Pain
Wars
II:
More
Docs
in
the
Dock
8/3/01
If misery loves company, Dr. Weitzel can take solace in being just one of a growing number of physicians targeted by law enforcers for their pain treatment practices. In recent weeks, the litany of physicians raided or arrested by law enforcement officials on prescription abuse charges (often also described as "fraud" because of Medicaid billing issues) continues to grow: In a Florida first, last week, a Jupiter physician was arrested and charged with racketeering, drug dealing and first degree murder after one of his patients overdosed on Oxycontin. Dr. Denis Deonarine, 56, is the first doctor in the state to have been charged with murder in connection with prescribing the opioid painkiller, the FDA and legal experts told the Palm Beach Post: Deonarine faces either life in prison or a death sentence if convicted in the death of 21-year-old Michael Labzda of Jupiter, who died February 8. According to autopsy reports, Labzda died after taking a combination of oxycodone (the active ingredient in Oxycontin and numerous other opioid pain relievers), high levels of the tranquilizer alprazolam, and alcohol. Prosecutors allege that Deonarine did not perform physical exams or other tests that would justify the medications he prescribed and that he prescribed the drug for his office manager and later lover. He also faces fraud charges over what the authorities deem "illegitimate" prescriptions. Deonarine's attorney, Richard Lubin, called the charges "meritless" and suggested the doctor was victimized by a deceptive patient and Purdue Pharma's aggressive marketing of Oxycontin. "If someone abuses a drug that he's been prescribed and takes it with other drugs and alcohol, all in violation of pain management agreements the doctor has every patient execute, how is the doctor responsible for the patient's death?" Lubin asked the Palm Beach Post. "To the extent Dr. Deonarine may have been a victim of misleading marketing by the manufacturer that may have occurred, he truly believes, and he has always believed, he has prescribed medicines when it was needed medically," he said. Deonarine, who has had no previous brushes with the law or Florida medical authorities, was last reported to be in the Palm Beach County Jail, where he is suffering from pneumonia, the Post reported. In South Carolina, the DEA has forced the closing of the Comprehensive Care and Pain Management Center in Myrtle Beach after raiding it in June 2000 and again last month: The DEA refuses to comment on its ongoing investigation, but in a letter to clinic patients, Dr. Michael Woodward wrote: "As you are probably aware, some time ago some former employees made some false accusations about me in order to gain a competitive advantage for a new center they had opened. Based upon these false accusations, the DEA has become focused, if not obsessed, with the Comprehensive Care and Pain Management Center... Unfortunately, as a result of the accusations, many of you have been contacted and even harassed and threatened by DEA agents. As you already know, in July 2000, the DEA took all of our patients' medical records as part of their 'investigation.' Despite our persistent protests, none of these records were ever returned. Instead, a few weeks ago, the DEA returned and took even more records that were made since the June 2000 raid. In addition, the DEA began to take away the abilities of our physicians to prescribe scheduled pain medication, first by using administrative registration technicalities and finally by frankly accusing our doctors of over-prescribing. Our former doctors have hearings scheduled in federal court over the next few months, at which time we hope they will be vindicated," Woodward told the patients. "As the DEA eliminated our regular doctors, one by one, they also prevented our replacing them with even temporary doctors, telling each temporary doctor that, since we were under 'investigation,' no new doctors coming to our center would be allowed to prescribe scheduled substances, even though they could do so anywhere else in the state!" Woodward continued. "By systematically eliminating our regular doctors while not allowing us to replace them, the DEA squeezed us out of business. "Don't let anyone kid you," wrote Woodward, "we believe in our patients' right to total pain management including the use of appropriate pain medications. When the DEA took our prescribing ability away from us, we could no longer provide as good of service as you could get elsewhere. This forced us to close." Woodward also related to his patients a conversation between a doctor interested in obtaining and reopening the Center and DEA agents in the state capital, Columbia. Unbeknownst to the agents, the doctor tape-recorded the conversation. "One of the agents essentially told the doctor that he would need to replace all of the patients currently attending the Center since none of them had anything really wrong with them!" Patients must contact the DEA to obtain their medical records seized from the clinic, Woodward wrote. He also encouraged patients to fight back. "I consider the actions of the DEA and the US Attorney's office in seizing and keeping your records and in harassing you to be outrageous. You may wish to take action. The complaint bureau for the federal government is the Office of Professional Responsibility," he told the patients. Local physicians are on notice, according to press reports. "No physician wants to be called on the carpet," Dr. Anthony Alexander, a psychiatrist at Strand Regional Specialty Associates, told the Sun News. "Therefore, they're very cautious about writing those prescriptions and documenting what the diagnosis is." Patients are also responding to the furor. Dr. Scott Sauer of the Center for Pain Relief in Myrtle Beach told the local paper some patients are asking to discontinue Oxycontin prescriptions because of the social stigma. "Patients think they have done something wrong by taking Oxycontin," said Sauer. "They come in and want to come off it. We then have to educate them about it and try to inform them that they're taking it properly." In the wake of the Center's closing, other area clinics and practices are seeing a steady stream of former Center patients seeking treatment for pain, the Sun News reported.
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