Doctors who give addicts their drugs: Ignorance or malpractice?
As a recovered alcoholic, I’m going to go out on a limb here and say that many doctors unwittingly commit malpractice when they prescribe a narcotic or benzodiazepine without first screening the patient for substance abuse.
Giving Xanax to an addict is a prescription for relapse. It’s not a shame-on-you mistake. It’s an irresponsible, negligent mistake that can be fatal. I’m not just talking about MDs either. I’m talking about the dentist who pulls a wisdom tooth and sends the patient home with a prescription for Percocet.
I have made this argument before and I get riled up every time I hear about a doctor who has done this. The latest case happened here in my hometown and the doctor was actually charged.
Dr. John Christensen, a chiropractor-turned-MD who got his medical degree from a school in the Dominican Republican that closed amid allegations that it was a diploma mill, has been charged with two counts of first-degree murder in the overdose deaths of two patients he treated at his clinic. Besides the two murder charges, Christiansen also faces 89 other charges, mostly trafficking in oxycodone.
Investigators focused on 35 patients from several Florida counties who died after Christensen prescribed them high-powered narcotics. In two of those cases investigators concluded they had enough evidence to charge him with murder.
According to investigators, Christensen prescribed lethal doses of oxycodone, Xanax and methadone to patients who didn’t have legitimate medical needs. In fact, Christensen’s attorneys argued in civil lawsuits that the doctor was trying to help addicts wean themselves from drugs. Christensen settled the suits without admitting wrongdoing.
Although this appears to be a case of a doctor who was operating a pill mill and wrote prescriptions with full knowledge that his patients were addicts, this is a start and hopefully a wake-up call for doctors who don’t bother to screen patients for substance abuse before writing a prescription for these drugs.
I believe this happens because of the ignorance and stigma of alcoholism and addiction. What would you think of doctor who prescribed a medication known to cause birth-defects to a young woman without asking if she is, may be or is trying to get pregnant? And if it turned out that woman gave birth to a child with severe birth defects, would that be malpractice? Would that doctor be guilty of criminal negligence?
If I had a nickel for every addict or alcoholic who relapsed after some doctor or dentist gave them a prescription for a benzo or pain killer without asking about their history of substance abuse, I wouldn’t be here. I’d be at my summer home in the Hamptons. In fact, I have friends in recovery who actually told their doctors that they were recovered alcoholics and the doctor STILL wrote them a prescription for a benzo or pain killer.
In one case, my friend questioned whether she – a newly sober alcoholic – should take the Xanax prescription he gaveher. The doctor told her it was okay. She threw it away. In the other case, when my friend turned down her dentist’s prescription for Percocet, she was simply asked what she wanted instead. My dentist was prepared to write a prescription for several days worth of Percocet after a nasty, complicated extraction. He knows I am in recovery but insisted that the pain would be severe. I asked him to write a prescription for two Percocets, enough to get me through the night. If I needed more, I would call. I took one and threw out the other.
Of course, there are exceptions. Addicts and alcoholics are notorious and brilliant liars. Even when questioned, they will deny their addiction or alcoholism. But at least the doctor tried. Likewise, it would be cruel not to give a pain killer to an addict or alcoholic experiencing extreme pain or deny an anti-anxiety medication to an addict or alcoholic suffering anxiety attacks.
But this must be done with extreme caution and oversight. Just as a doctor schedules a follow up appointment or calls the next day to make sure there are no complications, the doctor who prescribes a pain-killer or benzo to a patient she knows or suspects is an addict or alcoholic should follow up with that patient. Also, there is no need to write a lengthy prescription for a pain killer when the pain should subside in a few days.
Most of the blame goes to the medical schools that train our doctors. How much time do they devote to treating alcoholism and addiction – illnesses that afflict an estimated 20 percent of the population?
At this point, the negligence is so prevalent and systemic that they only way to change it appears to be through criminal charges and malpractice lawsuits. That’s tragic because charges and lawsuits are only filed after someone has died. Unfortunately, a lot more alcoholics and addicts are going to have to die before this changes.
Stapleton, C. (2013). Doctors who give addicts their drugs: Ignorance or malpractice?. Psych Central. Retrieved on April 18, 2015, from http://blogs.psychcentral.com/depression/2013/07/doctors-who-give-addicts-their-drugs-ignorance-or-malpractice/