MJ's Story Highlights Ease of Getting Prescriptions

As the world is learning of the facts surrounding the cause of Michael Jackson's death, I watch with a combination of frustration and hope. I am frustrated by the shock and fascination on the part of the media and viewing public at the role his physician played in administering a lethal dose of Diprivan (propophyl). I am hopeful because Michael Jackson's sad and untimely death is an opportunity to raise awareness of the role negligent physicians play in people's lives.

My street cred on this topic stems from times like last week when I stormed a clinic in Idaho to put on notice a doctor who had been misprescribing Xanax for a woman on methadone therapy. Her family had asked for my help. They had watched their daughter spiral deeper and deeper into the depths of prescription medication addiction. The methadone she was hooked on was supposed to help her get off street drugs, and it did, for a while. But her "dealer" prescribed her Xanax, a popular benzodiazopene used to treat anxiety and insomnia. Xanax is the same type of drug as Valium, and if you take it while you are on methadone therapy, you'll get high as a kite. Physicians know this, but most don't pay attention, and some prescribe with reckless abandon.

If a physician does not take a detailed addiction history from ANY patient to whom they prescribe a drug like Xanax, Valium or Oxycontin, they are abandoning their Hippocratic Oath and essentially becoming a dealer. They should be treated by law enforcement as such. These prescriptions have enormous medical value for a variety of ailments, but without proper screening of patients they are as deadly as cyanide and as disruptive as a loaded gun on a playground.

In a few cases, a physician genuinely may not have known what role they played in putting a patient at risk and would react with concern. Other physicians have actually said it was the patient's job to act responsibily -- demonstrating a profound and gross misunderstanding of the disease of addiction, our country's third leading killer. Still other physicians I have seen are almost sociopathic in their disinterest and seemed to have no conscience about their patients or their families after being paid for an office visit.

While I felt a sense of accomplishment in taking action against these practitioners and notifying the state medical board of their abuse, I think any real impact comes when someone loses their life and headlines grab the public's attention.

In watching the Michael Jackson news this week, that same sense of frustration returns. The greatest pop icon of our age died on the cusp of a comeback, while his devastated family tearfully provides testimonials about how his insular network of doctors never had his best interests at heart. His now fatherless children serve as living proof that Jackson's family members were right in their exasperation. In this drawn-out drama, they are far from unique.

As extraordinary as Michael Jackson's life story was, the story of his death is shockingly ordinary.

My frustration is that it's harder to buy a pre-paid cell phone in this country than it is to secure multiple legal prescriptions from different doctors to feed a deadly disease that hurts everyone surrounding the addicted patient. My frustration is that it takes a high-profile, headline-making event like the death of the King of Pop for us to examine accountability among the medical profession concerning contraindicated health risks for people struggling with addiction. My further frustration is that Michael Jackson's story is being perceived as unique while it's happening in living rooms across this nation daily, with real loved ones left behind crying real tears and sharing similar bewilderment that a "real doctor" was involved. But as I have learned as a person in recovery from my own drug addiction, frustration is an emotion we cannot afford. It must be turned into hope.

So my hope is that this coroner's ruling is a wake-up call for more checks and balances in the pharmacy system to prevent abuse of potentially dangerous prescriptions. My hope is that addiction be managed by physicians and the medical establishment in the same way diabetic patients are managed, with their chronic deadly condition at the heart of ALL treatment decisions. And my greatest hope is that I never have to fill out another police report or watch another news story about a doctor who provided a legal, physician directed regimen of a pharmaceutical that amounts to a potential death sentence for one of the 20 million Americans that suffer with addiction.

Comments

[NorthSide]

If i were rich enough to have a private doctor in constant attendance, then getting prescriptions for diprovan would indeed be easier than getting a cell phone. But since I'm not, I can't. As we explore this issue people seem to be trying hard to find a universal lesson in MJs tragic death. However, his situation is so unusual that little is applicable to the rest of us. I can't find diprovan at my local drugstore, I can't get a prescription for it, and the pusher down at the playground doesn't carry it. Even if i could get it, I probably couldn't inject it myself because I'd pass out before i got the needle out of my arm. Frankly, heroin would be easier to deal with.

