M.D.'s Are the New Pain-Pill Crime Wave

Dr. Dealer

The doctor, who devoted her life to treating low-income AIDS patients, had pleaded guilty to a staggering violation of her medical oath. Diana Williamson, 56, admitted she had written prescriptions for tens of thousands of powerful painkillers, which were then sold on the black market by a convicted drug dealer.

In preparation for her sentencing, Williamson's lawyers filed court papers last month containing an unusual defense: They said she had suffered from a multiple personality disorder for 25 years as a result of childhood sexual abuse by a priest. Williamson told her psychiatrists that she had no memory of committing the crimes—that one of her alter egos, a mischievous, immature teenager named Nala, was responsible. Nala "committed these crimes without telling Diana or the other parts of me about them," she wrote in a letter to the presiding judge.

Williamson still awaits sentencing, but the case, unusual as the details are, is hardly an anomaly. It is just one consequence of an epidemic that has spread across the region and continues to thwart government and law-enforcement efforts to stop it.

The prescription-painkiller problem presents itself in myriad ways: fatal drug overdoses, pharmacy robberies, Medicaid fraud, and "doctor shopping" by addicts looking for a friendly physician who will prescribe the painkillers without asking too many questions. And then there are the doctors and medical professionals who dive right into the fray.

Based on a Village Voice review of court records, at least 30 doctors, medical aides, and pharmacists have been indicted since 2010 for illegally prescribing painkillers, OxyContin, and related drugs known as opioids—semisynthetic drugs that act similarly to morphine and heroin. In at least 20 cases, patients of these doctors fatally overdosed on painkillers shortly after receiving prescriptions. Since the source of the pills can be hard to trace, that is probably only a fraction of the total deaths.

Likewise, because it's fairly difficult for law enforcement to make these cases, the actual number of doctors who are illegally prescribing painkillers is probably much higher. The state's medical oversight database shows that this year, dozens of other doctors licensed to practice in New York State have either lost their licenses or were disciplined in some other way for illegally or unethically prescribing painkillers. The most recent statistics show an increase in such disciplinary cases in each year from 2008 through 2010.

Williamson's arrest was unusual in that it involved a doctor working primarily with minority patients. Overall, the painkiller epidemic is considered a white, suburban, middle-class phenomenon. "I've been doing this for 25 years, and I've never seen anything as bad as it is now," says Jeff Reynolds, executive director of the Long Island Council on Alcoholism and Drug Dependence. "It's the perfect storm."

Attorney General Eric Schneiderman calls it "the perfect crime." "Everyone involved is covered by the paperwork," he said in a report on the painkiller problem.

Opioid painkillers have been around for 100 years. About 20 years ago, the medical community began to view pain not as a symptom but as a disease. Eventually the major medical associations ruled that patients must be treated for pain. Pharmaceutical companies saw a vast new market for their drugs, and the use and abuse of opioids exploded.

In the New York metro area, the tipping point for recognition of the epidemic took place about two or three years ago. Since then, law-enforcement authorities have gone to great lengths to address it and have provoked some changes, including a law signed in August by Governor Andrew Cuomo that will eventually allow authorities to track prescriptions more closely. But as Reynolds notes, it's still getting worse, fueled by a range of factors: naked greed, lapses in oversight, loopholes in regulations designed to regulate the drugs, roadblocks from laws designed to protect patient privacy, and carelessness in securing prescription pads and filling prescriptions.

Solutions are out there: improved methods to allow law enforcement to get information on miscreant doctors, mandatory training of medical staff, better labeling, tighter control of prescriptions, and making insurance coverage for drug-addiction treatment as easy to get as the drugs themselves. But the medical community, the pharmaceutical industry, and insurance companies continue to resist many of these changes. Some law-enforcement officials and drug-treatment experts—including the city's special narcotics prosecutor, Bridget Brennan—believe what's needed is a fundamental change in the way doctors treat pain.

Each week seems to bring new reports that yet another medical professional has been caught illegally prescribing painkillers. "As many physicians as we take down, I see more just coming up," a Drug Enforcement Administration agent testified in a Suffolk County grand jury investigation into pill abuse earlier this year.

It all began with heroin. At one time, heroin was legal and believed safer than morphine. Folks soon figured out the drug's recreational benefits, and the ensuing epidemic ended its sale in the commercial marketplace. In 1970, heroin was declared a Schedule I controlled substance. Related versions of the drug, known as opioids, arrived on the market.

Opioids are known generically as oxycodone or hydrocodone, and by trade names such as OxyContin, Percocet, and Vicodin. The strength of the drugs varies based on the amount of the active ingredient in each pill. Somewhat like antidepressants, each drug can have different effects on a given patient.

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5 comments
MrMxyzpltk
MrMxyzpltk

Enough already. There are human beings who are in great pain due to a number of illnesses. The government's nonsensical "War on Drugs" is causing people who legitimately need pain medications (e.g., opioids) great unnecessary problems. Too many doctors are afraid to prescribe medications that are medically necessary because they're scared of having the DEA show up in their offices demanding to see medical records - not just needed records, but ALL their records. So much for doctor-patient confidentiality. But screw confidentiality when so many people -- police, prosecutors, the narco-recovery complex, criminal enterprises, and more -- are hauling in the cash.

