“The moral test of a government is how it treats those who are at the dawn of life, the children; those who are in the twilight of life, the aged; and those who are in the shadow of life, the sick and the needy, and the handicapped.” – Hubert Humphrey
passionate pachyderms
Pharmacist Steve steve@steveariens.com 502.938.2414
Worst Epidemic in U.S. History? Opioid Crisis Now Leading Cause of Death for Americans Under 50
Start watching this video at 44:00… All of these “over dose deaths” Just chose a number… any old number.. it seems like everyone has their own number that they like… there are so many variables in the numbers that AT LEAST some of them … someone must have pulled them out of their lower posterior orifice… and comparison to deaths in some wars… Not the first mention of the two most LETHAL DRUGS — ALCOHOL & NICOTINE… NO MENTION of the potential of their being addictive. Maybe they are just afraid of the Tobacco & Alcohol industry as they comfortable SUCKING UP to the DEA.
Days after he relapsed on heroin last summer, Patrick Graney received an offer that was too good to turn down.
How would he like to get treatment in a beach town with a hipster vibe in South Florida — with all expenses paid, including airfare from his Massachusetts home? Graney didn’t have to think long. He was on a flight south the next day. Two months later he was dead.
The arrangement — according to interviews with Graney’s mother and girlfriend and saved Facebook messages he sent — was brokered by Daniel Cleggett, a flamboyant figure, and some would say a pillar, in the Boston-area drug recovery community. A former addict who has spent nearly a quarter of his life in jail, Cleggett has turned entrepreneur in the burgeoning treatment industry for people addicted to opioids such as heroin and prescription painkillers.
He presides over an expanding empire of treatment facilities in Massachusetts, but he has also helped recruit addicted young people from Massachusetts for drug rehab centers in South Florida, according to the patients’ families and others who know Cleggett and are familiar with the arrangements. Two of these young men, including Graney, died from overdoses in hotel rooms in the oceanside resort communities where they were sent for treatment.
Cleggett has pulled off a stunning and rapid turnaround for a man who was once homeless. He now drives a sleek, black Mercedes-Benz CLS 400 that retails for more than $65,000, and enjoys cruising his boat around Boston Harbor. Recently, he posted pictures on Facebook of him at opening day at Fenway Park in seats steps from the field, and attending a boxing match at a casino.
The 31-year-old Cleggett refers to himself on Facebook as a former “lunatic, outlaw addict” — but one who has been sober for five years and is now committed to helping others follow his path. In a brief telephone interview, Cleggett said he had no role in Graney going to Florida for treatment — despite the messages to the contrary Graney sent. He declined to answer any questions about brokering in general or his role in helping other people travel to Florida for treatment.
“I help people all day, every day. That is what I do,” he said. “I had nothing to do with whatever place he went to.”
Cleggett is just one player, albeit a prominent one, in a murky network of middlemen, often referred to as marketers or brokers, who recruit and arrange transportation and insurance coverage for desperate young men and women from the Northeast and Midwest.
Patient brokers can earn up to tens of thousands of dollars a year by wooing vulnerable addicts for treatment centers that often provide few services and sometimes are run by disreputable operators with no training or expertise in drug treatment, according to Florida law enforcement officials and two individuals who worked as brokers in Massachusetts. Cleggett refused to say whether he was paid to find customers for Florida treatment centers.
The facilities are tapping into a flood of dollars made available to combat the opioid epidemic and exploiting a shortage of treatment beds in many states. As center owners and brokers profit, many patients get substandard treatment and relapse.
The role of patient brokers in steering addicts to out-of-state treatment centers is now coming under scrutiny from law enforcement, including Massachusetts Attorney General Maura Healey, according to a spokeswoman for her office. “These recruitment operations take advantage of the desperation of people struggling with addiction to refer them to treatment centers not based on their best interest, but in order to get a commission,” Healey said in a statement. “Patients need to access safe and effective recovery options instead of being treated like paychecks.”
Such arrangements can be illegal in some cases under federal and Massachusetts law if facilities pay brokers to bring them patients and if patients are given inducements, such as free travel or insurance, to enroll in a particular treatment center.
Two people engaged in the business of recruiting addicts for Florida facilities said there are scores of people recruiting patients in Massachusetts and neighboring New England states where rates of opioid abuse are high. They spoke on the condition they not be identified for fear of prosecution.
Brokers are primarily paid in two ways, they said. One is a per-head fee — ranging from $500 to $5,000 — for each patient who successfully checks into a treatment center. In other cases, brokers get a monthly fee from a particular facility but must meet a quota of patients to collect payments as high as tens of thousands of dollars.
A change of scenery and pleasant weather are enough to entice some people to head to Florida to detox, the brokers said. However, most can’t afford it, so they are offered “scholarships,” with the patients paying nothing for their travel or treatment.
In addition to sometimes paying for patients’ flights, brokers often help them obtain private insurance, and then pay the premiums on their behalf until treatment benefits are exhausted after 60 to 90 days. The Florida centers frequently bill the private insurers at higher, out-of-network rates that can easily total $10,000 or more a week.
“They get down there, and it’s nothing more than a puppy mill for insurance billing,” said Eric Spofford, founder and CEO of Granite Recovery Centers in New Hampshire, who has learned of the brokering from the region to Florida centers from patients at his facility. “There’s no investment in helping them get better.”
When Graney, who grew up in Milton, Mass., was in Florida last summer, he repeatedly cited Cleggett as the person who arranged for his treatment in messages to four different people obtained by STAT and the Globe.
In a message to a friend on July 22, Graney wrote that after discussing with Cleggett the possibility of treatment in Florida “he had me on a plane the next day” and that it was “all free.” Two days later, Graney wrote to another friend that his treatment was free and “this kid clegget” got him insurance, misspelling Cleggett’s name. Graney then added, “they get paid 4 sendin kids down here.”
On Aug. 3, when a third friend asked him about his treatment in Florida, Graney wrote, “Yea Danny Clegget hooked it up all free.” The next day, he wrote to an acquaintance who runs sober homes in Florida. Of his insurance, Graney said, “sum1 back home sent me down here…but I didn’t pay for it.” When asked who sent him, he responded “Danny clegget.”
In a message to a fifth person, sent just hours before he died, he mentioned a second person who was involved in the arrangement of his treatment in Florida. The identity of that person could not be confirmed.
Graney’s mother, who provided the Facebook messages, and Graney’s former girlfriend said in interviews that Cleggett arranged free transportation and insurance for Graney.
Cleggett insisted in the interview that he didn’t pay for any expenses related to Graney’s treatment in Florida, including airfare and insurance — and that he had nothing to do with Graney traveling there. He refused to say whether he was working with another broker who paid those costs. Asked about Facebook and text messages with Graney, Cleggett said, “Your facts are not true.”
