I remember being a young nursing student in the 70’s. Those were the days we were not only taught how to care for sick patients but also to respect those who wore the white coats and signed their scribble with M.D. During my training I met and became friends with a female medical student. We became close as we bitched about the rigors of both nursing and medical school. She showed me the human side of medicine as she would talk about patients that both touched and broke her heart. These experiences would become her foundation for practicing the oath To Do No Harm. I remember hanging out one night after graduation. Sharing a celebratory bottle of red we got into a debate over that very oath.
Years later, with much experience under our belts we connected again. Both of us changed by the experiences we lived through in our medical careers. Again our conversations led back to that famous oath. Written by Hippocrates, it is the oldest binding document in history. Still recited in medical school graduations and supposedly held sacred by physicians.
Supposedly, because all physicians are not created equal.
Nothing in my nursing career could have ever prepared me for the type of doctors responsible for the opioid prescription epidemic. Known as pill mill doctors, they operate as pain management or pain clinics. They set up shop in benign looking buildings. The pill mill my son frequented was located in a row of town homes, looking like a private residence. Flowers in window boxes giving the appearance of a happy little home. That was until you walked through the doors. Imagine my shock when I followed my son one afternoon. I was greeted by a full waiting area. Glassy eyes followed me as I found an empty chair and sat. Some of these so called patients having trouble keeping their eyes open, slumping over onto the person sitting in the chair beside them. Then startling themselves awake. I sat there and counted fifteen people. All shapes, sizes and ages and all in the same state of physical condition. I sat and watched as one by one they were called back. First stopping at the reception window and pulling out bills or a credit card before going back for their poison.
I innocently asked the woman on my left about this practice accepting insurance. She looked at me with a smile, letting me in on a secret. Honey, it’s cash or credit only. I get my pills when I get my welfare check cashed. Oh dear God, I’m sitting in a room full of addicts and my son is one of their victims. I wanted to puke. I’d seen and heard enough. My plan was to confront my son in the very waiting room I sat, but now I had to get out and get air.
I was determined to find out everything I could about these pill mills and do what I could to save my son.
All the research stated the same facts. These clinics accept cash only. I witnessed that for myself. Cash, no paper trail for the reporting of income. The patient might not even be seen by a physician and have no physical exam during the visit. My sons scripts were written by a Nurse Practitioner. When I questioned Matt he denied ever being talked to about other means of pain control. Ever having diagnostic X rays ordered. No scripts for physical therapy, just a monthly supply of a deadly combo of drugs. Matt received scripts for Percocet, Methadone and a generic muscle relaxer. The deadly cocktail that I found was their prescribing practice. How could these so called doctors continue to prescribe a deadly combo of drugs and not be investigated. (http://www.cbsnews.com/news/whats-a-pill-mill/).
I got that question answered when I made copies of my sons prescriptions and filed a formal complaint against this pain management clinic to my State Board of Medicine. Here I was an educated medical professional expressing concern about the deadly combo of drugs being prescribed not only for Matt but more than likely for most of their patients. I was so proud of myself. Thinking I had done the ethical thing by reporting these imposters in white coats. I went as far as googling the Hippocratic Oath and found the line that clearly states “I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect.” (www.pbs.org/wgbh/nova/body/hippocratic-oath-today.html). So here it was in black and white for all the world to see. How could this type of practice make a living prescribing deadly combinations of drugs for cash and get away with it. Licensed doctors selling drugs with no intention of helping the sick or injured. How many patients came to them innocently seeking help only to become monthly cash income to the predators who knowingly fed them poison.
Imagine my shock and fury when I received the Boards response. My hope of saving the innocents from further harm blowing up in my face. Unbelievable words staring back at me. We find no fault with the prescribing methods of this practice. Thank you for your concern. I wanted to scream. How could this be acceptable. Did those physicians who make up the illustrious Board lose their minds. Were they so far removed from practicing safe medicine or were they blinded by their own greed. Sitting in ivory towers with the powers to prevent harm. Oaths taken so long ago now forgotten.
Anger turned into investigation. I discovered a study conducted by the Center for Disease Control and Prevention stating that a relatively small number of doctors were responsible for a large proportion of painkiller prescriptions. Imagine my surprise when Delaware was noted to be among the highest prescribers. In Delaware it was found that the top 1% of physician prescribers wrote 25% of the opiate prescriptions. Also noted in this study was the fact that these very same prescribers were writing scripts for benzodiazepines, a deadly drug combination. (https://www.opiates.com/media/prescription-drug-monitoring-combating-opiate-addiction/). This study backed up what I was living during my sons addiction. Multiple bottles of pills, Benzos, Percs and Methadone in quantities that could kill a horse. Instead they killed my son.
Delaware, the small state with a very big problem. The problem of doctors doing harm. The problem of doctors ignoring those doctors. An Oath written in the fifth century B.C.and still held sacred by some physicians but not all. Pill mill doctors, tainted by greed. Contributing to the disease of addiction. Causing more harm than good….