 

I know that there are people who are addicted and need help. I was one of them. I'm grateful to have been alcohol- and drug-free for 30+ years and still attend 12-step meetings. But this constant "war" on the latest evil-drug-o'-the-month is insane -- and it isn't working. From 1920 to 1933, the United States government and state governments attempted to ban alcohol. How well did that work? Well, it helped lead to the rise of organized crime, convinced many otherwise law-abiding people that the "law [wa]s a ass -- a idiot" (from Dickens' Oliver Twist), created a spectacular amount of hypocrisy (people who were entrusted with maintaining the law who themselves drank, or who took money from bootleggers, speakeasy owners, smugglers and the like, much the same as, oh, today) and killed a few people here and there. But what are a few deaths when morality is at stake?

 

The majority of medical personnel who prescribe pain medication are on the level. The ones whose pictures grace the newspapers are the exceptions to the rule. As far as this doc having an "alter ego" (current psych jargon calls it "dissociative identity disorder"), I can't help but snicker (although there's the off-chance that it's true). Even if it is true, though, it won't matter. We're at WAR, damn it! Come to think of it, this country is always at war against something or somebody. What would the U.S. do if it wasn't always fighting the latest enemy? Something positive, creative? Nah. Getting angry at an enemy is easier, even if the enemy is non-existent. And the "war" gives the U.S. the right to invade other countries in the name of protecting U.S. citizens who don't want to be protected. O tempora o mores! O bullshit!

nekoman
nekoman

First, I call BS on the Physician that claimed "multiple personality disorder due to sexual abuse by a priest as a child" ! Made-up psychobabble is what that is. She full well knew she was writing those prescriptions, just like all the other "candy store" Drs. out there. You hear of them everywhere you go. And, I'm not being bigoted or racist here only calling it like I see it, most of these Drs. are foreign trained! Greed, greed, and more greed is all it is. They see easy money in it, so they do it.

Second, I'm in a Pain Management program, and have been for six years. I have chronic, severe, intractable pain caused by severe nerve damage from the removal of a spinal cord tumor. I've been told by three Physicians that I will live with pain the rest of my days. I will have to take pain medication for the rest of my days. I have a stimulator implant. I get regular seroid injections, and am getting nerves temporaily destroyed soon, to try and relieve some of the pain. I have a detailed contract with my Pain Management Physician. I must follow it religiously. I am subject to random drug screening. All my medications (narcotic, and non narcotic) are counted every appointment (monthly). I am held accountable for my medications, and their use. At one time I had a daughter that lived with me that is a heavy drug user (severely addicted) and was stealing my medications. I, naively, thought at first that I was taking too many, until I discovered that I had the powerful timed release medication missing. I confronted her. She denied it, of course. I got a lock box, which was promptly broken into, and two pain killers plus anti anxiety medications went missing (large amounts). This got her booted to the curb when she also refused help. Missing medications stopped, but got me into deep shit with my Dr. , and I had to regain her trust in me. Because of the rampant abuse of pain medications in the population, and the greed of a relative few medical professionals, people like myself suffer the consequences! Like HAVING to make 60 mile round trips monthly (on a fixed income) just because the law says certain drugs (time release powerful narcotic pain relievers) have to be WRITTEN paper prescriptions, they cannot be called into, or electronically transmitted to the pharmacy like other medications, including short acting pain relievers which are WIDELY abused and sold illegally, can. So, this not only makes for unnecessary trips, but essentially unneeded Drs. Appointments, too. I follow the rules. I don't abuse drugs. I don't sell drugs. My Dr. is competent, and has high standards and morals. You will never see the addicts, and dealers lined up at her practice! She doesn't do that, and doesn't see those types, they're screened out long beforehand. There's no prescription selling, or handing out for faked, or suggested disorders. My daughter that I mentioned was seeing a Dr. (supposedly a pain specialist} here where I live, much closer than the Dr. that I see. She was obtaining large prescriptions of short acting, and for very powerful (think along the lines of Oxycontin) pain relievers for a supposed diagnosis of "scoliosis". Funny that! We made sure she had regular, yearly physical examinations growing up. Never once did any Physician ever find scoliosis! This is a grown woman that is 5'4" and about 110. No crookedness evident in her posture. No pain evident in her movement. I was a Registered Nurse for 30 years, so I know what I'm talking about. I found out, not only was she taking these drugs, she was also dealing. I also discovered that her Dr. had tried to prescribe fentanyl patches for her "pain", but insurance denied that one! This quack is still practicing, running his "candy store"! My daughter has dropped off the face of the earth after many offers of help to get rehab, she still denies a problem even though she's taken to snorting oxycontin, and the like, but also shooting up heavy shit. I'm in a small city of about 28,000 and the drug problem here is rampant, and so evident among the high school to 30s age groups that it's shocking. You see regular "deals" go down, in the open in front of stores, in parking lots, etc. And, it ain't pot! Pills are the thing here, just ask any younger person, all have used, or are more likely regularly using pain relievers, etc. Too easy for them to get. I've lived in large cities, LA for example, and didn't see drug use like I see it here. It's phenomenal!

jmmartin
jmmartin

Time to throw the baby out with the bathwater: outlaw priests and legalize drugs.

BradForrester
BradForrester

The cannabis community has been successfully weaning addicts off prescription narcotics for at least a decade. Start dumping your big pharma stocks now because when cannabis is legal, the pharmaceutical industry will will see a downturn of monumental proportion!

mbrachman
mbrachman

Damn paginaged articles! I know the VV has to sell advertising to survive, but I am SICK and TIRED of clicking FIVE TIMES to read the important articles. When are the business managers of the VV going to learn that those who read the serious articles not only DON'T look at the ads, we make a concerted effort deliberately to AVERT our eyes from the ads in the marginalia? Free the important articles from the tyranny of business-side-of-the-VV pagination!!!

 
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