He said Graney was a friend and added, “It’s very unfortunate what happened with Pat.”
The relocation to Florida did little for Graney. He was bounced out of a treatment facility, and two months after arriving, he was homeless and trying to find help on his own. He fatally overdosed in a Delray Beach hotel room with a stranger he met hours earlier at a detox center that turned him away.
“My son would still be alive today if he didn’t get on that plane to Florida,” said Graney’s mother, Maureen.
Maureen and Jack Graney pose in their home in Milton, Mass. Keith Bedford/The Boston Globe
Earlier this month, at a meeting of a community group that gathers regularly to discuss solutions to the opioid crisis, Cleggett sat slumped and expressionless at the front of a room in the Holbrook, Mass., town hall. Burly with close-cropped hair, he was dressed casually in a long-sleeve checked shirt.
Cleggett is a frequent presence at such meetings. An ex-con and a businessman, he can talk the language of inmates locked up on drug-related charges and of state officials working on solutions to the opioid epidemic.
He listened for about an hour while one speaker after another talked about finding sobriety and helping others. Finally it was his turn to speak. All eyes were on Cleggett as he leaned forward over the dais and began to tell his story, loud and rapid-fire.
He told the group that he was jailed for the first time when he was 14 and spent seven of the next 12 years locked up. He was homeless. He abused alcohol and drugs.
Law enforcement records offer additional details of a long and violent criminal history. After his first brush with police at age 14, the charges were dismissed, but over the next decade, dozens more followed. On at least three occasions, he led police on high-speed chases, hitting other cars in one and careening dangerously close to pedestrians in another, court documents show.
One chase, when he was 20, occurred just hours after he was released from jail after serving a six-month sentence for assault and battery with a dangerous weapon, according to court documents.
In his mid-20s, Cleggett went to a retreat modeled on the 12-step Alcoholics Anonymous program. The treatment clicked. He was soon managing a sober house in Maine where addicts in recovery lived together. Those experiences prompted him to open similar treatment facilities in Massachusetts, he told the group in Holbrook. He now operates five facilities with 100 total beds, he said.
He recently opened a 12-step retreat in a large home in Wakefield near a lake. He has a sober home in Weymouth and two other facilities in nearby Quincy. There are many people who credit Cleggett and his facilities with helping them get sober.
Cleggett paused, seeming to fight back tears, when talking about friends dying and his current work.
“If these kids got the help I got,” he told the group, “it didn’t have to be this way.”
Patrick Graney (right) with his sister Elizabeth in 2016. Graney family
A photo of Daniel Cleggett posted on his Facebook page. Facebook
Patrick Graney’s struggle with opioids began at his junior prom at Milton High School in suburban Boston. A friend offered him OxyContin, and his life changed instantly. He was quickly hooked on the drug and dropped out of school halfway through his senior year.
Graney was a gifted athlete — a star pitcher in Little League and a high-scoring hockey player. He had a thick Boston accent and a quick wit. As he descended into a decade-long addiction to opioids, his appearance changed as he put on weight and drifted from halfway houses to homelessness.
Court records reveal a record shared by thousands of others addicted to opioids: drug and theft charges, short stints behind bars, and in and out of treatment programs.
Somewhere along the way, Graney met Cleggett, when they were both using drugs and occasionally seeking treatment. After Graney started using drugs again last year, Cleggett sent him numerous text messages offering to arrange treatment for him in Florida, said Graney’s former girlfriend, Kerri Jones. He also offered to help get Jones treatment in Florida, she said, and he had previously arranged for her relative to get treatment there.
“The way it was explained to both of us is that it is a fresh start in a new state,” she said of Cleggett’s pitch. She said Cleggett sent photographs of a facility that looked like “a five-star resort.” There were daily yoga sessions, she said he told them, and clients were given money to go the movies.
Cleggett told them everything would be paid for, Jones said. They would be in a private insurance plan — not Medicaid, the government insurance program the two had used in the past and that pays far less for treatment than commercial insurers. If anyone questioned them about their insurance, Cleggett told them to say they were unsure about the details or they were covered by their parents’ plans, she said.
Screen grab of a text conversation between Cleggett and Graney. Courtesy Maureen Graney
About three-quarters of the rehab center patients with private insurance like Graney are coming to Florida from out of state, according to law enforcement officials in Palm Beach County. The Affordable Care Act, which both mandates payment for drug treatment and makes private insurance easier to obtain for young people, has created a pot of money that’s being exploited by unscrupulous treatment centers, according to those officials.
“There will always be people dying of drug overdoses, but it doesn’t have to be exacerbated by laws intended to get people healthy that have been misused to cause more deaths,” said Dave Aronberg, the state attorney for Palm Beach County, who created a task force to investigate abuses in the treatment industry that thrives in his area.
Graney’s mother said her son told her that Cleggett was arranging free travel and insurance for his treatment in Florida. He sent her a copy of a text message from Cleggett asking for his date of birth and other information so he could book his travel. Graney then sent his mother another message from Cleggett providing the details of his flight on American Airlines from Boston to Fort Lauderdale the next day.
Graney had been in and out of facilities in Massachusetts. When he was 19, Graney’s parents borrowed $10,000 to send him for treatment at a beachfront rehab in southern California. Nothing stuck.
His family focused on keeping him alive, hoping one day he would decide that he had enough with drugs, or find a treatment facility that worked for him.
Maureen Graney was suspicious of the Florida arrangement, but there was little she could do to stop her son from going.
The Florida Recovery Group in Delray Beach, Fla. Josh Ritchie for STAT
In the end, the lure of Florida was an illusion. A van was waiting when Graney arrived at the airport and he was brought to a treatment facility called Florida Recovery Group in Delray Beach, according to insurance records as well as friends and family.
The plan was for Jones, Graney’s ex-girlfriend, to follow him there a few days later. Graney told her not to bother, she said. The facility was not what he expected, he told her. He said he was sticking it out so he wouldn’t upset Cleggett.
After a few weeks in Florida, Graney relapsed. He connected with a high school friend from Milton, who was also struggling with opioid abuse, and a girl from Massachusetts. They had no place to stay and slept on the beach. Graney then made a telephone call and was picked up by a man in a sedan, who took him back to Florida Recovery Group, according to Maureen Graney.
Although he was back at the facility, there were problems with his insurance. Graney messaged Cleggett via Facebook on Aug. 24 to find out what was going on.
“Hey Watsup buddy,” Cleggett responded when Graney reached out.
“They ask me about my insurance today cause theres no payment on it,” Graney replied. Cleggett told him he would look into it and later told him, “All set bud.”
He wasn’t. Graney’s insurance was terminated.
