Doctors and the Oxycontin crisis in Pensacola, Florida and our Nation
Oxycontin abuse and distribution has become of epidemic proportions, not only in the Pensacola and Northwest Florida area, but Florida as a whole as well as in most places in the nation. Oxycontin is in the class of drugs called “opiates,” which are considered highly addictive. Often times, addiction experts state, that people who have permanent injuries are prescribed less strong pain killers and then graduate to stronger drugs such as oxycodone or oxycontin after they have become addicted to this class of opiates. Oxycontin was originally created in 1996 to assist people who were incurring substantial, chronic pain. Many cancer patients have been prescribed Oxycontin. Doses come in varying strengths to deal with what would otherwise be unbearable, sometimes end of life pain the patient otherwise would experience. It is a good drug if taken as prescribed for people who have severe chronic pain.
However, for the last ten years has been abused in several different ways. It’s been abused and distributed improperly not only by doctors, who sometimes over prescribe it, but also by people who become addicted to pain killers, often time even starting with something less strong, such as percocet, Lortab, or other opiate medication. Often times, opiate addiction, including oxycontin addiction, can lead to heroin addiction because if someone who is addicted to opiates cannot obtain an opiate drug, they can obtain a similar physical effect from heroin. (And also keep from becoming extremely ill). Addicted people can take copius amounts of oxycontin, or roxycontin, which is basically oxycontin but is immediate acting, in such amounts that would kill a person who has not built a tolerance to the drug, which enevitably happens. (Oxycontin is a time release drug; some abusers will often crush it and snort it, smoke it, or reduce it to liquid and inject it directly into their veins).
There are two very different circumstances under which opioid analgesic medications are used inappropriately even if prescribed by a doctor. First, there are some licensed physicians who have simply ended their legitimate practices and are creating bogus pain management clinics, at which prescriptions are sold with no pretense of quality care and not in compliance with the statutory "standard of care" which applies to physicians. These physicians are being prosecuted, in most cases by the federal government, however state court cases exist in smaller numbers. Dr. Graves of Pensacola and Pace, Florida was prosecuted in state court in Milton, Florida many years ago and was sentenced to 60 years in prison. These classes of cases always involved "distribution of controlled substances resulting in death." Someone has overdosed, died, and the government's theory is the doctor presribed the pain killer not in accord with the "standard of care" necessary for this drug to be prescribed. These prosecutions have resulted in some doctors not prescribing the drug even though it is the drug that should be prescribed. Second, there are compassionate and caring physicians who are periodically duped into prescribing opiates for addicts or dealers, believing these people to be legitimate patients who need pain management, and who arguably don't breach the standard of care for prescribing these drugs. Law enforcement authorities indicated that the effective prosecution of the first group is difficult, because the offenders claim to be within the second group.
I have seen doctors prosecuted who I personally believe are in the second category because the government, generally the U.S. Attorney’s Office, believes they are breaching the "standard of care" in prescribing these powerful medications without following proper protocol. The federal government uses as an "expert" physician who goes from trial to trial testifying as to his opinion of how a practicing physician that may have caused patients to overdose on opiates and die. It’s a fine line, as the paragraph above denotes; there certainly are some doctors that I have known prosecuted who should have been considered in the first category– they turned their practices into bogus pain management clinics. However, I know of one recent prosecution where a doctor who truly cared for his patients, worked himself to death, still made home visits, seven days a week who was prosecuted in Pensacola and convicted. He likely will receive at least 20 years in federal prison. He is approximately 66 years of age. The government's expert alledged he breached the "standard of care" in prescribing controlled substances. Some doctors do have more liberal presribing habits but do not breach the standard of care in doing so. The defense expert in this case, who was a pain management and addiction specialist, who reviewed the patient's records, provided very credible testimony that this particular doctor did not breach the standard of care. However, with the resources of the government, teams of FBI agents, experts at their beckon call, and even a team of prosecutors, in this particular case this doctors court appointed attorney, of no one attorney, appointed or otherwise, could prepare themselves for trial as well as the government's huge team. Another doctor was prosecuted by the federal government in 2009 for similar charges. He had enough resources to hire Roy Black, Esq., an excellent attorney from South Florida. Mr. Black assembled a large trial team that at least matched the government. However, from what I understood about the case from watching some of the trial, this doctor had turned his practice into a drug distribution center, and based on documentary evidence it was very difficult to claim this doc had not breached the standard of care, unlike the doctor I mention above who only had one appointed lawyer to represent him.
Of course, even on the counts that do not involve death, the doctors are also prosecuted for medicare/medicaid fraud by the government's claim that the drug were not necessary and therefore the doc sending the bill for his or her payment to be fraudulent.
In my humble opinion, the government prosecutes the right people sometimes. Innocent people do get convicted everyday in state and federal courts everyday. We only hear about those who have been on death row or serving life sentences who are released because of newly tested DNA evidence. However, imagine the thousands of people who are innocent but convicted of crimes where there is no DNA evidence. The people making the decisions to present cases to grand juries are only human and see people and crimes through their own "set of glasses." Grand juries generally follow the government's request; not always, but most the time. You probably have heard the phrase "the government can get a grand jury to indict a ham sandwich" meaning they can present what ever evidence they want to obtain an indictment. Hearsay is admssible and there is no judge present during the grand jury proceeding to impose any evidentiary code requirements.
The system isn't perfect. It would be better if there were checks and balances that don't exist at some levels of the criminal justice system.
M. James Jenkins
