Tom Corbett: Jailer of Healers and the Sick

Attorney General Tom Corbett: Jailer of Healers and the Sick; Alex DeLuca; War on Doctors/Pain Crisis; Pain Relief Network; 2007-06-27.[See also: Tom Corbett Bags Another Dangerous Doc; DeLuca; 2007-06-26.]

“Our grievous error was in allowing the narcotics addict to be pushed out of society and relegated to the criminal community. He isn’t a criminal. He never has been. And nobody looked on him as such until the furious blitzkrieg launched around 1918 in connection with the enforcement of the Harrison Act…
Narcotics-users were “sufferers” or “patients” in those days; they could and did get relief from any reputable medical practitioner, and there is not the slightest suggestion that Congress intended to change this-beyond cutting off the disreputable “pushers” who were thriving outside the medical profession and along its peripheries.”
[The Narcotics Bureau And The Harrison Act: Jailing The Healers And The Sick; Rufus B. King; 26 Yale Law Journal, 784-787; 1953.] [See also: The War on Drugs, War on Doctors, and the Pain Crisis in America; DeLuca; 2004.]

From the website of Pennsylvania Attorney General Tom Corbett regarding Dr. Lawrence Kansky, D.P.:

Attorney General Corbett Announces the Arrest of a Luzerne County Doctor on Charges of Prescription Drug Abuse; 2007-06-26.

WILKES-BARRE - A Luzerne County podiatrist was arrested today for fraudulently obtaining prescription narcotics for his own personal use.

Attorney General Tom Corbett identified the defendant as Dr. Lawrence Kansky, D.P., 50 [who] had two practices: the Northeast Foot and Ankle Center, 943 Church St., Hazelton, and 62 Mountain Blvd., Mt. Top.

“It is extremely disappointing to see another medical professional charged with prescription drug abuse,” Corbett said. “These cases are becoming more common and it is unfortunate that individuals such as Dr. Kransky would risk their entire career for a temporary high.

“Pennsylvanians need to understand that prescription pain relievers, not just street drugs, are extremely addictive and powerful substances.” …

Nonsense. What Pennsylvanians need to understand is that AG Tom Corbett is mis-informing them and playing them for fools in a venal and socially destructive game that at once creates, and then plays off of, Americans’ trumped-up fears of a ‘prescription drug crisis’ for which there is very little scientific evidence. What Pennsylvanians need to understand is that it is bizarre and unnecessary and a complete waste of taxpayer money for their Attorney General to attack what are, at worst, allegedly substance misuing physicians who pose close to zero public threat, as ‘dangerous drug criminals.’

Unbelievable. In New York cases like Dr. Kansky’s and that of Dr. Zampogna discussed here yesterday [AG Corbett Bags Another Dangerous Doc], would be referred to the Committee for the Physicians Health (CPH) which works closely with the Office of Professional Medical Conduct (OPMC) which is our state Medical Board.

These docs, in NY, if determined to be suffering from a Substance Misuse Disorder on expert Addiction Medicine evaluation, would be treated as “impaired physicians”, and they would be compelled by the CPH / OPMC, under threat, usually, of licensure revocation, to enter a more or less intensive, depending on the individual case, monitored treatment program. For example, a treatment plan for an opioid-misusing doc, who was not a pain patient herself, might include supervised (witnessed) naltrexone therapy three times a week (100mg on Monday, 100mg on Wednesday; 150mg on Friday) that would render an opioid-misusing physician entirely unable to feel the effects of any opioid, entirely unable to “abuse” opioids.

I used to treat such ‘impaired physicians’ who were being monitored by CPH routinely from 1990-2000 in my positions as medical director and later chief of Smithers Addiction Treatment and Research Center in NYC (which now has a new name, due in no small part to yours truly - it’s an old, long, ultimately senseless story). Anyway, Smithers had an Impaired Physicians program, and those patients’ cases were directly managed by our most senior and expert physicians, the medical director (me) or my mentor Dr. Anne Geller who was chief of Smithers until her retirement in 1998 when I replaced her.

Docs recover at a phenomenal rate, by the way, due in part to excellent, consistent and persistent, usually expert, treatment. That sort of approach, encouraged by New York’s CPH, treats ill physicians up to the medical standard of care, and keeps them working if that can safely be accomplished. Corbett’s approach criminalizes them at great social expense.

There is no medical justification for treating substance misusing physicians as criminals (cleave them from Medicine into the hands of Law), nor is there any compelling public health reason for doing so. Physicians are one of the few groups of addiction patients who overwhelmingly have excellent outcomes with standard-of-care medically-directed therapy. But don’t wait for the academic medical community to stand up against drug warriors like Tom Corbett who are grossly distorting the norms and ethics of Medicine, nor should you expect state medical boards weigh in on the advisability of treating sick people as criminals as a matter of State policy. And, of course, the American Society of Addiction Medicine (ASAM) is MIA.

This is all as it ever was. The AMA, various pain societies and addiction medicine societies, and the honorable and ethical segment of the legal and law enforcement profession, historically ALWAYS CAVE before the policeman’s wrath. I have mused, a little, on the reasons for this elsewhere. [The Solution... Is NOT More Negotiation with Law Enforcement; DeLuca; 2004]

Dermatologists? Podiatrists?? Self-prescribing doctors are socially significant dangerous drug criminals? Jeez, get a grip! I’d like to think these were humorous aberrations, but I’m starting to get the sickening feeling that there is a method to this madness.

Here is what I fear is behind Corbett’s criminal indictments of what are, allegedly, physicians with Substance Misuse Disorders (yes, that is the correct terminology), based admittedly on only two data points - Dr. Kansky, discussed above, and Dr. Zampogna: I fear what we are witnessing is the evolution of a new war on doctors tactic - demonize physicians directly. Cast suspicion on ALL physicians, if possible, but certainly imply that any physician who ever handles or prescribes any controlled substances for any reason is a presumptive criminal sleaze. That’s the default perception drug warriors like Tom Corbett seek to firmly establish in the public mind, and in the minds of judges, and juries.

At least they are consistent. Having succeeded in making all pain patients defacto criminals and all clinicians justified, if not legally obligated, in treating them all as potential criminals first and as patients second, it is only a logical, incremental, very do-able next step to work the exact same magic on the providers themselves. Here comes the media blitz; doctors with drug problems! (gasp!)… wait for it.

Corbett is just another self-serving drug warrior panderer. He is truly a Jailer of the Healers and the Sick. The good people of Pennsylvania ought put a stop to his destructive and selfish little pogrom against easy prey physicians. I cannot believe PA is so rich, or it’s voters so self-righteous and mean-spirited, that they would pay for and put up with the likes of Tom Corbett. Your AG is off the rails, Pennsylvania; do something about it!

Sickeningly fascinating.

[END]