the record.
If there is not, then stop pretending permission created the right.
Government did not give me ownership of my body. It did not give me the desire to survive pain. It did not create the responsibility I carry for my own conduct, and it cannot morally sell those things back to me seven percent at a time.
If I am harmless, whose permission do I need to relieve my own suffering?
I say nobody’s.
That is the Right of the Harmless.
Continue the record: Contract for Care · The Right of the Harmless · On Cannabis · Oklahoma Pain Atlas · On Poppy Tea · Mr. DEA’s Diversion