PHARMACIST STEVE

Like a lot of puzzles, one cannot see what the final picture is going to look like until you get more and more pieces in place.  The same seems to be the same how about all the “things” that the DEA has done basically “behind the curtain”…  as people retire, some are starting to talk about what they did and what they saw while working in law enforcement, DEA or within our judicial system.

Richard A. Lawhern recently published a article A Good Man Speaks Truth to Power

Because I write and speak widely on public health issues and the so-called “opioid crisis”, people frequently send me references to others’ work.  One of the more startling articles I’ve seen lately was published November 20, 2018 in Pharmacy Times.  It is titled “Should We Believe Patients With Pain?”.  The unlikely author is Commander John Burke, “a 40-year veteran of law enforcement, the past president of the National Association of Drug Diversion Investigators, and the president and cofounder of the International Health Facility Diversion Association.”

The last paragraph of Commander Burke’s article is worth repeating here.

“Let’s get back to dealing with each person claiming to be in legitimate pain and believe them until we have solid evidence that they are scamming the system. If they are, then let’s pursue them through vigorous prosecution, but let’s not punish the majority of people receiving opioids who are legitimate patients with pain.”

This seems a remarkable insight from anyone in law enforcement — especially from one who has expressed this view in both Pain News Network, and Dr Lynn Webster’s video “The Painful Truth”.   Recognizing Commander Burke’s unique perspective, I followed up by phone to ask several related questions.  He has granted permission to publish my paraphrases of his answers here.

1. “Are there any available source documents which establish widely accepted standards for what comprises “over-prescription?” as viewed by diversion investigators?”Burke’s answer was a resounding “NO”.  Each State and Federal Agency that investigates doctors for potentially illegal or inappropriate opioid prescribing is pretty much making up their own standards as they go.  Some make reference to the 2016 CDC Guidelines, but others do not.
2. “Thousands of individual doctors have left pain management practice in recent years due to fears they may be investigated, sanctioned, and lose their licenses if they continue to treat patients with opioid pain relievers.. Are DEA and State authorities really pursuing the worst “bad actors”, or is something else going on?Burke’s answer:  “Regulatory policy varies greatly between jurisdictions.  But a hidden factor may be contributing significantly to the aggressiveness of Federal investigators.  Federal Agencies may grant financial bonuses to their in-house diversion investigators, based on the volume of fines collected from doctors, nurse practitioners, PAs and others whom they investigate.“No law enforcement agency at any level should be rewarded with monetary gain and/or promotion due to their work efforts or successes. This practice has always worried me with Federal investigators and is unheard of at the local or state levels of enforcement.”

Commander Burke’s revelation hit me like a thunder-clap.  It would explain many of the complaints I have heard from doctors who have been “investigated” or prosecuted.  It’s a well known principle that when we subsidize a behavior, we get more of it. Financial rewards to investigators must inevitably foster a “bounty hunter” mentality in some.  It seems at least plausible that such bonuses might lead DEA regulators to focus on “low hanging fruit” among doctors who may not be able to defend themselves without being ruined financially.  The practice is at the very least unethical. Arguably it can be corrupting.

I also inquired concerning a third issue:

3. “I read complaints from doctors that they have been pursued on trumped-up grounds, coerced and denied appropriate legal defense by confiscation of their assets – which are then added to Agency funds for further actions against other doctors. Investigations are also commonly announced prominently, even before indictments are obtained – a step that seems calculated to destroy the doctor’s practice, regardless of legal outcomes.  Some reports indicate that DEA or State authorities have threatened employees with prosecution if they do not confirm improper practices by the doctor. Do you believe such practices are common?”Burke’s answer:  “I hear the same reports you do – and the irony is that such tactics are unnecessary.  Lacking an accepted standard for over-prescribing, the gross volume of a doctor’s prescriptions or the dose levels prescribed to their patients can be poor indicators of professional misbehavior.  Investigators should instead be looking into the totality of the case, which can include patient reports of poor doctor oversight, overdose-related hospital admissions, and patterns of overdose related deaths that may be linked to a “cocktail” of illicit prescribing.  Especially important can be information gleaned from confidential informants – with independent verification – prior patients, and pharmacy information.”

