Pubdate: Thu, 03 Oct 2002
Source: Mobile Register (AL)
Copyright: 2002 Mobile Register.
Contact:  http://www.al.com/mobileregister/today/
Details: http://www.mapinc.org/media/269
Author: Brendan Kirby

DISTRICT ATTORNEY, INVESTIGATIONS TAKE NEW TRACK

BAY MINETTE -- The next front in the war on prescription drug abuse may be 
doctors' offices, but Baldwin County District Attorney David Whetstone said 
state law makes it nearly impossible to prosecute physicians acting in 
their official capacities.

Whetstone has set up a team of investigators to examine a rising wave of 
deaths attributed to prescription drug overdoses. Previously, after ruling 
out foul play, investigators labeled such deaths accidents and then moved on.

"It didn't really extend back to, 'Could this have been a person who was 
prescribed drugs inappropriately?'" said Lt. Huey "Hoss" Mack Jr., the 
chief investigator of the Baldwin County Sheriff's Department.

Now, investigators on the new team will work backward to try to discover 
how the victims received such drugs.

"It's going to be very cumbersome in terms of paperwork. But it's a problem 
we feel needs to be addressed," Mack said.

Whetstone said he wants to find out if there is a pattern.

"If we have an unusually high number, then we have a problem with rogue 
health professionals," he said. "We know where it comes from because these 
kids sell it on the streets and we trace it back."

Headlines in recent months have detailed the problem vividly. Investigators 
determined that a combination of Valium and OxyContin caused the overdose 
death of Walter "Sandy" Wade in Orange Beach.

In August, the Alabama Medical Licensure Commission temporarily suspended 
the medical license of Gulf Shores Dr. John Howle Sox after the state Board 
of Medical Examiners stated that he suffered from a "neurocognitive 
impairment" that makes him unable to safely practice medicine.

The licensing panel will consider a permanent revocation of the license at 
a Nov. 20 hearing.

Whetstone has said investigators believe Sox has a connection to Wade's death.

In another related development last month, Angela Goodman was convicted of 
driving the getaway car for her husband in the robbery of the Family 
Pharmacy in Orange Beach. Drugs, not cash, were the target of that heist, 
according to reports.

And on Tuesday, the Baldwin County Drug Task Force announced the arrests of 
eight people indicted by a grand jury on drug possession charges. In each 
case, according to authorities, the suspects tried to illegally obtain 
prescription drugs by getting multiple doctors to write prescriptions for 
the same drug and then filling those prescriptions at different pharmacies.

Whetstone said the vast majority of Baldwin's doctors and pharmacists are 
honest professionals. But the few who are not enjoy broad protections from 
prosecution, he said.

"We have got a problem in this state because of it," he said. "We should be 
able to prosecute a doctor who is essentially a drug smuggler."

Dr. John McDuff, who runs a medical practice in Fairhope, said a small 
number of doctors "taint" the entire profession.

"I think there are some of them that are just plain crooked," he said. 
"There are bad doctors. There are doctors who do things that are 
questionable. ... There are doctors that get rather creative."

McDuff, former president of the Baldwin County Medical Society, said some 
doctors may get an outright kickback from drug abusers desperate for 
prescription drugs. For others, he said, the payoff is more subtle.

He laid out this scenario: A physician with a flagging practice may shore 
up the bottom line by writing more prescriptions for pain medication. The 
doctor gets paid for the visit by Medicare or a private insurance company. 
The doctor soon develops a reputation among people in search of drugs to 
feed their habits, and business for the doctor booms. Drug investigators 
said a number of prescription drugs have become valuable commodities on the 
black market. Among the most notorious is OxyContin, a potent narcotic used 
legitimately to treat pain.

McDuff said the pill contains a time-release component that gradually 
dispenses the medicine over several hours to maintain its effectiveness 
until it is time for the next dose. He said addicts bite through the 
capsule, causing the entire amount of the medicine to rush into the user's 
system at once.

The result is a powerful high, but one that can be deadly -- especially 
when the user has taken other drugs or alcohol.

McDuff said it is usually easy to spot a drug addict searching for a 
prescription drug fix. The most brazen patients ask for specific drugs by 
name on a first visit, he said.

McDuff said he cannot imagine a situation in which he would write a 
prescription for a powerful painkiller on a patient's first visit. And if 
the patient requests a specific drug by name, he added, that should send up 
a red flag.

"He ain't getting it," McDuff said. "Somebody that's experienced ... should 
be able to pick up on this fairly easily."

While he would like the state Legislature to make it easier to prosecute 
doctors who knowingly write prescriptions to addicts, Whetstone said 
lawmakers should also pass laws to deal with what is a far more common 
problem: a lack of communication among doctors and drug stores.

Most doctors and pharmacists are honest, Whetstone said. Addicts often 
obtain excess medication by shopping around for doctors and pharmacists in 
different parts of the county and state.

Unlike some other states, Alabama has no central database that would allow 
pharmacists and doctors to immediately check what other medications a 
patient has been prescribed in other areas.

"It would prevent a great deal of shopping around to get too many pills," 
Whetstone said.

State Rep. Steve McMillan, R-Orange Beach, said he is not sure that setting 
up a statewide database would be worth the expense. He said addicts could 
circumvent it by using fake names. A better solution, he said, is to 
consider stiffening the penalties.

McMillan said he is open to changes in the law that would make it easier 
for prosecutors to go after rogue doctors.

"If it's something that's a problem, even in one county, it ought to be 
addressed," he said.
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