Opioid Crisis Scapegoat and the American Drug Cartel
For many years primary care doctors have been a target of prosecutors and FBI agents in the fight against Medicare fraud. The federal government and Drug Enforcement Agency focused their fight on organized crime and drug cartels in the anti drug war that Nixon initiated in the late 1960s. The drug war included marijuana which has put a lot of innocent people in jail. Unfortunately the federal government still has not yet removed marijuana from schedule I list of drugs that are dangerous and offer no medicinal benefit. We’ve had record numbers of drug overdoses from heroin and crack cocaine that reached epidemic levels in the 1980s. When these numbers hit the heart of America after the introduction of OxyContin to the market, the focus of attention shifted to primary care doctors who prescribe this drug and others like it.
I am a primary care physician with a 27 year exemplary record of practicing family medicine in Michigan and Illinois. I also used marijuana for 35 years. Most of that time it was illegal. It became legal in Michigan in 2009. I was arrested in 2003 for possession of a small amount of marijuana. I went through four years of inpatient and outpatient rehabilitation for marijuana addiction in order to protect my medical license and the ability to practice medicine. I was ostracized by most hospitals, insurance providers and companies, including Medicare. This made it almost impossible for me to run my own practice. By 2009 I was bankrupt and working multiple locations including some smaller Emergency rooms in northern Michigan.
I have been a target of the DEA since 2009. The FBI told me so when I was arrested in March of 2013. I had a criminal record. I was a marijuana user. I did not have a stable working address. I was prescribing OxyContin. I was working at a marijuana clinic providing medical marijuana authorization for my patients in Michigan. Finally, I was a dark middle aged man and from the Middle East. I was charged in grand jury indictment and rounded up in wide reaching dragnet operated by the FBI, DEA, and local police authorities out of metro Detroit. I was arraigned the same day in federal court along with one hundred other co defendants in this single superseding indictment. I plead guilty o conspiracy to distribute OxyContin because I was giving my signed blank prescriptions to a physician assistant and he was using them to sell OxyContin without my permission. I was guilty of negligence which is not a criminal offense.
I prefer not to discuss what hardships I have had since my arrest. I surrendered my medical license and lost my freedom. I lived in federal custody for nearly a decade. Suffice it to say I am still working on my resentments and forgiveness. Thank goodness my family and wife have been very supportive. In Nation Heal Thyself I describe how hurt I was when my brother became gravely ill and died unexpectedly and I was not granted permission to see him and be with my family during this difficult time. The FBOP treated me unjustly. It was around this time that another prisoner who also was a doctor handed me a Detroit News clipping which labeled me along with fifteen others as Michigan’s top doctor drug pushers. That was in 2015.
Many people fail to realize how the Sackler family and Purdue pharmaceutical tricked doctors into believing that OxyContin was a better and less addictive alternative. The FDA approved the labeling of OxyContin. The largest and guiltiest party in this opioid epidemic is Richard S. Sackler MD and some of the Purdue pharmaceutical board members. The company and board members agreed to pay billions of dollars in restitution to the federal government, but no one admitted guilt nor had to spend a single day in jail. Most of the doctors and other health care professionals plead guilty, lost everything, and spent years in federal prison. I actually knew a couple of older doctors who died in federal prison while serving their sentences.
Physicians including myself have relied on drug manufacturers like Purdue pharmaceutical to work ethically with the FDA to safely bring new medication to market in our collective fight against disease. Of course, this is a utopian view. In reality these drug companies, collectively known as “big pharma”, make hundreds of billions of dollars and they employ and army of drug sales representatives and lobbyists. These salespeople have direct influence on prescription writing and drug regulation. Primary care doctors who are trying to provide good standard care to rural and poor intercity communities depend on these drug companies and their sales force to provide samples and access to their medicines. For some doctors and their patients this can be a lifeline.
Primary care doctors are first to treat acute and chronic pain. Specialists like orthopedic surgeons and cancer doctors treat serious and very painful conditions, but often refer back to the primary care doctors for pain management. I can tell you from personal experience that primary care doctors relative to specialists are definitely underpaid and overworked. There is a reason that we have a primary care physician shortage in most places in this country. Disparities in physician reimbursement and unmet expectations continue to create shortages in primary care. This fuels physician burnout and eventually dropout. The healthcare that is available is often inaccessible, costly, and ineffective in prevention of chronic disease.
Primary care doctors were often vilified during the opioid crisis. They are criticized for initiating and over prescribing addictive pain medication. Conversely, they are criticized for poor pain management and inadequate addiction treatment. We are rightfully charged with safeguarding the health of our citizens and when the high death toll from drug overdose struck the heart of America, doctors of course were the first to blame.
The very nature of treating pain and addiction in today’s environment, especially during the opioid epidemic places physicians at risk. Most physicians including myself try to practice with compassion and as best as we can while doing no harm. I went a bit further, while in prison I completed a prevention healthcare guide that I used with my patients and family for decades. I created a health assessment tool that provides a personal healthscore that can be used to gain improvements in one’s physical and mental health. It is free. Visit preventionhealthscore.com.
Take your free health assessment and tell your patients to do the same. Reduce physician burnout and be a better doctor to help your patients stay well.
Dr Malik H Dababneh
Author of NATION HEAL THYSELF
WWW.PREVENTIONHEALTHSCORE.COM
