Medical Professionals Say Opiate Crackdown Has Risks

Tough pill to swallow for doctors, dentists


Doctors and dentists said they worry a new law enforcement crackdown on opiate prescriptions could have a chilling effect on those who help patients manage chronic pain.

“I think we need a balance,” said Dr. Jonathan M. Davis of Tufts Medical Centre. “You have to be careful. The last thing you want is for the front page of the Herald to show a doctor being led away in cuffs, and it turns out he has a palliative care (pain management) practice.”

He said prescription pill sanctions could lead to more heroin use, saying, “Addicts will continue to buy pills on the street, but that gets more expensive and heroin is cheaper.”

Dr. David Lustbader, vice president of the Massachusetts Dental Society, said the initiative could hurt those patients who need aggressive pain management.

“No one wants to be audited by anyone for the state,” Lustbader said. “If they’re going to pick a number, and they pick the top 20, maybe they’ll go to the next 100 after that.”

Attorney General Maura Healey yesterday cited a nearly 140-per cent rise in opiate prescriptions across the state since 1995 as she vowed to prosecute those who illegally prescribe and dispense painkillers to known addicts.

The crackdown was announced as part of a new partnership with the FBI, US Department of Health and Human Services, US Drug Enforcement Administration, US Attorney’s Office and the state Auditor’s Office.

“I recognise and understand that the vast majority of prescribers across this state are doing the right thing, are taking care of their patients, are serving those in need,” said Healey. “There are also a number of folks who are in need of access to pain medication. This working group is not about them. This working group is about the fact that we do have actors out there in our state who are illegally, unlawfully prescribing prescription pain medication and that is causing great harm.”

Boston attorney Andrew C. Meyer, Jr. said doctors can face malpractice lawsuits for getting patients hooked on opiates and even criminal charges for fraudulent practices, such as writing prescriptions in a dead person’s name, but prescribing opiates to known addicts — including those undergoing medical procedures or surgeries — isn’t a crime by itself.

“Just because someone is an addict doesn’t mean you can’t prescribe to them,” said Meyer. “You just can’t have the criminal intent to cause harm.”

In May, a federal jury acquitted Dr. Joseph Zolot, who was accused of over-prescribing opioid-based painkillers at his Needham orthopaedic clinic. Prosecutors dropped charges involving the deaths of six of Zolot’s patients in the wake of a Supreme Court ruling setting higher standards to prove drugs caused a death. – Erin Smith,Lindsay Kalter

(Photo caption: Aiming high: AG Maura Healey discusses the fight against illegal opioid prescribing and dispensing yesterday as FBI Special Agents in Charge Harold Shaw, left, of the Boston Division, and Michael Ferguson, right, of the DEA’s New England Field Division, look on. (Credit: Patrick Whittemore))