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

Dr. Dealer

Lutful Chowdhury, 62, a Baldwin, Long Island, pharmacist indicted in February on conspiracy to distribute oxycodone and fentanyl (a drug for post-surgery pain), allegedly told his customers not to use the same name on their prescriptions. Chowdhury had been prescribing drugs to Kayla Gerdes, 20, of Freeport, Long Island, who was sentenced earlier this year to nine years in prison for killing a Hempstead doctor in 2010 while high on oxycodone and Xanax.

If you think doctors are carefully securing their prescription pads, consider this: In the June raid, authorities caught 11 people throughout Long Island using forged prescriptions from 11 different doctors. In September, Suffolk police arrested a man who was so rabidly obsessed with obtaining the drugs, he hung around emergency rooms and doctors' offices trying to steal their ID card so he could use them to buy pills.

In January 2010, police arrested Arnaldo Gonzalez for possession of forged prescriptions. He told police that on visits to Long Island doctors, he just lifted them. "I noticed a prescription pad on the desk and took a bunch of prescriptions when no one was looking," Gonzalez said.

Pharmacist Lutful Chowdhury prescribed drugs to a woman sentenced with killing a doctor while she was high on oxycodone 
and Xanax.
Courtesy Long Island Press/Rashed Mian
Pharmacist Lutful Chowdhury prescribed drugs to a woman sentenced with killing a doctor while she was high on oxycodone and Xanax.
Prosecutor Bridget Brennan says the medical community needs to take the lead in fighting pill abuse.
Courtesy New York Law Journal/Rick Kopstein
Prosecutor Bridget Brennan says the medical community needs to take the lead in fighting pill abuse.

While the oversight of painkillers might appear to be highly regulated, it is riddled with loopholes, information gaps, delays, and poor monitoring. State public health law blocks law-enforcement agencies from obtaining patient information. The state Bureau of Narcotic Enforcement, which is supposed to oversee these issues, might have information about illegal prescribing, but it is barred from sharing it. The bureau can't initiate that process—the police have to know something first.

Another problem is the lag of up to 45 days between the time pills are sold and when the sale is reported to state authorities. That makes tracking illegal prescribing more difficult.

Pharmacies and doctors can check a free state database of patient prescription histories, but only about 2 percent of them actually do it. If a pharmacy assistant is fired for stealing drugs, no record is kept. That employee can get the same work again.

Even though medical professionals have to get a DEA license to write prescriptions, there's no requirement for initial training, board certification, or ongoing education in federal or state law in prescribing painkillers.

On the plus side, last August, Cuomo signed the so-called I-Stop legislation, which creates a prescription monitoring registry and mandatory electronic prescribing (making prescriptions easier to track in real time). The teeth of the law won't go into effect until the end of 2014.

The bill was introduced by State Senator Andrew Lanza, from Staten Island, an epicenter of the epidemic.

Last June, Lanza described the problem as a "medicinal Trojan horse."

"On the outside," he said, it was "a medicine born legitimately, something we're all accustomed to seeing in our society as something that helps us. And meanwhile, on the inside, there's a killer lurking."

The Medical Society of the State of New York and seven other doctors' associations had qualms with the legislation, however, saying doctors didn't have time to check a database every time they wrote a prescription.

A much deeper problem is the medical community's philosophy about the treatment of pain. Brennan points out that hospitals commonly prescribe 30-day supplies of multiple pain drugs even to patients who were admitted for fairly routine injuries. Because they believe insurers won't pay for a second visit, doctors often prescribe a much larger amount than might be necessary. They are also afraid of being sued or receiving a lower rating on claims for not fully treating pain. But the practice floods the market with unneeded, incredibly addictive drugs.

"The medical community has to take a hard look at its prescribing practices," Brennan says. "There are doctors who were trained to liberally prescribe opioid drugs without a lot of thought about their addictive properties. The solution has become worse than the problem."

Brennan supports mandatory training for medical staff as well as relabeling the drugs from "for moderate to severe pain" to variants of "for severe pain" or "for severe pain and to ease terminal cases," so they aren't applied to such a wide variety of pain. She believes these steps will sharply reduce the black-market supply. "You would see the number of prescriptions written go way down," she says.

Reynolds of the Long Island Council on Alcoholism says a lot more needs to be done, including increasing the penalties against doctors. He is also urging health officials to do a better job of monitoring doctors who are prescribing a lot of painkillers. "I-Stop was a great step in the right direction, but if you cut off supply without addressing demand, it will get worse," he says. "That demand goes somewhere. It's like squeezing a balloon."

Reynolds now wants the state legislature to focus on the responsibility of insurance companies for the epidemic. Insurers, he says, are quick to pay millions for medication, but they balk at treatment. "They say the patient has to fail at outpatient treatment before they'll pay for inpatient," he says. "A chronic addict needs 30 days. But the insurers will only pay for three to five days. That's just not enough time, and, of course, the patient relapses. Then we ask the insurer to send them again, and they say no, it didn't work the first time. It's akin to using a Band-Aid to treat a severed arm."

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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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