Jan Goodman, the CEO of Florida Recovery Group, confirmed that Graney was a patient there, after Maureen Graney signed a privacy waiver allowing him to speak to Graney’s case. He said in a statement that Graney received “an excellent level of care.” The center does not allow people to be kicked out for lapsed insurance and Graney stayed from Aug. 24 to Sept. 7, with the understanding he would pay for his treatment later, Goodman said.
Graney was ultimately discharged after it was reported that he brought heroin into the facility and gave it to another patient, who overdosed, Goodman said.
He said he had never heard of Cleggett and that the Florida Recovery Group does not use patient brokers. The center has no history of complaints filed with Florida’s Department of Children and Families.
On Aug. 29, Graney asked Cleggett via Facebook if he could send him bus money to come home. Two weeks later, when Graney was still in Florida, his mother began working to get her son home. She planned to buy him a ticket on a Greyhound bus leaving at 12:35 p.m. on Sept. 10. First, she had to find him a place to stay and booked him a room for the night of Sept. 9 at the Residence Inn in Delray Beach.
Patrick Graney, however, was struggling.
A friend of his from Boston, who spent time in jail and detox with him, was also in Florida and saw Graney around this time. Graney was in bad shape, he said, and had recently drunk kratom, a plant that is often brewed and produces opioid-like effects.
On the evening of Sept. 9, Graney went to a Delray Beach detox center seeking help. He was turned away because no beds were available, according to a police investigation of his death. He then checked into the hotel room, bringing along a man and a woman he met at the detox center. At 2:12 the next morning, the man called 911 to report Graney was unconscious on a couch with a brown liquid coming from his mouth.
The stranger attempted CPR until paramedics arrived. It was too late. Graney was dead from what the medical examiner later determined was acute cocaine intoxication. He was 30 years old.
Patrick Graney (center) with his parents. Graney family
The sunny getaway promoted by Cleggett and other brokers is hardly paradise. Palm Beach County is so packed with addiction treatment facilities that many call it the “Recovery Capital of America.”
At the Dunkin’ Donuts on Atlantic Avenue in Delray Beach, white vans carrying patients to treatment facilities pull in and out of the parking lot throughout the morning. People spill out of the vans, grabbing a quick cigarette break or a cup of coffee. They reload and head off to rehab centers in bland office parks, far from the white sand beaches and trendy restaurants and galleries.
Officials estimate that Delray Beach alone — a city of 16 square miles with 67,000 residents — has more than 800 treatment facilities. And within five miles of the city, according to one rehab operation, there are hundreds of Alcoholics Anonymous meetings every week.
Cities such as Delray Beach are a draw for out-of-state residents seeking recovery because they are walkable, the weather is warm, and the people are friendly. It’s a perfect place to come get sober — or get rich off those trying to do so.
“It’s where the money is,” said Aronberg, the state attorney. “This is a hotbed of corruption.”
The problem had become so pressing by 2016 that the state appropriated $275,000 to create a task force in Palm Beach County to go after corrupt operators, including those engaged in patient brokering. Earlier this month, two sober home owners investigated by the task force were sentenced to prison as part of a money-laundering scheme. Patients at those homes were allegedly given drugs, and female patients were sexually exploited.
Numerous centers are run by people with little expertise in substance abuse treatment or with questionable backgrounds — staffed by people like Dr. Evan Zimmer, listed in a court record last year as medical director of Bright Futures Treatment Center in Boynton Beach. That’s where Cleggett arranged for Evan McLaughlin of Plymouth, Mass., to go for treatment, according to McLaughlin’s mother, Tina, who said she paid for his travel and insurance.
Evan Mclaughlin, left, of Plymouth, Mass., died in a Florida hotel room after seeking treatment for his addiction to opioids. Facebook
Tina McLaughlin grew up with members of Cleggett’s family in Braintree, Mass. Her son was admitted on June 10, 2016, under Zimmer’s medical direction, according to a document filed as part of a heroin possession case against McLaughlin in Massachusetts.
Zimmer, a psychiatrist, had his medical license suspended for three years beginning in 2012 after numerous complaints he was possibly under the influence of drugs and alcohol, according to state medical board records.
It was the second serious sanction from the medical board. His license was revoked in 1985 after Zimmer was charged with driving under the influence of drugs following an accident, and was subsequently found to have written prescriptions in the names of patients he had no record of treating. Police found hundreds of prescription pills in his vehicle, including Valium and Percocet. He received a new license in 1991, according to board records.
Zimmer said his own experiences with addiction make him a better practitioner. He said he didn’t know how McLaughlin ended up in Florida, but added he is opposed to patient brokering. The facility’s management did not respond to a request for comment. Bright Futures has no history of complaints with the state Department of Children and Families.
Tina McLaughlin said her son initially did well after arriving in Florida. He had struggled with an opioid addiction since he was prescribed painkillers as a teenager following a hockey injury that fractured his neck. By the time he was 16, he was shooting heroin.
McLaughlin said her son was managing two sober homes, where people in recovery live together, and had just signed a contract to be a marketer for a rehab facility. She described that job as “doing what Danny does.”
“As far as I knew, he was doing great,” she said of her son.
Just after Thanksgiving in 2016, Evan McLaughlin relapsed without warning, his mother said. His body was discovered by a housekeeper in a Boynton Beach hotel room on Dec. 1. On a countertop, police found two syringes and a burnt spoon. The medical examiner determined he died from an overdose of carfentanil, a particularly dangerous opioid originally developed as a tranquilizer for large animals such as elephants.
Zimmer said McLaughlin didn’t comply with treatment in Florida and was using steroids. “The writing that was on the wall for Evan would have been on the wall regardless of where he was,” said Zimmer. “It was about who he was rather than where he was.”
Tina McLaughlin doesn’t blame Cleggett for her son’s death at age 24 and remains friendly with him.
Bright Futures Treatment Center in Boynton Beach, Fla. Josh Ritchie for STAT
Cleggett literally wears his spirituality as a sleeve. His right arm has a tattooed image of Jesus nailed to the cross. His entire back is tattooed with an elaborate illustration of Satan and Jesus arm-wrestling.
At the Holbrook meeting last month, he said he will be sober five years this summer and credited his success to following the 12-step program and finding God. He named his company A Vision from God LLC, and he is an active member of Life Community Church in Quincy and recently helped the church move into a new building.
“I used to be just a junkie convict and I handed my life over to God,” he told the group. When the meeting ended, he walked outside and drove away in his Mercedes.
Could this suggest why Legislators/Legislatures do nothing about the 100,000/yr preventable alcohol related deaths or the 450,000/yr preventable Nicotine related deaths ? Can you be part of the solution… if you are part of the problem ? Could all of the various legislatures be focusing on the “opiate epidemic” to distract from the real “epidemic” of preventable deaths because they personally could lose access to their “drug of choice” ?
