William Fisher

NEW YORK, May 24 2006 (IPS) – Two weeks from now, a South Carolina pain management physician will surrender at the Talladega, Alabama prison to begin serving a two-and-a-half-year sentence for drug trafficking, racketeering and money laundering.
Dr. Michael Jackson is one of hundreds of pain management specialists arrested, charged and jailed by federal and state authorities for violating the Controlled Substances Act, designed to limit the dispensing of illegal prescription drugs by doctors and their use by patients.

Meanwhile, the high profile right-wing radio talk show host Rush Limbaugh, charged with doctor shopping for prescription medication for chronic back pain, reached a settlement with the Florida state attorney, under which the charges will be dismissed in 18 months if Limbaugh complies with court guidelines. As a primary condition of the dismissal, Limbaugh must continue to seek treatment only from the doctor he has seen for the past two-and-a-half years.

Dr. Jackson told IPS that the contrast between his treatment and Limbaugh s underlines a widespread double standard one for the haves and another for the have-nots .

Not only do celebrities have access to the best lawyers, but they utilise their status in society, as I would have, if I were a somebody , he said.

The haves include a long list of individuals , in addition to Limbaugh Senator Edward M. Kennedy s son, Congressman Patrick Kennedy, Miami Dolphins football star Ricky Williams, former baseball great Darryl Strawberry, Florida Governor Jeb Bush s daughter, Noelle, former Pittsburgh Steelers football quarterback Joe Gilliam, and a multitude of other athletes, movie stars and family members of the well-to-do , Dr. Jackson charged.
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He added: As for the have-nots , there is only one group to mention the poor. With few exceptions, they re the ones that fill the jails. And the haves who have gone to jail only did so because they violated their probations; otherwise, they would be in rehab, Jackson told IPS. He said these included Strawberry, Downey, Gilliam and Noelle Bush.

Limbaugh s attorney was famed defence lawyer Roy Black of Miami. Dr. Jackson was represented by a court-appointed public defender he could not afford to hire an attorney because revocation of his Drug Enforcement Administration (DEA) registration meant he could not practice and thus had no income.

Over the past several years, the DEA, cooperating with state and local law enforcement authorities, has been conducting an aggressive campaign against pain management physicians and their patients. Its primary target is a prescription painkiller called Oxycontin, a drug in the opioid category, which the DEA says is being over-prescribed. It claims that prescriptions for this medication frequently end up being illegally sold on the street by drug dealers.

The DEA-state campaign has resulted in the widespread arrest and jailing of both doctors and their patients many for long sentences. The DEA defends the campaign as an important part of the war on drugs , but has been widely criticised by state attorneys general, professional medical associations, and pain management advocacy groups.

Dr. Jackson s case was part of a prosecution known as The Myrtle Beach Eight . The eight physicians were all associated with a pain clinic in Myrtle Beach, South Carolina. The accused also included Dr. Michael Woodward, the owner of the clinic, the Comprehensive Care and Pain Management Centre.

According to Dr. Jackson, Dr. Woodward was coerced into plea bargaining against the other physicians, including myself. He perjured himself by implying that there was a conspiracy to distribute opioids illegally. As a result of this conspiracy charge, a motive to commit a crime does not have to be proved.

Jackson was charged in June 2001 with manslaughter, over-prescribing of opioids, prescribing opioids without a legitimate medical reason, and prescribing the drugs to patients with whom he had no legitimate doctor-patient relationship.

The first step in his prosecution was revocation of his DEA registration, effectively putting an end to his medical practice and his source of income.

He was forced to use his house as collateral to raise the 25,000-dollar bond that has kept him out of jail for the past five years while his appeals moved forward.

He was found guilty in early 2002 after a jury trial in federal court in Florence, South Carolina, and sentenced to 25 years in prison. The verdict was upheld on appeal, but the sentence was reduced to two-and-a-half years after the prosecution dropped the manslaughter charge it was revealed that the patients who overdosed and died from multiple drug abuse were not his patients. Dr. Jackson appealed to the U.S. Supreme Court, but the high court declined to review the case

Dr. Jackson claims the DEA often charges physicians with more serious crimes such as manslaughter to give them an excuse to revoke a doctor s DEA registration.

Other physicians associated with the Myrtle Beach Eight have also been prosecuted. Dr. Deborah Bordeaux received a sentence of eight years and one month for being included in an alleged conspiracy to prescribe medications such as OxyContin. Her sentence was based on working for only 57 days at the pain clinic.

Dr. Ricardo Alerre, a 74-year-old physician at the clinic, was sentenced to 19 years and seven months in prison. Drs. Deborah Sutherland and Thomas Devlin received two years each. Dr. Benjamin Moore, who pleaded guilty, committed suicide prior to sentencing.

In response to a plea to reduce Dr. Alerre s sentence based on his age, U.S. District Judge Weston Houck said the law doesn t allow it: I m convinced in my mind that Dr. Alerre is a good person; and you ll never see him in jail again, but I m not going to break the law.

I believe and I hope that this case has sent a clear message to the medical community that they need to be sure the controlled substances they prescribe are medically necessary, said Assistant U.S. Attorney Bill Day. If doctors have a doubt whether they could get in trouble, this case should answer that.

I ve done everything by the book I don t even have a parking ticket, Dr. Jackson said at sentencing. I think this is just a mistake the government made.

The DEA and its state and local associates have been just as tough on patients. One, wheelchair-bound Richard Paey, has become a kind of poster child for patient prosecutions. A victim of multiple sclerosis, Paey was convicted in Florida s third attempt concerning his use of painkillers. The 45-year-old Mr. Paey turned down an offer of probation based on principle but has now been given a mandatory minimum sentence of 25 years in jail.

Paey s supporters say he was unable to find medical help to ease unbearable pain. He was not convicted of selling any medication, and even the prosecutor admitted he used the pills himself. In prison, he is on a morphine pump that administers more pain-killing medication than he was accused of taking before he went to prison.

Physicians organisations say that one of the worst consequences of the DEA s campaign against Oxycontin is that doctors are being cowed into giving up the practice of pain management precisely at a time when science is discovering more effective methods of palliative care.

The doctors charge that DEA agents are not physicians and are not trained to make medical judgments.