Dirty Doctors

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In 2016, the number of drug overdose deaths in the U.S. rose to nearly 64,000 people, a 21 percent increase over 2015 and an all-time high. Roughly 2 in 3 of those deaths were attributed to opioids.

The heart of America’s opioid crisis isn’t just rooted in the people who use drugs – but also where the drugs originate. In February 2016, Dr. Hsiu-Ying “Lisa” Tseng of Los Angeles became the first doctor in the U.S. to be convicted of murder for overprescribing opioids to multiple patients. Tseng was sentenced to 30 years to life for the deaths of three patients, including after she sold Xanax and oxycodone to a college student who later died after mixing the substances with alcohol.

To learn more about the role physicians play in the growing opioid epidemic in America, we analyzed data from the Drug Enforcement Administration’s Cases Against Doctors report, which investigates and details the arrest and prosecution of physicians across the country. Our breakdown illuminates states where physician arrests are highest, the number of pills (or dosage amounts) in question, and a possible explanation as to why these drugs make it out of medical offices and pharmacies and onto the streets. Read on to see what we uncovered.  


Harmful Handouts

West Virginia ranked for the greatest number of physician arrests (adjusted for population) and drug overdoses in 2016, according to the DEA.

In 2017, two of the largest drug wholesalers in the country agreed to a combined $36 million settlement as a part of a West Virginia lawsuit alleging the companies benefited financially from the state’s drug crisis. In addition to monetary compensation, both companies agreed to alert state authorities of suspicious activity or drug orders from pharmacies in the future. Previous reports show out-of-state drug companies shipped nearly 9 million hydrocodone pills to a single pharmacy in Kermit, West Virginia, over the course of just two years. The population of this Mingo County town was just 392 people at the time of the report. 

Pennsylvania, Mississippi, and Utah also ranked among states with the highest average number of physician arrests. While overdose deaths in Mississippi have been historically lower than other parts of the country, both Pennsylvania and Utah were among the top 10 states for drug overdoses. In 2015, more than 3,380 people died from drug overdoses in Pennsylvania, leading the state to crack down on overprescribing by implementing new pharmaceutical guidelines. In 2017, the state announced a budget of more than $108 million to include continued investment in holistic treatment and expansions including access to naloxone for first responders and treatment options for the uninsured population.


Uncontrolled Distribution

Seventy-two percent of all substances identified in physician arrests since 2003 were opioids, including oxycodone (31 percent) and hydrocodone (25 percent). Of the 42,000 Americans who died from opioid overdoses in 2016, 40 percent were attributed to prescriptions. 

When used properly and over a short period, opioids can be a powerful aid for managing physical pain. However, these drugs also produce a sense of euphoria, which can often lead to misuse, including ingesting higher doses than prescribed or without a prescription at all. Even under a doctor’s care, regular use of prescription opioids can lead to dependency or death.

Men and women who become dependent on opioids often experience an increase in pain sensitivity. Research suggests this increase in pain has been linked to higher rates of suicide, particularly among adults who may suffer from various mental health conditions or chronic disorders.

Americans who use or misuse opioids aren’t the only ones suffering from this crisis. Addiction can be equally as challenging on the families it touches, and reports have identified a relationship between opioid use and an increase in parental neglect. Cases of children entering the foster care system where one or both parents misused drugs rose to 92,000 in 2016, the highest rate in over 30 years.


Critical Quantities

 

Of the 264 cases detailed by the DEA since 2003 regarding physician arrests, only 11 percent of cases recorded the specific number of pills or dosage units distributed by the doctor charged. Of those cases, over 132 million pills (or dosage amounts) were illegally distributed.

In almost equal quantities, over 62 million pills or dosage units each of hydrocodone and unspecified Schedule III drugs (which include anabolic steroids and ketamine) were illegally distributed. At a standard 5 milligram dose, that’s enough hydrocodone to supply over 21,400 adults for a year, at a maximum of eight tablets per day.

While drug companies may have once marketed these drugs to doctors as a safe and nonaddictive solution for managing pain from chronic conditions and outpatient procedures, the truth about opioids is now abundantly clear. Hydrocodone – the leading substance identified by the DEA in its arrests – is among the most common drugs involved in prescription opioid overdose deaths.

 

Uncovering the Crime

 

While the DEA chronicles the arrests of physicians illegally dispensing substances, these aren’t the only means in which opioids make their way into communities.

The DEA also keeps tabs on drugs that are either lost or stolen. In 2016, there were nearly 19,800 cases of drug theft or loss from pharmacies and almost 5,700 incidents in hospitals, with 68 percent of all incidents identified as “lost in transit.”

In one instance, a pharmacist stole over 35,000 pills (including oxycodone) over a three-year period from the Pennsylvania hospital where she was employed. The hospital was later ordered to pay $510,000 to settle the allegations that they enabled this staff member to steal the drugs. After pleading guilty to 25 counts of possession, the pharmacist was sentenced to six years in prison and three years of supervised release.

In the case of government-run hospitals (like those affiliated with the U.S. Department of Veterans Affairs), the rate of drugs reported missing is more than double the rate reported by private-sector facilities. In response, the VA argued many drugs were lost in transit, although the DEA argues those cases may have been wrongly classified. Studies have shown veterans are more than twice as likely as nonveterans to die from accidental opioid overdoses, particularly among those who experience chronic pain as a result of their service or deployment.  


Finding a Lasting Solution

Since 2014, the life expectancy in the U.S. has fallen as a result of the opioid crisis. Today, scientists are working toward a vaccine that could help counter the addictive properties of these drugs, and the FDA recently revised the labels of pediatric cough and cold products to help reduce the risk these medicines pose to adolescents. Still, as our analysis of DEA data reveals millions of opioid pills and dosages are flooding streets as a result of overprescribing, illegal distribution, and theft.

If you or someone you love has a drug addiction, you are not alone. At Detox.net, we’re committed to helping you find the personalized and focused treatment needed to overcome the powerful grip of addiction. From individual and group therapy sessions, an extensive aftercare network, and relapse prevention, our goal is to help you live your best life today. To learn more, or for additional resources on drug and opioid addiction, visit us at Detox.net.

Methodology

We analyzed data from 264 cases detailed in the DEA Diversion Control Division’s Cases Against Doctors report, updated as of Oct. 12, 2017. “This is a listing of investigations of physician registrants in which DEA was involved that resulted in the arrest and prosecution of the registrant. DEA is in the process of adding to this site cases against DEA physician registrants since 2003 which have resulted in arrests and prosecutions.” Dates of convictions ranged from April 1, 2003, to Aug. 23, 2017.

Limitations

Eleven percent of cases detailed the specific number of pills or dosage units involved. It is possible that with more cases, we could have gained more insight into this population.

Sources

 

Fair Use Statement

If your readers are concerned about the opioid crisis in America, we welcome you to share the images and information found in our study for any noncommercial use. We only ask that you ensure a link back to this page so that they can access our research in its entirety and our contributors earn credit for their work.