Dallas police arrested the Texas House Democrat voted “Freshman of the Year” late Tuesday night for driving while intoxicated.
Officers, responding to message that a vehicle hit a tree, later learned that the allegedly drunk driver was state Representative Victoria Neave (D-Dallas).
Reportedly, she did not cooperate with law enforcement who arrived on scene. The arrest warrant described Neave, 36, as having a strong odor of alcohol, unsteady, and with bloodshot eyes and slurred speech, WFAA reported. Officers also documented the state lawmaker’s behavior as uncooperative, refusing to perform field sobriety tests, and give breath or blood samples. According to police records, Neave repeatedly told officers in slurred speech: “I love you and I will fight for you and I’m invoking my Fifth Amendment rights.”
Officers booked her into the Dallas County Jail at 3:30 a.m. (CDT) on Wednesday where she remained, waiting to see a magistrate. However, on Wednesday, shortly before 2 p.m., Neave took to social media with a public Facebook apology. She stated: “Last night, I disappointed my family, my constituents, and my supporters. I disappointed myself. I’m deeply sorry. I’m so grateful that no one was hurt. I will accept full responsibility for my actions and I will work to make this right.”
Ironically, Neave participated in a Mesquite-held event promoting safe driving on Sunday, June 4.
Screengrab credit: Twitter/@JuanDel20662323
The often outspoken freshman representative has maintained a highly visible profile during the state’s 2017 legislative session. In April, she marched in Dallas against Texas sanctuary city legislation, Senate Bill 4, which Governor Abbott since signed into law. Breitbart Texas reported she tweeted: “Eleven years ago, I marched w/my family. This time, I march as a State Representative fighting anti-immigration legislation at #txlege.”
A few weeks later, she led a hunger strike to oppose SB 4, asking other Democrat lawmakers and open border advocates to join her, as was reported by Breitbart Texas. She was also the organizer of the Dallas Women’s March and Texas House Democratic Caucus recently named her “Freshman of the Year.”
On Wednesday morning, Dallas County Democratic Party Chair Carol Donovan responded to the news of Neave’s arrest by issuing a statement:
We understand, and are thankful, that no other person was involved or injured in the accident. Nevertheless, we look forward to speaking with her regarding the facts of her case and to insure she is alright. We wish her the very best and pray for her swift recovery so that she can resume her strong representation of the citizens of House District 107.
Neave’s district encompasses East Dallas, Mesquite, and Garland. By trade, she is a lawyer with a practice in Dallas.
The National Council on Alcoholism and Drug Dependency estimates that over 23 million Americans (age 12 and older) are addicted to alcohol and other drugs. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), just under 11% (2.5 million) received care at an addiction treatment facility in 2012. SAMHSA also estimates that the market for addiction treatment is about $35 billion per year.
The vast majority of addiction treatment is based either partially or entirely on the 12 Steps of Alcoholics Anonymous (AA), but is there scientific evidence to support AA as a clinical treatment? Should addiction treatment centers make enormous profits by simply funneling substance abusers into the free fellowship of AA?
These are the primary questions behind The Business of Recovery ‒ a new documentary that opened earlier tonight at the Newport Beach Film Festival. Like many documentaries, there are some startling statistics ‒ including this provocative one delivered early in the 81-minute film.
I became the Director of the Alcoholism Treatment Unit at Harvard’s McLean Hospital. I’ve probably treated a couple of thousand people who have one addiction or another. Almost all residential treatment programs in the United States are 12 Step based, so their effectiveness will depend entirely on whether 12 Step programs work and the statistics for AA are not good. It is helpful for 5‒10% and that’s a good thing. That’s 5‒10% of people who are being helped by A.A. ‒ it’s a lot better than zero percent ‒ but it shouldn’t be thought of as the standard of treatment because it fails for most people ‒ for the vast majority of people. Lance Dodes, MD ‒ Addiction Expert & Author ‒ Harvard Medical School Graduate in The Business of Recovery
As a part of the annual film festival in Southern California, the film is being shown again Tuesday evening and the producers are working toward a broader, public release later this year. The critical assessment of addiction treatment is both timely and sobering.
12 Step programs are very popular, but if you’re looking for figures and randomized trials and scientifically rigorous studies of how they work and for how many people they work ‒ you will not find those studies. You will find anecdotal evidence ‒ for people that it did work [for] ‒ but unfortunately we don’t have the scientific basis to say how many of all those people that tried a 12 Step program ‒ how many of those did not succeed. Ruben Baler ‒ Health Scientist, National Institute on Drug Abuse in The Business of Recovery
The film is timely because the market does seem poised for accelerated growth based on a number of key attributes.
A real‒estate component that can easily scale to any size ‒ including the private, single family residence (called “sober living homes” ‒ by one estimate over 10,000 in Arizona alone).
Almost no federal, state or municipal oversight for credentials or treatment pricing.
Advertised success rates of 80% (or higher) with no scientific evidence.
This last one is the most troubling since addiction is often couched in clinical terms like “disease” and “treatment.” The AMA first defined alcoholism as an illness (1956) and then a disease (1966), but there’s little scientific evidence to support a disease diagnosis. That also makes it challenging to categorize any program based on the 12 Steps of AA as clinical treatment ‒ even if there is a billing code.
AA is not really a treatment ‒ it’s a fellowship. If you go to your doctor to be treated for cancer or heart disease you expect your doctor to be doing what the science says is the best treatment available for what you have. That has not been the standard in addiction treatment. William R. Miller, PhD ‒ Emeritus Distinguished Professor University of New Mexico in The Business of Recovery
Two events last year (not included in the documentary) also signal a healthy and growing commercial industry.
The first was the merger between two iconic treatment brands ‒ the world-renowned Betty Ford Center and Hazelden (founded in 1949). The combined non‒profit entities are now simply the Hazelden Betty Ford Foundation. As with many non‒profits, there are no outside investors to satisfy, but the salaries of key execs are often in the high six‒figures (and well above averages for even practicing physicians ‒ any specialty).
The second event was the IPO last fall of AAC Holdings, Inc. ‒ which is really the first attempt at a publicly traded company exclusively for addiction treatment (the AAC stands for American Addiction Centers). The quoted price range for a 30-day “treatment plan” (again ‒ revolving largely around AA) was $15,000 to $26,000. The Hazelden Betty Ford Foundation is easily twice that amount and other, more exotic treatment facilities (often catering to celebrities in swank resort‒style locations) can easily run into the low six‒figures.
As a publicly traded company ‒ something that Betty Ford and Hazelden have both intentionally avoided ‒ AAC has already hit some significant headwinds in the form of accusations, short‒sellers and legal scrutiny. One of the reasons is that a sizable source of high‒margin revenue appears to be urine testing which can be used in high‒volume and is relatively easy to game for serial revenue and profits.
