No Winners

Here is another story about a doctor convicted of overprescribing, which led to the death of a patient, and this 71 year-old is going up the river for a likely 20-year term.  U.S. Attorney Ben Glassman brags, “We’re going to investigate those doctors. They’re going to be tried, and … they’re going to be finding themselves in prison for a long time.”  Dr. Saad Sakkal was convicted of illegally distributing and dispensing controlled substances, which reportedly led to the death of a patient.  This patient was found dead, with a boatload of oxycodone and Xanax in her system, both of which she had obtained scripts from Sakkal the day before.  The defense argued that it was the dead woman’s fault, because she took more than was prescribed.  The prosecution argued that the fault was with the doctor for (re)prescribing to an obvious junkie, a position bolstered by an angry family wanting justice.  Obviously, all three parties were correct.  

Sakkal had led protests outside pharmacies that refused to fill his controlled scripts, which probably weren’t amused by the combo names in the indictments:

  • Holy Trinity, which consists of an opiate, a benzodiazepine and a stimulant
  • Prescriptive Speedball, which includes an opiate and a stimulant
  • Triple Threat Heaven, which consists of methadone, a benzodiazepine and a stimulant.

Count me ignorant, but I didn’t know that combo slang.  I also didn’t know until yesterday that big pharmacy chains are now refusing more than 50 Morphine milligram equivalent (MME) daily doses.  This was a callback from another physician’s prescription, as I NEVER wrote that much even before the “crisis”, but now pharmacy chains have corporate limits set by hiding behind the CDC guidelines. 

 Where does this week leave us?  There are opioid deaths occurring due to patient misbehavior, and this will not change, no matter how much the White House screams about “crisis!”  There are scumbag docs out there operating sleazy pill mills who do contribute to the addiction and death of patients.  There are angry, vengeful families and ambitious prosecutors who will use awful cases to further restrict honest doctors.  They will be assisted by corporate interests as all of society continues to substitute its feelings and frustrations for the clinical judgment of competent, trained physicians.  Perhaps the worst aspect of this case is that it will further entrench in everyone’s mind that doctors are not to be trusted.  It is no excuse or sympathy for the Sakkal’s of the world to observe that all of these worsening trends will be blamed on those trained to alleviate pain.  Gloomy times, indeed.

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