When Is a Pain Doctor a Drug Pusher?

NY Times ^ | June 17, 2007 | TINA ROSENBERG

[neverdem]

Ronald McIver is a prisoner in a medium-security federal compound in Butner, N.C. He is 63 years old, of medium height and overweight, with a white Santa Claus beard, white hair and a calm, direct and intelligent manner. He is serving 30 years for drug trafficking, and so will likely live there the rest of his life. McIver (pronounced mi-KEE-ver) has not been convicted of drug trafficking in the classic sense. He is a doctor who for years treated patients suffering from chronic pain. At the Pain Therapy Center, his small storefront office not far from Main Street in Greenwood, S.C., he cracked backs, gave trigger-point injections and put patients through physical therapy. He administered ultrasound and gravity-inversion therapy and devised exercise regimens. And he wrote prescriptions for high doses of opioid drugs like OxyContin.

McIver was a particularly aggressive pain doctor. Pain can be measured only by how patients say they feel: on a scale from 0 to 10, a report of 0 signifies the absence of pain; 10 is unbearable pain. Many pain doctors will try to reduce a patient’s pain to the level of 5. McIver tried for a 2. He prescribed more, and sooner, than most doctors.

Some of his patients sold their pills. Some abused them. One man, Larry Shealy, died with high doses of opioids that McIver had prescribed him in his bloodstream. In April 2005, McIver was convicted in federal court of one count of conspiracy to distribute controlled substances and eight counts of distribution. (He was also acquitted of six counts of distribution.) The jury also found that Shealy was killed by the drugs McIver prescribed. McIver is serving concurrent sentences of 20 years for distribution and 30 years for dispensing drugs that resulted in Shealy’s death. His appeals to the...

[Grammy]

Add to that the need to control how many Dr.s per specialty and you may end up having a pediatrician doing pain management.

[185JHP]

Thanks for your inclusion of the depraved/dishonest behavior of the seekers.

[Lx]

Schedule I drugs are illegal narcotics such as cocaine, marijuana and heroin while Schedule V drugs are over-the-counter medications. Schedule II drugs are potent medications such as morphine and Ritalin. Schedule III and IV drugs are the pain medications such Xanax, Lorcet, Soma and oxycontin, drugs prescribed by unscrupulous pain management clinics.

So many mistakes.

1) Xanax is a benzodiazapene like Valium and is a tranquilizer. Schedule 4

2) Some is a muscle relaxer- doesn't appear in any schedule but I know it needs a prescription.

3) Lorcet, is like Vicodin, hydrocodone and Tylenol- Schedule 3.

4) Oxycontin-time release form of Oxycodone. Schedule 2.

DEA Schedule:

http://www.usdoj.gov/dea/pubs/scheduling.html

I keep track of these things because I am a chronic pain sufferer whose life is made bearable by drugs like Oxycontin.

Now the weird thing with the schedules is that pot is a schedule I like PCP!

[dcwusmc]

Thanks, doc... Wish you were in my area to help me deal with MY pains when EVERYTHING hurts. But the rub is that the drug warriors want to put docs like you and like the one in the story away because someone, somewhere, might “abuse” a drug to get high... just like it was OK for government to get involved in such things, though I have YET to find the section of the Constitution which grants such authority.

[tacticalogic]

Any help here?

None here. I'm in pretty much the same boat. I've been on oxy and hydrocodone a few times for physical injuries and a couple of minor surgeries. It's good for the pain if I have it, but I don't understand the fascination with going through life groggy and constipated.

[cookiedough]

Yes, we are talking terminal. I suppose the doctors don’t want to hasten his death.

My dad had a kidney removed a couple of years ago when he had kidney cancer.

I am sorry about your father’s disease and death; he was so young. My father is in his mid-70s.

I agree with your perspective on pain medications for terminally ill people. However, since I have never spoken to my father’s doctor, I have not been able to discuss it with him. My father just wants to be out of severe pain (which was accomplished), his wife doesn’t want to hear the words “terminal” or “hospice”, and his adult daughter (my 1/2 sister) is freaking out about the entire situation.

I live quite far away and am not there to be of more help with the situation, and I’m not sure I would be allowed to intervene anyway. The entire situation is a big mess and I don’t understand the dynamics of my father’s second family.

But I agree with you wholeheartedly.

[-YYZ-]

Thanks for your comments, it was very difficult at the time.

I hope your father’s situation will be resolved as well as is possible given the circumstances.

Take care

[mvpel]

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