On March 3, 2015, SeekingAlpha published an article asserting, among other things, that AAC Holdings: (i) conducts unnecessary urine drug tests that contribute to its outsized margins; and (ii) lowered its provision for doubtful accounts after acquiring a revenue management company from its CEO and president’s spouses, which boosted its net income before its IPO. On this news, shares of AAC Holdings fell $3.54 per share or over 10% from its previous closing price to close at $30.37 per share on March 3, 2015, damaging investors. The Rosen Law Firm (announcing its investigation into potential securities claims on behalf of investors)
The lack of certification also supports a very low barrier to becoming an addiction treatment counselor.
There is no mandatory national certification exam for addiction counselors. The 2012 Columbia University report on addiction medicine found that only six states required alcohol and substance-abuse counselors to have at least a bachelor’s degree and that only one state, Vermont, required a master’s degree. Fourteen states had no license requirements whatsoever ‒ not even a GED or an introductory training course was necessary ‒ and yet counselors are often called on by the judicial system and medical boards to give expert opinions on their clients’ prospects for recovery. Gabrielle Glaser ‒ The Irrationality of Alcoholics Anonymous (The Atlantic)
So we developed this history of providers being people who are themselves in recovery ‒ originally with no educational requirement at all. In New Mexico, we now have a Bachelors degree required to be a substance abuse counselor and it was quite controversial to do that. I don’t know of any other life‒threatening illness where it’s controversial if you should have a college education to treat it, but it has been in the addiction field. William R. Miller, PhD ‒ Emeritus Distinguished Professor University of New Mexico in The Business of Recovery
Even the judicial system contributes to the confusion by often mandating AA attendance to offenders who arrive in court as the result of criminal charges associated with substance abuse (most commonly driving under the influence).
It is completely inappropriate and dangerous for courts to be mandating AA treatment. This amounts to malpractice. It’s medical malpractice by the judge. It’s as foolish as if the judge said to you ‘ok ‒ you have an infection ‒ I mandate that you take penicillin because I believe that’s the effective drug. Lance Dodes, MD ‒ Addiction Expert & Author ‒ Harvard Medical School Graduate in The Business of Recovery
Outside of AA, newer alternatives are also gaining broader awareness, acceptance ‒ and real scientific evidence of efficacy (JAMA meta‒analysis here).
I made the documentary One Little Pill to help spread awareness about a treatment for alcoholism that literally saved my life. It’s called the Sinclair Method and it’s based on using the FDA approved generic drug naltrexone to create an effect known as pharmacological extinction. The success rate is very high ‒ nearly 80%. I also started a non‒profit called the C3 Foundation as a more direct way to help people find the clinical information and doctors that support the use of this life saving treatment. Claudia Christian ‒ Actress
New drugs will also challenge the conventional wisdom around AA being the primary ‒ often only solution to substance abuse. There is also the very real possibility that AA is not helping people with other mental or behavioral disorders that can be easily masked by substance abuse. The AA mantra of “more meetings” could well be counterproductive to many who arrive at the fellowship with a wide range of psychological, behavioral and other clinical issues.
Ultimately, whether AA is scientifically effective ‒ for whom and how many ‒ is a secondary issue. No one argues that it has helped to destigmatize substance abuse and it definitely helps some. Unlike for-profit treatment plans, however, AA has never had fees or dues of any kind since its inception in 1935 ‒ and likely never will. The real issue then is a $35 billion a year industry that’s largely based on funneling substance abusers into the free fellowship of AA ‒ or simply providing large doses of AA meetings themselves.
To be sure, there’s a lot of hand‒waving, glitzy marketing and pseudo‒science to justify the enormous cost associated with treatment plans, but little proof of scientific efficacy. Court mandated attendance isn’t profitable, of course, but it does legitimize the process of funneling people into A.A. in ways that also benefits the industry at large.
As highlighted through several tragic stories in the documentary, family members are naturally eager to spend whatever money they have ‒ and often money they don’t have ‒ in desperate attempts to save loved ones from the harsh realities of substance abuse and addiction. Preying on this strong desire is the very real and profitable business of recovery ‒ and one that the documentary exposes with clear‒eyed and sober detail. I do hope the film finds a way to a larger public audience. There’s still so much we don’t know about substance abuse and addiction ‒ except ‒ at least according to one compelling film ‒ how to turn it into a very lucrative business.
They liberally throw around verbs and adjectives that makes one think that things are not only POSSIBLE.. but.. they suggest that bad/lethal outcomes are ABSOLUTE. They go to a area that is KNOWN for high incidents of drug/substance abuse and claim that MORE PEOPLE are DYING from pts taking the combo of certain medications.. they DO NOT STATE.. if the pts were taking the combination of medications as prescribers OR was taking more than prescribed and combining them with other substances including alcohol.
They claim that 28,000 died from opiate OD in 2014… and HALF was from prescription opiates.. SO, 14,000 died from a OD of ILLEGAL OPIATES ??
More people died from prescription drug overdoses in 2014 than any other year on record.. WHAT MEDICATIONS were involved ?? Controlled med prescriptions typically account for 15%-20% of all prescriptions… I thought this article was about the dangers of the opiate/benzo combo ? Just throw in an OBSCURE FACTOID ???
The number of patients prescribed both an opioid pain reliever and a benzodiazepine increased by 41 percent between 2002 and 2014.. SOUNDS SCARY ?… that is only a average of a 3% PER YEAR increase.. Doesn’t sound so bad now ? Our overall population increases abt 3%/yr.
This is NOT A LAW or a RULE… prescribing these two medications is still up to the prescriber and untold number of medications have a BLACK BOX WARNING from the FDA that prescribers use EVERY DAY.
Mixing prescription opioid painkillers with a class of drugs that includes popular sedatives such as Valium and Xanax can cause a fatal overdose, U.S. health officials warned Wednesday.
The U.S. Food and Drug Administration said it will require “boxed warnings” on 389 different products to inform health professionals and the public of this potentially lethal drug interaction, FDA Commissioner Dr. Robert Califf said during a media briefing.
Benzodiazepines — which include Valium and Xanax — affect the central nervous system, and are used to treat conditions like anxiety, insomnia and seizures, said Dr. Doug Throckmorton, deputy director of regulatory programs with the FDA’s Center for Drug Evaluation and Research.
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Surgeon general’s letter to clinicians in crusade against opioid abuse
If benzodiazepines are combined with opioid medications such as oxycodone (Oxycontin) and hydrocodone (Vicodin), a drug interaction can occur that could result in coma or death, Throckmorton said.
“Nearly one in three unintentional overdose deaths from prescription opioids also involve benzodiazepines,” said Baltimore Health Commissioner Dr. Leana Wen, who worked with the FDA to produce the new warning.