No formal legal prosecution should ever proceed from the testimony of only one witness — even one as well informed as Commander John Burke.  But it seems to me that it is high time for the US Senate Judiciary Committee to invite the testimony of others in open public hearings, concerning the practice of possible bounty hunting among Federal  investigators.

for years Commander John Burke contributed a monthly op-ed in Pharmacy Time – one of the two major pharmacy magazine sent to all pharmacies in the country.  As I remember, just about every article that Burke wrote, seemed to be from the perspective of law enforcement that suggested that everyone taking prescribed opiates were doing so because they were addicted or selling the meds  to supplement their income.  Once I wrote Pharmacy Times and suggested that they discontinue publishing Burke’s biased op-eds…   Of course, they continued to publish his one-sided point of view..  Here is a list of various organization that he was affiliated with and his titles within these organizations:

• Executive Director @ International Health Facility Diversion Association
• President @ International Health Facility Diversion Association
• Commander @ Warren County Drug Task Force
• Past President @ Ohio Task Force Commanders Association

• Past President @ National Association of Drug Diversion Investigators
• Sergeant @ City of Cincinnati
• President and Owner @ Pharmaceutical Diversion Education

I guess that should help explain the contents of all the articles that he published in various medias. I did a search for his Pharmacy Times articles and her is a link to what I found  https://www.pharmacytimes.com/authors/cmdr-john-burke?page=17.  Apparently he stopped a few years back.

Here is a blog post from 5 yrs ago about a job posting by the DEA   Forfeiture Financial Specialist Supporting the DEA    and within the job description:  Provides support in conducting pre seizure analysis.   This would seem to validate what the previous DEA employee stated in the above video.

Here is a more recent blog post  wonder how many members of Congress is aware of this – and have turned a blind eye and deft ear to how corrupt the DEA is ?    A  DEA agent who is going to jail for 12 yrs and who “spills the beans” on all the diversion of confiscated money, drugs and what many of these agents spent the money on themselves. According to this article some agents that were involved, where allowed to just retire with out any legal consequences.  A quote from the agent in the article ….“You can’t win an unwinnable war. DEA knows this and the agents know this,” Irizarry said. “There’s so much dope leaving Colombia. And there’s so much money. We know we’re not making a difference.”

Here is another recent blog post  Is this why 90%+ of people taken to Federal Court – ARE FOUND GUILTY ?      Judge denial all the NINE expert witnesses from testifying for the physician/defendent and the only witness for The prosecution was expert, Dr. Timothy King, is an Indiana anesthesiologist who makes large amounts of money testifying for the federal government.  The 85 y/o physician, is currently serving a five-year prison term in a minimum security prison

Here is just one blog  post head of Suboxone mafia: testified at J&J opiate crisis trial  on the J&J trial in OK in the summer of 2019 where the judge decided that J&J COULD NOT HAVE A TRIAL BY A JURY … it was to be a BENCH TRIAL – where the judge acts as JUDGE, JURY & EXECUTOR  and J&N was being sued for being a PUBLIC NUISANCE because they were basically the WHOLESALER of raw opiate powder to the pharma industry. 

Doc’s office raided: purportedly treating addicts with a drug called buprenorphine

The “BAD AND THE UGLY – there is NO GOOD” of the PDMP’s and Narxcare and the INACCURATE CONCLUSIONS from those databases

The True Story of Morphine Milligram Equivalents (MME)

The “BAD SIDE” of Epidural Spinal Injections

Who said that dead bodies DON’T TALK ?

How DEA does a UNDER COVER INVESTIGATION

The FOUR DIFFERENT WAYS MME’S CAN BE CALCULATED

 

 

 

Filed under: General Problems