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PAIN MANAGEMENT: A DOUBLE STANDARD?

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WILLIAM FISHER
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The first step in his prosecution was revocation of his DEA registration, effectively putting an end to his medical practice and his source of income.

He was forced to use his house as collateral to raise the $25,000 bond that has kept him out of jail for the past five years while his appeals moved forward.

He was found guilty after a jury trial in Federal Court in Florence, South Carolina, between January 31 and February 10, 2002, and sentenced to 25 years in prison. The verdict was upheld on appeal to Fourth Circuit Court of Appeals, but the 25-year sentence was reduced to 2.5 years after the prosecution dropped the manslaughter charge -- it was revealed that the patients who overdosed and died from multiple drug abuse were not his patients. Dr. Jackson appealed to the US Supreme Court, but the high court declined to review the case

Dr. Jackson claims the DEA often charges physicians with more serious crimes such as manslaughter to give them an excuse to revoke a doctor's DEA registration.

Other physicians associated with the "Myrtle Beach Eight" have also been prosecuted. Dr. Deborah Bordeaux received a sentence of eight years and one month for being included in an alleged conspiracy to prescribe medications such as OxyContin. Her sentence was based on working for only 57 days at the pain clinic. Dr. Ricardo Alerre, a 74-year-old physician at the clinic, was sentenced to 19 years and seven months in prison. Drs. Deborah Sutherland and Thomas Devlin received two years each. Dr. Benjamin Moore, who pleaded guilty, committed suicide prior to sentencing.

In response to a plea to reduce Dr. Alerre's sentence based on his age, US District Judge Weston Houck said the law doesn't allow it: "I'm convinced in my mind that Dr. Alerre is a good person; and you'll never see him in jail again, but I'm not going to break the law."

"I believe and I hope that this case has sent a clear message to the medical community that they need to be sure the controlled substances they prescribe are medically necessary," said Assistant US Attorney Bill Day. "If doctors have a doubt whether they could get in trouble, this case should answer that."

"I've done everything by the book; I don't even have a parking ticket," Dr. Jackson said at sentencing. "I think this is just a mistake the government made."

The DEA and its state and local associates have been just as tough on patients. One, wheelchair-bound Richard Paey, has become a kind of poster child for patient prosecutions. A victim of multiple sclerosis, Paey was convicted in Florida's third attempt concerning his use of painkillers. The 45-year-old Mr. Paey turned down an offer of probation based on principle but has now been given a mandatory minimum sentence of 25 years in jail.

Paey's supporters say he was unable to find medical help to ease unbearable pain. He was not convicted of selling any medication, and even the prosecutor admitted he used the pills himself. In prison, he is on a morphine pump that administers more pain-killing medication than he was accused of taking before he went to prison.

Physicians' organizations say that one of the worst consequences of the DEA's campaign against Oxycontin is that doctors are being cowed into giving up the practice of pain management - precisely at a time when science is discovering more effective methods of palliative care.

The doctors charge that DEA agents are not physicians and are not trained to make medical judgments.

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William Fisher has managed economic development programs in the Middle East and elsewhere for the US State Department and the US Agency for International Development. He served in the international affairs area in the Kennedy Administration and now (more...)
 
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