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. - --- MAP posted-by: Beth