Tennessee Gave Pain Physicians Green Light

By Lord, Rich | Pittsburgh Post-Gazette (Pittsburgh, PA), May 26, 2016 | Go to article overview

Tennessee Gave Pain Physicians Green Light


Lord, Rich, Pittsburgh Post-Gazette (Pittsburgh, PA)


In 2001, Tennessee politicians were fighting about the state income tax when the Intractable Pain Treatment Act floated through the Legislature.

"In the hands of knowledgeable, ethical and experienced pain management practitioners," the legislation declared, "opiates ... can be safe." Doctors would not be disciplined for prescribing drugs like Purdue Pharma's hot OxyContin for patients with "intractable pain."

"With 11 minutes of deliberation, the Tennessee General Assembly passed what Purdue was telling states to do," said state Sen. Janice Bowling, who was not in the legislature in 2001, but later researched the bill. "The patient became the prescriber, if you will."

Their act remained law for 14 years, during which Tennessee was inundated with pain clinics -293, at last count. Neighbors rankled by "pill mills" and the crowds of local addicts and interstate travelers they attracted could complain, but neither prosecutors nor the Board of Physician Examiners could do much about it.

"There are rural counties in Tennessee that had more pill mills than grocery stores," said Ms. Bowling.

The former legislative leaders who shepherded the act into law, Sen. Roy Herron and Rep. Mark Maddox, could not be reached for comment.

Starting in 2007, Tennessee took measures to track and slow prescribing. From 2011 through 2015, 74 Tennessee physicians were disciplined in relation to their narcotics prescribing by the state's licensing boards. At least 10 doctors were prosecuted as drug dealers in federal courts in Tennessee in the past five years.

Finally, last year, the legislature repealed the 2001 legislation. But in 2014 alone, 1,269 Tennesseans died of drug overdoses, according to the Centers for Disease Control.

OxyContin for crack

The prescribing free-for-all in Tennessee came at a perfectly awful time for Sanford Kent Myers.

A Knoxville native, Myers studied medicine in the 1980s, when "there was no training on over-prescribing," he wrote to the Post-Gazette from the Montgomery Federal Prison Camp in Alabama. In the 1990s, hospitals were "really into making sure patients were treated for pain."

By the time he was in his mid-40s, he was in the middle of a decade-long crack habit that burned "over a half million dollars," he wrote. "In 2005, I decided to go full blown with writing OxyContin [prescriptions] to obtain crack."

Myers wrote prescriptions for 90 pills of OxyContin, 80 mg strength, once or twice a month, for each of a roster of "patients" that he never saw, according to the plea agreement he signed. Myers' drug dealer would shepherd the patients to pharmacies, pay them $250, and sell the pills -around 30,000 a year -on the black market. The dealer paid the doctor in money and cocaine.

Myers is now 61 with the prospect of release next year, and wrote that he'll work to "demonstrate to the public just how [drug use] will certainly end up twisted, but how it is possible to survive the consequences and become a much better person."

Charles Michael Howe, an obstetrician and gynecologist who started his residency in 1967, would meet certain patients in the parking lot of his office, in the little Chattanooga suburb of Jasper, to hand them prescriptions for hydrocodone, methadone or oxycodone. Once he told a patient "that she was asking for too much medication and that he just wanted sex," according to a plea agreement he signed. The next day, though, Dr. Howe "wrote a prescription for [the patient] for 60 oxycodone 15 mg pills."

Now 74, Howe did not respond to a letter sent to Montgomery Federal Prison Camp, in Alabama, where he is serving a three-year sentence.

Jerome A. Sherard, then a doctor, and his nurse practitioner would see 100 patients a day, according to board documents and court filings in the Eastern District of Tennessee. His Chattanooga clinic parking lots became places where "drugs were illegally used, abused, and distributed by patients," according to the plea agreement he signed. …

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