Thousands of people in Nevada depend on OxyContin and other prescription pain killers -- drugs that are also popular on the black market. Trouble is, the government's actions to keep OxyContin out of illegal channels are making it more and more difficult for the tens of millions of Americans who suffer from chronic pain to get relief.

Of the 4,383 pain management doctors listed on the DoctorsForPain.com registry, 54 are located in Nevada. To the Drug Enforcement Administration, this fragile network of care givers is a tempting law enforcement target.

Because OxyContin is seldom addictive, pain doctors prescribe increasingly high doses until the patient's pain abates or side effects set in. Because this treatment is still controversial among some physicians, pain practitioners are vulnerable at trial.

In 1993, to bankroll the DEA's war on doctors, Congress set up a diversion control fund. Each year, 1 million doctors buy a license to prescribe FDA-approved drugs. In 2003, this fee was doubled. The DEA now rakes in about $130 million per year from these fees, money that is used to hire investigators to target physicians. The agency also gets funding each year -- $54 million in 2002 -- from an asset forfeiture fund, including assets that once belonged to physicians prosecuted by the DEA. These two pots of money afford the DEA the financial incentives and the freedom from congressional oversight to prosecute pain doctors.

The DEA monitors the prescription writing habits of all doctors, and those prescribing high doses of OxyContin raise a red flag. Investigators go to work. Plea bargains win testimony from former patients. Indictments are filed.

Since 2001, says Dr. Joel Hochman, director of the National Foundation for the Treatment of Pain, the DEA has investigated about 1,800 doctors; 1,200 lost their prescription license. "When doctors are investigated by the DEA, their usual response is to cease treating pain patients," he said.

Each publicized DEA investigation and conviction spreads fear. Other doctors voluntarily get out of, or decide not to go into, the practice of pain management. To catch the few bad doctors, the DEA is driving many more good ones out of business. Some patients who lose their support systems turn to the black market or even suicide for relief.

Dr. Jane Orient of the Association of American Physicians and Surgeons says the DEA plays dirty to convict doctors: "Prosecutors manipulate the legal system to frighten doctors who might be willing to testify on behalf of wrongly accused doctors."

In March 2004, DEA administrator Karen Tandy told Congress her drug warriors have "been successful in addressing OxyContin diversion as evidenced by a reduction in the rate of increase of OxyContin prescriptions being written and a leveling-off of OxyContin sales."

For DEA, the fewer pain-relief prescriptions written, the better. This cockeyed measure of success makes no sense because experts estimate the pain experienced by 40 percent of cancer, AIDS and terminally ill patients is not treated adequately.

Thanks to the DEA, Orient predicts, "if you have an operation or an acute injury, chances are your doctor will order adequate pain medication. But if you are one of the millions with chronic, intractable, so-called benign pain, you may be told to learn to live with it."

Bottom line: The loss of one Nevada pain physician will not create a ripple in the black market. But 300 honest citizens in pain may curse the DEA's tactics when they are told, "Learn to live with it."