Physician's Prescription For Patient's Pain Leads To Prison
Physician Ronald McIver’s thirty (30) year sentence for prescribing pain medication too “aggressively” to too many patients was upheld by the Fourth Circuit last week, and while reading the opinion, I thought footnotes 3 through 7 were a little odd:
3 Oxycodone is a potent and addictive opioid that is classified as a Schedule II drug under the Controlled Substances Act. See 21 U.S.C. § 812 (2000); 21 C.F.R. § 1308.12(b)(1) (2004). It is marketed in instant-release form under trade names such as Roxicodone, Roxicet, OxyIR, and OxyFAST, and in a controlled- release form as OxyContin.
4 Dilaudid is the trade name for a medication that contains hydromorphone, a potent and addictive opioid that is classified as a Schedule II narcotic. § 1308.12(b)(1).
5 OxyContin is the trade name of a controlled-release form of oxycodone that can be crushed to circumvent the time-release mechanism and then taken either nasally or intravenously.
6 Methadone is a potent and addictive synthetic opioid that is used to treat pain and addiction to other opioids. It is classified as a Schedule II narcotic. § 1308.12(b)(1).
7 Morphine is one of the most powerful and addictive opioids. It is classified as a Schedule II narcotic. § 1308.12(b)(1).
Why did the court feel the need in a legal opinion to note this? Do they feel the need to justify this unreasonable sentence by emphasizing the potency and addictive nature of these drugs? Why the reference to “circumventing the time release mechanism” of OxyContin?
From the statement of facts from the appellant’s brief in this case:
The practice of pain management is varied and controversial. There is no standardization in the treatment of pain. There is a question among physicians over how aggressively to treat chronic pain patients. Most physicians agree on the use of high doses of opioids to treat terminal cancer patients.
While the majority of physicians do not use opioids aggressively with non-terminal patients, there is a minority group of physicians who treat chronic pain more aggressively and with more opioids than the majority group. A physician’s prescribing practices should be dictated by his clinical experience.
The use of opioids(narcotics) is a legitimate treatment option.
All true. And it’s denied by no one that Dr. McIver was legally allowed to prescribe these medications, if he thought it in the best interest of his patients.
So the War on Drugs now includes federal prosecutors deciding what medications are legitimate for you to take, how much you may have, and how long to imprison your doctor if they think he got it wrong. And the appellate court thinks it can hoodwink the readers of its opinion by justifying the sentence, because the meds are “potent and possibly addictive”?
Downright scary…