Products that will carry the boxed warning — the strictest one possible — will include benzodiazepines, prescription opioid painkillers such as oxycodone and hydrocodone, and cough medicines that contain opioids, the FDA said.
Combining these drugscan dangerously depress a person’s breathing and make them extremely sleepy, the FDA warned.
Califf said he heard about this threat during a recent trip to the Appalachians, a region hard hit by the prescription drug abuse epidemic.
“One thing really stood out to me, that I heard consistently from each place on our trip — benzodiazepines and opioids were an increasing threat for overdose as seen in their emergency departments,” he said.
“This rise in overdoses and deaths due to the combined use of these products isn’t new,” Califf added. “Communities have been seeing this trend for some time, but ultimately we needed data in order to act today.”
A review conducted by the FDA identified a troubling trend in which patients are often prescribed these drugs in combination, even though they can interact in dangerous ways.
The number of patients prescribed both an opioid pain reliever and a benzodiazepine increased by 41 percent between 2002 and 2014. That translates to an increase of more than 2.5 million opioid painkiller patients also receiving benzodiazepines, Throckmorton said.
“We know approximately half of concurrent benzodiazepine and opioid analgesic prescriptions were dispensed to patients on the same day and prescribed by the same health care provider,” Throckmorton said.
More people died from prescription drug overdoses in 2014 than any other year on record, according to the Centers for Disease Control and Prevention.
Opioids killed more than 28,000 people in 2014, and at least half of those deaths involved a prescription drug, the CDC says.
Doctors routinely prescribe benzodiazepines along with opioids, unaware of the potential overdose risk, Wen said.
“If a patient was in a car accident and experiencing neck pain, a clinician might prescribe opioids for the pain and benzodiazepines for muscle spasms,” she said. “A patient who is on benzodiazepines for anxiety disorder might get prescribed opioids for pain relief, and vice versa.”
Wen urged doctors to heed the new warning, and patients to review the drugs they’re taking.
“I urge patients to look inside your own medicine cabinets and ask, ‘What is this medication for? Do I need it? What are the side effects? Could there be a dangerous combination?’ “ she said. “Please speak to your doctor if you have questions or concerns.”
Hi Steve My name is xxx and i guess im reaching out for help, let me start off and tell you a little, about myself. Im a 45 year man, that got hurt on the job, had 85 pound package fall on top of me, i worked for ups! At the time of my accident, I was going to school to become a certify mechanic.and i was part owner of janitorial bisness. while going to school and putting in my hours at used car dealership intill i finished school, Yes i know your going to ask, how is it possible to work 3 jobs and go to class. and get enough sleep, i didn’t get much, but all i wanted to do was better myself for my family, My family and friends are the most important things in my life, my other love was cars. building racing them. My accident happened in 1992, my injuries were so intense i was in a wheel chair for the first year. at one point that doctor i was with, said i may never be able to walk agin. i was 23 when i was injured. so i rehabbed for 5 years, and yes at one point i was put oxy cotton, being young and thinking ok he’s a good doctor, at the time i was persribed those meds, i didn’t know how additive they were. So my next vist i requested not to be put something so strong and so additive. i ask for hyrocodone, it seemed to help atleast enough for me too give some type of relief. So after a long law suit and 5 years of hard work!!!!!! and rehab i was able to get back on my feet, but that’s about it. i won my law suit, but the kicker is i had to stop going to school and yes lost all my jobs, My family stepped up and took care of me. never reached out for a free ride
never got medacade. So after several years went by. i never even asked for disabilitie, i found a job that fit the restrictions that my doctor told me not to step over. and stayed on meds while making a whole life changes. eveything i did to take care of my family i couldnt do any more, So being im kinda independent person and i was raised to work hard and respect what god has giving. i stayed on the meds at that time of corse hyrocodone 10 500. and it was working, atleast enough to still be a proud father and provider for my family. well my doctor retired and closed his office, So im going to say maybe 3 or 4 years went by. I did my rehab and i even made the biggest mistake of my life, I need to know what my body could handle. i stopped tacking the meds. that lasted a very short time before my back gave out again!!!!!! Yes back to where i started back to not be able to walk. So i had a cropractor friend. that stepped up to help me, after having seeing all my ex rays and mri reading. he told me he didn’t feel comfortable with doing any type of that feild. due the damage that im suffering from eveyday day in day out. So the situation was ok intill just resent. My cropractor friend was able to get me in with a pain management doctor. ive been with this same doctor since 2009, we sat down and came up with a plan to get me though my bad painful days. All i asked of him is please dont give anything that my cause to be a junky. im just looking for some relief from being in so much pain, of corse surgery has been my biggest problem. the surgery there wanting to do, all my resuch and talking with other patients that had the same surgery. They all told me they hurt worse after the surgery. like 2 people said it helped. so after my resuch i didn’t feel comfortable with any surgey, due to the lack of positive feedback. So this were im at now, still in more pain then anybody should have to deal with, because im not looking to get high off the meds i just wanted to manage my pain. So ive been on soma and hyrocodone 7.5 knowing yes i could get way stronger meds, but this is working, yes im still in pain that never stops. i know i could get much stronger meds, but i choice not too. So now you know alittle about why im reaching out for help. My problems started last year, My doctor had me on somas and the pain meds since early 2010. well last year walgreens told me i couldnt have both its considered a cocktail. they told me one or the other.My first question was my doctor wrote me this script and your telling me NO, how does this make sense, if this the case why am i paying my doctor when can over rule what he thinks is best. of corse no answer that made any sense to me was giving. So because i was so scared of losing my pain meds. i took the hit. but wait i went back to my doctor on my normal monthly visit. he said don’t worry about it and wrote 2 scipts and sent me to his pharmacy, ok no problems well that didn’t last long before they closed theres door’s. ok i know your going holly crap this a long email. but i dont know what to do. So in May 5 i went to my apointment like every month. took my scipt into the same walgreens like ive always have. the pharmacist ask me like 5 times are these the only meds you get, and said yes, and she kept asking that same question. So i told about a year and half ago, you took my soma away, she ask why, and i told her that walgreens says thats a cocktail. she said i dont understand why they took them away, its not a benzo. of cores, i asked whats a benzo she said couple names zan x and some other meds i can’t remember. So i asked so your telling me, i can have my soma back if my doctor is ok with it. she said yes. So this is were we are at now, today was my opponment june 5 went in, spoke with my doctor about the somas. he had no problems. So i go to same walgreens, and this is we’re things get interesting. So the pharmacies, starts to explain that in the future there might be a problem in the near future we will not fill any of your scripts, i ask why this is a long trem injury. and this is how we’ve been able to manage my pain, all she would tell me is there rules have changed, i understand your rules have changed and im trying to respect them. but if you decide to take me off what my doctor is writing me, how can you say no, she agreed that my doctor is trusted and a good doctor. but your not going to fill my on time doctor’s persribed script. I hope i gave you enough information to give some adivce. its so important to me that i get some kind of answers please feel free to call me tex email. xxx-xxx-xxxx. thanks for any help and your time have a blessed day
I would be nice if all healthcare professionals – especially pharmacists – were on the same page with the SAME ANSWER(S) !!!
