#OurPain: Doctors caught in the cross hairs

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The crackdown on prescribing pain medication is intended to help the addiction crisis but it’s leaving chronic pain patients in the lurch — and their doctors in the cross hairs.

Dr. Daniel Laird has been a pain specialist for more than two decades. He’s treated thousands of patients using a mix of western and eastern approaches. Yoga, acupuncture, aromatherapy and only prescribing opioids as a last resort. But since the Centers for Disease Control issued stricter guidelines — severely limiting dosages — everyone in the opioid chain is alarmed.

“Everybody’s afraid. The pharmacist is afraid, the pharmacy manager is afraid, the district manager’s afraid, the doctor’s afraid, the nurses are afraid. Nobody wants to be accused of being a drug dealer or a drug dispenser, or a drug pusher. And so everybody’s constantly looking over their shoulder,” he said.

Dr. Laird files nearly 50 pages of paperwork per visit per patient. He doles out opioids much more frequently than other doctors. So he’s keenly aware that the feds and state agencies are monitoring him. 

“I suppose that every doctor has this horror scenario in his mind or her mind that the DEA is going to show up at your office door with a pair of handcuffs and confiscate all of your patient files and you’ll be hauled off to federal prison.”

“It’s a total witch hunt,” said Dr. Mark Ibsen.”

Montana based doctor Mark Ibsen knows what it’s like to be in the cross hairs. The Drug Enforcement Agency thought he was overprescribing, and raising the risk of addiction and overdose. Investigators came to his office multiple times and he briefly lost his medical license. 

“It’s a hostile regulatory environment. I can’t help anybody if I’m in prison so I stopped. I helped my patients taper down did my best. DEA came to check on me. Came to visit me five times. It’s like the mafia coming to see you.”

His license was eventually reinstated but he no longer issues prescription painkillers. Stories like this are not uncommon.

Prosecute one doctor and it sends shock waves through the medical community. Dr. Chris Christensen, a practicing physician in Montana was charged with dozens of felony counts after two of his patients died from an overdose. Dr. Stefen Kertesz from the University of Alabama at Birmingham stresses, doctors are being squeezed. 

“So, there’s doctors who truly believe that if they just stop prescriptions, they’re in the clear. The patient will be better off,” Dr. Kertesz said. “So, we have this perverse situation, where if you reduce doses, even if it causes your patient to die from suicide or other forms of distress, the doctor’s record looks better, not worse.”

“Physicians, prescribers are scared. They want to do what is best for their patient but they are also a regulated profession, and in the current anti-opioid climate, as it relates to prescription drugs, they do not want a knock on the door from the DEA. So, what we find is, a lot of physicians are opting out of pain management because it’s too much trouble. They’re being demonized much like pain patients are being demonized,” said social scientist Dr. Stephen Ziegler, Purdue University.

Cutting a patient off cold turkey can be dangerous and even deadly. The challenge is to strike a balance between the needs of a patient dealing with chronic pain while also reducing the risks of opioid related overdose and deaths. That’s why Dr. Laird requires his patients sign a written agreement. 

“Part of the reason is that it lists everything that could go wrong with their opioid therapy. It’s a reminder to them. Keep these medications locked up. Dont let little kids get near them. Don’t let your pets eat the Percocet that falls on the floor. And the reason I do it is , number one to document that I’m doing what I’m supposed to be, but number two, to remind the patients that these are dangerous drugs. They really are, but do have their place,” Dr. Laird said. 

More stories, links and information can be found in a special opioid section on LasVegasNOW.com.

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