Painkiller use rising at alarming rate

It is no small wonder that federal authorities suspected the area was home to a notorious “pill mill,” or a clinic that dispenses prescription medication without verifying that it’s needed.

The U.S. attorney for South Carolina secured a 58-count indictment in June 2002 against seven physicians and one employee of the Comprehensive Care and Pain Management Center, a nondescript storefront on Myrtle Beach’s main drag.

Tipped off by local pharmacists concerned about an increase in the volume of painkiller prescriptions, the federal investigation created a furor in the medical profession. The owner, D. Michael Woodward, was sentenced to 15 years in the case and has relinquished his license.

A second physician, Deborah Bordeaux, had worked at the clinic less than two months before quitting in disgust. Bordeaux, now serving a two-year prison term, was threatened with a 100-year sentence if she did not help the prosecution.

Officials with the Justice Department and DEA would not discuss what some activists say is a “war on doctors.”

‘It was a witch hunt’
Reynolds, the widow who drove her late husband hundreds of miles for his pills, became an activist after the Myrtle Beach indictments. She contributed money to appeal some of the criminal convictions in South Carolina and started the Pain Relief Network, an advocacy organization for people living in pain. She believes the doctors sent to prison were railroaded.

“It was a witch hunt,” she said.

Bordeaux’s husband, Edworth Swaim, agrees. A retired U.S. Postal Service employee, Swaim believes his wife was sentenced to two years because she would not turn on her former colleagues. Even though Bordeaux had worked at the clinic less than two months and eventually sued over what she alleged was rampant Medicare fraud, he said she did not stand a chance of avoiding prison.

“She wasn’t guilty of anything, so she wasn’t going to plead to anything,” Swaim said. “She was absolutely railroaded, made an example of. I can’t tell you how angry I am.”

Myrtle Beach physicians are not convinced that the “Myrtle Beach Eight,” as they became known, were innocent.

A Myrtle Beach internist who also works in addiction medicine, Brian Adler, said physicians were flooded with patients seeking pain medicine after the clinic was shut down.

The community has a slightly higher-than-average number of older people and relatively high numbers of people between 21 and 64 who describe themselves as disabled.

“There’s a significant problem with narcotics in this area,” Adler said. After the pain management clinic closed, “all those folks were like rats, scurrying from a burning building, trying to get their fix.”

Other physicians were concerned about patients with legitimate needs for painkillers. The federal bust raised the stakes.

'Walking a narrow path'
When radio commentator Rush Limbaugh settled a federal case charging him with illegally obtaining painkillers, he did not get prison time. Neither did NFL star Brett Favre, who publicly acknowledged an addiction to Vicodin that he obtained legally.

To pain management specialists, they were being blamed for everyone’s addiction.

The DEA cites 108 prosecutions of physicians during the past four years; 83 pleaded guilty or no contest, while 16 others were convicted by juries. Eight cases are pending, and one physician is being sought as a fugitive.

In congressional testimony, the agency’s deputy assistant administrator, Joseph T. Rannazzisi, estimated that fewer than 1 percent of the nation’s physicians — under 9,000 — illegally provide prescription drugs to patients. He told lawmakers it is far more common for people to illegally obtain prescription drugs from friends and family members.

“It is not merely illegal but could feed or lead to an addiction and place that loved one in a life-threatening situation,” Rannazzisi said.

It is impossible to reliably measure painkiller abuse.

A 2004 government study estimated between 2 million and 3 million doses of codeine, hydrocodone and oxycodone are stolen annually from pharmacies, distributors and drug manufacturers. The AP’s analysis only included retail sales and did not include estimates of diverted pharmaceuticals.

John Charles, director of medical affairs at the Grand Strand Regional Medical Center in Myrtle Beach, practices pain management. A few years ago, Charles said, he took a drastic step to reduce his potential legal risks: He stopped prescribing painkillers.

The decision gave him peace of mind, but he does not expect there to be less of a need for painkillers or physicians who prescribe them.

“People with cancer are surviving longer, elderly people are living longer,” Charles said. “So, physicians are walking a fairly fine line. We’re walking a narrow path. And I think we’ll continue to see it for a while.”

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