Guess where the word/description “COCKTAIL” comes from ??? How about the DEA ? They have stated that there is NO VALID MEDICAL USE for the combination of a opiate – muscle relaxant – benzo..
The “street name” for the combo of Hydocodone/Benzo/Soma is referred to as “The Holy Trinity”.. Other combinations – including with alcohol – have different “street names”.
Of course, there is always that rare incident that a particular pt would have a adverse reaction to just about any medication, or combination of medications. If a person is taking way above average of a combination of medications – and perhaps alcohol – almost certain serious adverse reactions – even death – can happen.
What seems to be at play here is that some pharmacists and chain pharmacies are taking the description of these adverse interaction and jumping to the conclusion that when taken as prescribed MAY, MIGHT, COULD, POSSIBLY cause adverse reactions and inserts the “action word” for when people take excessive combinations of these medications “CAN” cause adverse interactions.
There are no BLACK/WHITE drug dosing problems when dealing with human beings… but.. these healthcare professionals apply the WORSE CASE to EVERY PT getting these medications in particular combinations.
Apparently their practicing “aggressive CYA”… if you JUST SAY NO… there is no chance of anyone having an adverse reaction to the medications.. of course, the adverse reactions for a pt not having their health issues receiving proper therapy. Of course, those healthcare professionals who are participating in this denial of care… WON’T FEEL A THING !!
SALT LAKE CITY — Two Utah doctors who were among the most prominent advocates of using opioids to treat chronic pain are now entangled in a spate of lawsuits filed against opioid manufacturers in several states.
In one of the most high-profile lawsuits to date filed last week by the Ohio Attorney General, Salt Lake City pain researcher Dr. Lynn Webster and University of Utah anesthesiologist Dr. Perry Fine are named as part of a “small circle of doctors” with ties to the pharmaceutical industry who supported chronic opioid therapy in books, articles, speeches and educational seminars in the 1990s and 2000s.
The Ohio lawsuit does not name Webster or Fine as defendants but instead names them as part of a larger case the state is building against five pharmaceutical companies for deceptive marketing that downplayed the risks of prescription painkillers like OxyContin.
According to the CDC, Utah ranked seventh in the country for drug overdose deaths between 2013 and 2015. Approximately 24 Utahns die every month from overdosing on prescription painkillers, according to the Utah Department of Health. In 2015, 282 Utahns died from prescription opioid overdoses — about six per week.
Ohio, likewise, consistently ranks near the top of drug overdose rates.
The Ohio complaint alleges that drugmakers used “key opinion leaders” like Webster and Fine to spread statements about the risks and benefits of opioids, helping to fuel the prescription painkiller and heroin crisis responsible for the deaths of more than 3,000 people in Ohio last year.
“Our office believes the evidence will show that drug companies used front groups, official sounding communications and authority leaders to promote a message that is different from what would be on the warning labels,” Dan Tierney, spokesman for the Ohio Attorney General’s Office, said.
Webster and Fine are also named in a lawsuit filed by the city of Chicago as opinion leaders, but are not defendants in that case. They are named as defendants in a similar case brought by several counties in New York against pharmaceutical companies.
Both doctors objected to the claims in the lawsuits and said they did not downplay the risks of opioid use to patients or other doctors.
“Whatever claims are being made are absolutely false,” said Fine, who practices at the Pain Management Center at University of Utah Health. “That’s it.”
“Chronic pain is a very serious public health problem and … substance abuse and misuse are equally significant and public health problems. And my efforts as a physician have always been to follow my duty to optimize the health and well-being of people with illness or injury.”
Webster, who works as the vice president of scientific affairs at research organization PRA Health Sciences, called the Ohio lawsuit’s claims regarding his work “baseless.”
“I have probably, as much as anybody in the country, worked to try and prevent people from harm and all of my educational materials and lectures were about the risk of opioids,” Webster said.
Webster and Fine were known throughout Utah and the U.S. as prominent pain experts in the ’90s and ’00s.
Both have previously served as presidents of the American Academy of Pain Medicine, a doctors’ group. Webster also developed a risk-screening tool that was used in many states’ opioid prescribing guidelines, including Utah’s 2009 overhaul to make guidelines stricter.
The Ohio complaint claims that “key opinion leaders” like Webster and Fine were “selected, funded and elevated by (the pharmaceutical companies) because their public positions supported the use of opioids to treat chronic pain.”
Among other things, the lawsuit mentions a DEA probe that had targeted Webster in 2010, spurred by the number of patients in his former pain clinic who overdosed on opioids. The DEA closed the case without charges in 2014.
The lawsuit also pointedly criticized Webster for promoting a concept called “pseudo-addiction,” the notion that some patients who exhibit addiction-like behaviors may simply be undertreated.
In a 2007 book about managing pain and opioid abuse, Webster said that when faced with signs of possible addiction, “in most cases” increasing the dose to see if the patient needed more of the drug “should be the clinician’s first response.”
According to Andrew Kolodny, co-director of Opioid Policy Research at the Heller School for Social Policy and Management at Brandeis University, the concept of “pseudo-addiction” came into vogue in the 1990s as doctors began freely prescribing opioids.
“Primary care doctors were being told that true addiction is extremely rare,” Kolodny said.
But then those doctors would see patients coming back looking for more doses at higher levels. That’s where “pseudo-addiction” came in, Kolodny said. Under that theory, patients seeking higher doses, acting like an addict, were often not addicts at all. They were, rather, suffering from severe pain and needed higher dosage.
Kolodny declined to comment on any individual doctors, but he was sharply critical of the concept of pseudo-addiction.
“To tell doctors that if your patient looks addicted you should give them more?” he asked incredulously. “That concept must have killed many people.”
Webster acknowledged that pseudo-addiction “became an excuse sometimes to provide more medicine.” He also acknowledged that doctors had learned more about opioids over the past 15 years.
“There certainly was a time we thought we could eliminate pain and provide people a quality of life by giving them whatever we needed to,” Webster said. “And I think that we recognize that that’s not the case.”
But “I think today there is an attack on people in pain,” he added. “If they’re using an opioid, they’re stigmatized. If you’re prescribing an opioid, you are often accused of contributing to a huge social problem, and I don’t think that is fair.”
