Last week federal agents and police officers arrested a 74-year-old Staten Island doctor and two others under charges they were running a pill mill operation. And, according to authorities, this was no ordinary pill mill setup. They allege the good* doctor wrote prescriptions for over “4 million pills with a street value of $40 million to Staten Islanders”.

They further allege this pain management specialist* took money and other items as payment, including single malt whiskey, for these prescriptions. He is accused of writing prescriptions for oxycodone and Xanax without examination, MRIs, or medical records.

The other two people arrested are suspected of aiding the process, including finding the patients* and distribution of the drugs.

The operation is said to have been running since 2012.

Just think about the magnitude of the charges here. Over 4 million – that is 4,000,000 oxycodone and related narcotic pills being distributed in Staten Island in under 5 years. That could represent a huge number of addicts suddenly left in the lurch when their supply chain* takes an unscheduled holiday*. This leads me to ask, what happens when the clinician is thrown in the clink?

Just because the supply is terminated doesn’t mean the people addicted to this crap will simply go away. As a nation, we’ve already seen a surge in heroin use as the screws get slowly turned* on prescription opioids. What will happen with the Staten Island addicts? Can we reasonably expect a surge in illicit drug activity in the wake of this action? Are we about to see a major shift to heroin use in the Staten Island area?

The nature of drug abuse and addiction has shifted greatly in the past couple of decades. My position on “traditional” illicit drug abuse was not a politically correct or popular one. I understand that we need to help people addicted to drugs. I understand they were (heavy sigh) addicted, and that addiction is (exaggerated eye roll) a “disease”. Yet, in the pre-prescription world of old-fashioned drug abuse, some as yet to be addicted individual had to make the conscientious decision to smoke crack, take LSD, snort cocaine, shoot heroin or some other illegal concoction. Often labeled under the guise of curiosity or experimentation, the addictions we saw for many years were the result of an initial poor decision; a decision that led to the ruining effects of addiction.

Now, that is all out the window. The addict of today is just as likely to be a person who wasn’t curious or experimenting. They weren’t trying to fit in. They weren’t trying to be cool. They just trusted their doctor, and an incompetent medical system that was oblivious to the damage it was doing. Certainly there are criminal elements associated with this, as certain pill mill pain specialists* were more interested in lining their pockets than actually helping people. Still, the pill mills are a result of a poorly conceived medical policy, not the cause of it. Some of this operations customers were likely patients addicted through legitimate medical practices; people for whom their initial supply line was no longer available. 

So what may be overlooked in necessary raids of this nature, is the continued damage and heartache these operations leave behind. Sadly, our medical systems have created an entirely new category of drug dependent victims. Simply cutting off the supply doesn’t fix the problem they have created. Where will the addicts turn now? 

Within the workers’ compensation industry, we now have fairly broad recognition of the problem at hand. Still, the discussion largely centers on the initial problem and the cessation of widespread use of opioids. The conversation on what to do with the people left in the wake of this poor practice has been the providence of a much smaller subset of specialists and industry practitioners. That awareness needs to expand into deeper segments of our industry.

At this point, stopping the onslaught of opioid use is just half the problem. The carnage they have already created must be considered in the broader solution.

The doctor who is subject of this story, if convicted on the charges that have been leveled against him, will hopefully spend what is left of his life in a small cell where he will have ample opportunity to contemplate his actions. Prescribing drugs for fun and profit is a ruinous affair, and the (still alleged) violation of his Hippocratic oath is unforgivable in the face of the damage those actions caused. But just tossing the specialist in the slammer won’t stop the carnage that has been set in motion.

I hope there are contingency plans in place for helping the victims that have been left in his wake.

 

*Term used loosely.

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