
A 93-year-old pain management specialist was convicted of writing illegal prescriptions for a number of different painkillers, including oxycodone, for people who were living with addiction or in the business of selling pills on the black market.
At the end of last month, almost six years after his arrest, a federal court found the doctor guilty of 11 charges related to drug sales and money laundering. His medical assistant was convicted of eight counts connecting him to the doctor’s opioid conspiracy. A pharmacist who was included in the 2011 indictment will face a new trial next month after a mistrial was declared in his original trial when a jury was unable to return a verdict on the charges of one count of conspiracy to distribute oxycodone.
The doctor’s lawyer unsuccessfully argued that the 31 cash deposits he made over a 46-week period amounting to $263,000 from the sales of a range of prescription drugs was a result of his age and outdated medical training.
What do you think? Does age have anything to do with the choices the doctor made?
Outdated Medical Training
It is true that part of the campaign to end the opioid addiction and overdose epidemic that has swept the country is focused directly on the physicians who prescribe these addictive pills. Family practitioners and others who do not specialize in pain management may not have completely understood the devastating possibilities associated with use of these drugs, and as a result, they may have written prescriptions that were inappropriate or otherwise undermanaged their patients’ use of these pills.
Many states require that doctors who prescribe painkillers and other addictive drugs take part in training to help them better understand the latest information about these medications and how best to monitor a patient’s use of these drugs, especially in the case of treatment for chronic pain – but these are doctors who have graduated in the past couple decades who cannot claim to have been involved in World War II, as can the 93-year-old doctor convicted of drug conspiracy.
So, is it possible that the doctor in question managed to escape this information and not realize what he was doing? Not likely. Cash exchange for medication was clearly a new choice for the doctor in the year prior to his arrest given the sudden onset and frequency of his bank deposits, so there must have been some understanding that what he was doing wasn’t on the up and up. It was not something that he had engaged in over the course of his career, so the choice had little to do with his education or lack thereof.
Medical Monitoring
Doctors who illegally prescribe medications and sell drugs to patients on the side are directly contributing to an epidemic that is deadly. According to the Centers for Disease Control (CDC), the number of deaths in the United States caused by the use of opioid drugs (e.g., painkillers and heroin) quadrupled between 1999 and 2015. Medical monitoring through statewide databases that require doctors and pharmacists to coordinate information on prescriptions filled by patients has helped to identify those doctors and pharmacists who may not be prescribing pills and filling prescriptions with medical necessity in mind. It has also served to identify patients who may be struggling with addiction and in need of treatment as well as those who may be siphoning pills onto the black market.
Painkillers to Heroin
Though it is always a positive thing to remove doctors who are taking advantage of those living in addiction or who are inadvertently creating new addictions through mismanagement of painkillers, in too many cases, the damage was done long ago. Patients who initially started or furthered an addiction through the use of prescription painkillers may have since turned to the use of heroin. With increased heroin potency on the black market over the last decade, many find that they can experience a high similar to that found in the use of prescription painkillers by smoking heroin. As a result, though heroin is illegal, many former painkiller patients find that it is cheaper and easier to buy than it ever was to get prescription medications. It also means regular ingestion of a drug that is just as deadly as painkillers with a host of new risks and concerns due to variable potency and chemical makeup.
Do you think that removing doctors who are illegally prescribing pills will help to stem the tide of addiction? What other measures do you think would help to address the opioid epidemic in the US?