His testimony at kevinmd.com reads like something written during the height of McCarthyism or COINTELPRO. But it was earlier this year–July 25th–and Dr. L. Joseph Parker, research scientist and pain care specialist, is looking at a 20 year sentence for dispensing appropriately prescribed pain medications. The meds in question are opioids, which our society has decided are verboten and the people who prescribe them should stop–or go directly to prison. And the federal government agencies which deal with substances and their issues (DEA/FBI//DOJ) have landed on these physicians with all the ungodly force Uncle Sam can bring to bear.
Dr. Parker’s ordeal began last year when he received a call from a fellow pain care specialist (PCS). She told him the state medical boards had complained that she was prescribing opiates to some patients at 90 MDE (maximum daily exposure or intake), which they claimed was excessive. She pointed out that the Center for Disease Control (CDC) clearly meant those guidelines to apply to primary care physicians, not pain care specialists. The board responded by suspending her license.
Dr. Parker discovered the reason that this happened to his colleague was that the DEA was quoting morphine dose/milligram equivalents, leaving the press and the public with the impression that these were individual pills rather than the maximum dosage taken per day in aggregate.. He wrote a letter to the paper trying to correct these misstatements but no correction was made. This would not be the first or last time that the Fourth Estate aided and abetted law enforcement in this matter.
Then another colleague was arrested for prescribing Xanax to a patient in crisis. The scene of the “crime”: a McDonald’s parking lot. Yes, that raised some eyebrows, but the nature of crises is that we have no control over where or when they occur. Under intense questioning by Federal agents, the doctor panicked and claimed she hadn’t written the prescription. Interestingly, at sentencing, the government did not ask for prison time, but the presiding judge, wishing to “make an example” of her, sentenced her to three years. Three years for a momentary lapse of reason.
Dr. Parker then found himself a victim of this witch hunt: a sheriff’s deputy arrived at his office with a temporary letter of suspension from his medical board. A former employee had called an insurance company, pretending to be a patient of Parker’s, and complained that he was “treating addicts.”
As Parker explains, “The insurance investigated and found that some patients had died within thirty days of being treated by us…It turns out that any patient that dies while taking opiates is listed as an “opiate-associated” death, even if they die in hospice or by suicide. I even had a patient who died in police custody, twenty hours after taking his medications and after being denied proper medical care. The jail told his family he had died of an overdose, despite the coroner’s autopsy finding that he died from a cardiac condition.” (Emphases mine.) As the result of shoddy math and data conflation, local and federal authorities could make the case to a jury that a legitimate pain care specialist was a “pill mill” doc out for the bucks. But Dr. Parker is not a pill mill doc. In fact, he took hundreds of hours of CME (continuing medical education) in pain management and addiction and joined both the American Academy of Pain Medicine and the American Society of Addiction Medicine.
I’ll let Dr. Parker describe what happened next:: “The insurance company investigation found that our treatment had been reasonable but felt they had to notify the medical board. The medical board felt they had to issue an emergency order of suspension without giving me a chance to defend my practice. When I finally went in front of them, the suspension of my license was lifted, and I thought the ordeal was over. Instead, law enforcement officers went on the news to say that the board had been too easy on me, and I was indicted that same day. I did not plead guilty but took it to trial.
“The government wanted to give me twenty to life for the patient who died in police custody. I took the stand in my defense and tried to help the jury understand the complications of medical practice and the risks and benefits of opiate therapy. I explained that I was certified to treat addiction, and that while my patients on opiate therapy did not have addiction, even if they did, the benefits of treatment could outweigh the risks. The government’s expert testified that MRIs were not objective, that a veteran treated with methadone for pain meant he had addiction, that a man with a hand crushed so badly that a finger was pulled off did not have “real” pain and should not have been treated.
“The fact that I had cut him back from three opiates to two and from two benzodiazepines to one on that first visit went right over the jury’s heads, as well as the fact that I had reduced his opiates sixty days and his benzodiazepines thirty days before his death.” (Emphases mine.)
As of this writing, Dr. Parker does not know his fate.