In the wake of the National Enquirer’s widely publicized report on Rush Limbaugh’s addiction to potent painkiller drugs, The Washington Post ran a five-part series about the lax control exercised over the prescribing and distribution of dangerous addictive drugs. The Post has been researching this story for a year, and its two reporters, Gilbert Gaul and Mary Pat Flaherty, deserve a lot of credit for exposing the seriousness of the lack of control over the unscrupulous wholesalers who sell large quantities of these drugs on the Internet and through small “closed door” pharmacies that order large quantities of drugs that they claim they sell to institutions, such as nursing homes. Actually many of them have few if any institutional customers.
Located frequently in small towns and run by people who are not pharmacists and who sometimes have criminal records, they specialize in selling large quantities of painkillers, often using the Internet. They hire doctors to write prescriptions. The doctors interview the customers for a few minutes. With no knowledge of their medical history except what the customer tells them, they dash off prescriptions for large quantities of drugs such as OxyContin and Vicodin.
This is a lucrative business for the doctors. One of the Post’s stories is about Ernesto A. Cantu, a Texas physician who was addicted to Vicodin and Valium. According to court records, he had written prescriptions for over a million doses of Vicodin and other dangerous drugs for the “pillbox.com. ” The Post says he earned $147,000 in eight months.
A California physician, Jon S. Opsahl, had his license revoked for prescribing medications without “good faith” examinations. The judge, who had suspended Opsahl’s license prior to the revocation, wrote that it is virtually impossible to practice medicine when the only contact with the patient is by telephone. The Post found that Opsahl had written 24,000 prescriptions in 13 months for two Internet pharmacies. It analyzed the pattern for nearly 15,000 and found that 67 percent were for Vicodin and another 18 percent were for Valium and Xanax.
Even though his license has been revoked, Opsahl is still in the business of prescribing drugs over the phone for Internet companies. He arranges consultations by phone with a doctor in good standing who shares his consultation fee with him. Opsahl apparently sees nothing wrong with what he is doing, although he told the Post reporters that he was disturbed to learn that in some cases the drugs were sent to several different names at the same address.
This could mean that the patients were concealing the quantity of drugs they were taking from the doctors. That could be dangerous. Last year, there were nearly 6,000 drug-related deaths in Florida. Over half of them involved the use of pharmaceutical drugs. In the year 2000, nearly 500,000 people overdosed on prescription drugs and had to get emergency treatment in hospitals. We need a high-powered campaign to crack down on the Internet and the closed door pharmacies. The Washington Post is leading the charge.