[DrNimbin]

Sounds like someone big noting themselves rather than trying to understand the complex issues associated with addiction medicine. If someone is dependant on benzodiazapines like Xanax the worse things that could happen would be for them stopped suddenly. You should be aware that this can lead to a life threatening withdrawal syndrome that includes grand mal epileptic fits. Putting 'doctors on notice' will make it more likely for them to suddenly cease prescribing and put the patient at risk.
It might be better for the patient to: 1. Discuss it with the patient and make them aware of the risks they are taking. Most will respond to this as they do not want to die. 2. Inform the methadone clinic that the patient is being prescribed medication by another doctor. The clinic is often unaware that they are seeing another doctor for medications of this nature and often the patient would not have informed the prescribing doctor that they are on methadone. 3. Inform the prescribing doctor that the patient is on a methadone program. (see 2) and suggest that the patient might need help withdrawing from Xanax, ideally this should be managed under the supervision of the addiction medicine specialist who is prescribing their methadone.
Your confrontational approach might make you feel good but in the long term it is unlikely to help the patient. They usually find another doctor to prescribe for them just as MJ did when other doctors refused to prescribe and administer propofol.

[JJThinking]

I wasn't aware that individuals could get "prescriptions" for anesthesia. Oh, that's right, they can't. Nor can one becom "addicted" to anesthesia.

Had MJ died of a prescription drug overdose, this article would be more relevant. While you are correct that we should raise awareness of prescription abuse, prescription abuse is not what ended MJ's life on June 25.

[Robin-B]

Brad,while your street cred on this topic might sound all nice in 'black and white' print,it's not quite so pretty and perfect when you're living the life of a chronic pain patient.
While you are 'storming' these clinics to help a person suffering from drug addiction.you are chasing out,scarin­g,closing,­and otherwise hurting and harming people who are there to see their Drs.and nurses.People who are there to get treatment for living in pain sometimes so severe that without these medications (they) cannot have a quality of life that allows them to even get out of bed at times.
Brad,while the fight you are fighting is worthy and justified,perhaps it might be better fought on another turf,rather than taking one drug addict into and 'storming' clinics--where not ALL patients,and not ALL Drs are guilty of nefarious behavior.
One bad apple ,you know?

[Rstonecoco1]

I have to agree with TarqunBiscuitbarrel - for every one MJ, there are probably hundreds of everyday people who don't get adequate pain treatment because doctors are scared to death to prescribe narcotics. Why are doctors scared? Because of people like Brad Lamm and his cowboy swagger, bragging about his "street cred" from when he "stormed a clinic." Instead of rational and compassionate dialogue, these so-called "specialists" (in what, exactly?) play Desperado and rattle the cages of enough doctors that they don't prescribe adequate medications to their patients. I can't help but think of an analogy with those who intimidate abortion doctors and brag about how they are fighting the good fight, while in reality necessary women's health services become increasingly scarce because doctors are scared away from providing these procedures.

It's easy to generalize from sensationalized stories like Michael Jackson's death. No doubt, in his case, severe wrongdoing occurred and the guilty parties should be disciplined appropriately. But the bigger problem here is undertreatment of pain, not overtreatment. And woe to the unfortunate person who had some remote history of addiction and who has a serious injury; if your doctor takes a "detailed addiction history" and is scared to prescribe you medications, it's back to the 19th century for you!

[ReealOne]

Very well said Brad! What seems to be lacking here is responsibilty and accountability on the part of physicians who swore their hippocratic oath to "first do no harm".

Although no one wants to see anyone with addictions to the point where it takes their precious lives, it is really obscene and a betrayal of trust, when it's done with the willing assistance of a physician who knows in detail the dangers of these addictions and over-prescribing drugs to enable the addicts.

I agree that what happened to Michael Jackson is not unique and happens everyday. It's so very sad that many precious lives are being lost everyday to drug addictions, and the folks who are their enablers.

[situationcritical]

I understand your frustration. Do you understand mine? Where is your proof of Michael Jackson's prescription drug addiction? Really, it's hearsay.

[MrsTarquinBiscuitbarrel]

In the not-famous, not-MJ category, believe me, it is much easier to purchase a pre-paid cell phone than to find ONE ethical physician specializing in pain management. Though there are individuals who divert medications or lie to their physicians, there are countless more who have endured intolerable pain and suffering because almost all physicians will do almost anything to avoid prescribing Schedule II narcotics if they possibly can avoid it. People on ongoing, as-prescribed opioid therapy for chronic pain do not get high from the medication--they stop hurting and can resume something resembling a normal life.

"intervention specialists" make it their business it is to get people off drugs, any drugs, for any reason. Who can argue with that? The people in pain who are totally honest and compliant with their pain management physicians. If they can't find one, they lose, living death in life.

[mahonpe]

I must agree in my many times of being in and out of the hospital, many times in an emergency room under heavy pain. I would be give strong painkillers while there but when discharged almost everytime the pain not cured or gone the doctors would not give a prescription for a strong narcotic. Even though they had me on high amounts of them to even bring the pain down.