The plunge into using opioids to treat chronic pain occurred with very little research or forethought, according to Michael Von Korff, a senior investigator at Kaiser Permanente Washington Health Research Institute who researches opioid risk reduction.
“For nearly 25 years we were acting on expert judgment, rather than on science,” Von Korff said.
Von Korff views the mistakes as well-intended treatment, and he puts blame on institutions like the American Pain Society and the American Academy of Pain Medicine, on the industry which pushed to expand usage, and on the doctors who helped normalize it.
Von Korff cites a 1996 consensus statement by the American Academy of Pain Medicine and the American Pain Society on the use of opioids to treat chronic pain as example of how unscientific the field was when the epidemic began. 1996, not coincidentally, was also the first year that OxyContin was approved by the FDA.
Much of that 1996 statement reads like a strong plea advocating wider use of opioids for treat chronic pain and downplaying risks.
“Misunderstanding of addiction and mislabeling of patients as addicts result in unnecessary withholding of opioid medication,” the statement argues, adding that “there does not appear to be an arbitrary upper dosage level.”
“I tend to assume that people are doing what they think is the best interest of the patients,” Von Korff said. “The problem is that the research that should have been done wasn’t done. Meanwhile, the professional organizations were getting a lot of money from the pharmaceutical industry.”
Webster is still a major researcher for many pharmaceutical companies today. According to the federal government’s Open Payments database, Webster received nearly $100,000 in payments from pharmaceutical companies for speaking engagements and consulting fees in 2015, the most recent year available, as well as $1.4 million in associated research funding.
Fine received $15,000 in payments from pharmaceutical companies that same year, mostly for speaking engagements and consulting fees.
1 comment on this storyFine also previously served on the board of the American Pain Foundation, once the nation’s largest organization for pain patients. The foundation shut down in 2012 after reports came out about how much of its funding came from opioid drugmakers.
Fine denied that pharmaceutical companies have ever influenced his medical judgment and said that all professional societies he has been a part of sought only to advocate for patients and advance research into pain treatment.
“I’ve always practiced the highest standard of professionalism and followed the essential obligations of medicine: First, do no harm,” Fine said.
Thank you for helping us learn more about the opioid overdose epidemic. This survey will be used by the Bend Bulletin, a daily newspaper in Bend, Oregon, to gather information on how the opioid epidemic has impacted different types of people, and to track how efforts to address the crisis are impacting them. Please be sure to indicate whether you would be willing to talk to us further about your experiences.A NOTE ABOUT OUR COMMITMENT TO YOUR PRIVACY: We appreciate you sharing your story and we take your privacy seriously. The Bulletin is gathering these stories for the purposes of our reporting, and will not share your information with anyone without your express permission. If we would like to include you in an article, we will also contact you in advance and conduct an interview.
Buckeye State residents should, perhaps, take some pride in knowing the American Medical Association calls Ohio the top state in the country in terms of monitoring prescription drugs. The Board of Pharmacy’s Ohio Automated Rx Reporting System, established in 2006, has processed more than 24 million queries from doctors and other health professionals. In 2015, Gov. John Kasich had it integrated directly into electronic medical records and pharmacy dispensing systems.
According to the Board of Pharmacy, “OARRS collects information on all outpatient prescriptions for controlled substances dispensed by Ohio-licensed pharmacies and personally furnished by licensed prescribers in Ohio. Drug wholesalers are also required to submit information on all controlled substances sold to an Ohio licensed pharmacy or prescriber. The data is reported every 24 hours and is maintained in a secure database.”
By all accounts, it is a fantastic system, and one worth accolades from the likes of the AMA.
Some experts, however, believe Ohio did such a good job with that crackdown that it drove addicts to even stronger street drugs. And the number of drug — prescription or otherwise — overdose deaths in Ohio is increasing: 4,149 died last year (a 36 percent increase from the previous year); and coroners across the state says this year’s overdose fatality numbers are outpacing 2016.
Dr. Thomas P. Gilson, Cuyahoga County’s medical examiner, last month told a U.S. Senate committee studying ways to combat illicit drugs, “The opiate crisis is a slow-moving mass-fatality event that occurred last year, is occurring again this year and will occur again next year.”
Certainly the majority of more recent deaths are due to heroin, fentanyl, carfentanil and any number of deadly combinations and new ingredients.
Ohio officials did a remarkable job of locking down the pill mills that started this plague. It turns out that was just the beginning of their fight. It is time for them to focus the same common sense and resources that created OARRS into winning the next battle — and, eventually, the war.
An Oklahoma City doctor was sentenced to prison three years ago after he was found guilty of second-degree murder for overprescribing drugs.
William Valuck was convicted in the overdose deaths of eight patients, and Drug Enforcement Agency said he’s not alone.
“There are, unfortunately though, those who are basically a drug dealer with a lab coat,” said Lisa Sullivan, manager for the DEA’s Diversion Program. “(There are a) very small amount of them, but they’re absolutely out there. And they result in people being overprescribed.”
DEA officials said doctors are tough to prosecute.
Amar Bhandary, an Oklahoma City psychiatrist, was charged in 2012 with 53 counts of illegal distribution of controlled substances. Federal prosecutors claimed the over prescribing resulted in the deaths of five people.
The trial ended in a hung jury and mistrial. Bhandary eventually pleaded guilty to health care fraud.
“In this case, the jury was not going to convict a doctor because the doctor says, ‘I’m trying to help patients in pain.’ All you have to create is a reasonable doubt,” said Richard Salter, assistant special agent in charge of DEA Oklahoma.
The DEA’s Diversion Program regulates pharmaceuticals in Oklahoma and works to make sure they’re used for legitimate medical reasons. The program has almost a dozen people working for it — compared to the nearly 17,000 practitioners in the Sooner state.
Those practitioners are also supposed to use an online prescription monitoring program to help people who “doctor shop.”
“They’ll hit five different doctors in a day, go to five different pharmacies,” Sullivan said. “If those doctors were to look at the PMP, they’d see that individuals were doing that, and they’d know they don’t need these medications for a legitimate need.
“And if they don’t, then they’re contributing to the problem.”
DEA officials have stressed that most physicians are trying to provide the best care to its patients. They also said after Valuck and Bhandary went to trial, many doctors on the DEA’s radar left the state.
Start watching this video at 44:00… All of these “over dose deaths” Just chose a number… any old number.. it seems like everyone has their own number that they like… there are so many variables in the numbers that AT LEAST some of them … someone must have pulled them out of their lower posterior orifice… and comparison to deaths in some wars… Not the first mention of the two most LETHAL DRUGS — ALCOHOL & NICOTINE… NO MENTION of the potential of their being addictive. Maybe they are just afraid of the Tobacco & Alcohol industry as they comfortable SUCKING UP to the DEA.
