The DEA's War on Pain Doctors

Siobhan Reynolds: "All over America, pain patients are committing suicide because of the DEA's campaign."
(photo: Brian Kennedy)
Many doctors used to think that extreme pain was something that their patients just had to live with. The pain-management movement that has sprung up over the past few years takes a radically different tack, believing that long-term chronic pain can be managed with large amounts of synthetic opium, a treatment that remains controversial both within and outside the medical community. The extremely high doses often prescribed—sometimes dozens of pills a day—can seem dangerous and excessive to both laymen and other physicians. A number of doctors insist that these drugs are so powerful that no one should be prescribed them except end-stage cancer patients. But pain-management advocates argue that despite the scare stories, drugs such as OxyContin are actually safer than the alternatives and are much more effective.

The DEA denies there's been an increase in investigations and prosecutions of physicians and refutes the notion that it's engaged in a crackdown on pain doctors in general. The agency insists that it's after only rogue practitioners who overprescribe the medicines and who know—or should know—that their patients are selling the drugs on the black market. So far this year, says the DEA, the agency has launched 557 investigations, pursued actions against 441 doctors, and arrested 34, a small fraction of the nearly 1 million physicians licensed to dispense controlled drugs. "DEA statistics," the agency proclaimed on October 30, "show that the vast majority of practitioners registered with the DEA comply with the requirements of the Controlled Substances Act and prescribe controlled substances in a responsible manner." The agency added, "Doctors operating within the bounds of accepted medical practice have nothing to fear from the DEA."

illustration: Viktor Koen

But some doctors believe that the DEA, having conspicuously failed to stem the tide of illegal drug use in this country, is coming after physicians to ratchet up the agency's prosecution count. (This year alone, two federal reviews lambasted the DEA for its poor performance in fighting illegal drug use, one report giving the agency a zero on a scale of one to 100.)

"They're unable to take down the real drug lords, so they're coming after doctors using the same tactics," one pain physician tells the Voice. For an agency keen to justify its massive budget, doctors provide an easy target. Consider some other recent cases:

In Roanoke, Virginia, pain specialist Dr. Cecil Knox and two of his associates were accused of operating what federal prosecutors call "a pill mill." Prosecutors alleged that Knox overprescribed OxyContin and methadone to increase the profits of his financially struggling operation and that this contributed to the deaths of eight patients. Armed agents in flak jackets raided Knox's office. "They all came in with guns drawn," a clinic employee who was present during the raid reported to the Pain Relief Network. "I thought I was going to die. My husband was helping out that day, and a DEA agent came in and pointed a gun at his head and said, 'Get off the phone now.' " (As this story went to press, news came that the feds failed to win a single conviction in the case; the jury cleared Knox of 30 of the 69 charges, deadlocking on the remaining counts.) In another case of DEA strong-arm tactics, more than 20 agents burst into a Dallas pain clinic in June. The agents kicked down doors, ransacked the office of Dr. Daniel Maynard, and handcuffed patients, including an elderly woman with a stroller and an oxygen tank.

In South Carolina, physician Deborah Bordeaux was convicted earlier this year under a federal drug-kingpin statute and is currently awaiting sentencing. She faces up to 100 years in prison as a major drug dealer for dispensing opiates to patients suffering from chronic pain at a Myrtle Beach clinic, where she had worked for only two months. Dr. Benjamin Moore, who worked at the same clinic, committed suicide in July 2002 rather than testify against his co-workers.

In Arkansas, Dr. Randeep Mann claims that a patient approached him in 2002 and told him that a federal agent had offered her $250 to say that Mann had prescribed her painkillers in exchange for sex. Mann also charges that another female patient told him that local authorities had offered to forgive her cocaine arrest if she told the same lie in court. "They destroyed my practice and they've managed to run away a lot of my patients, and I can no longer prescribe opioids, but I still have my license," Mann tells the Voice.

In New Orleans, Dr. David Jarrott, who specializes in pain management, claims that an undercover DEA agent posing as a truck driver tried to entrap him by giving him fake X-rays to secure a supply of Vicodin for a supposed bad back. Jarrott also says the same agent tried to bribe him for amphetamine-based diet pills claiming he needed to stay awake while driving his truck. In early October, the doctor had his license suspended for three years after two of his patients died, one of whom, unbeknownst to Jarrott, was mixing street drugs with his legitimate medication.

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