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To Treat or Not to Treat with Oxy

A “Painful” Truth for Florida Doctors...

Published on February 2013 | By Mark NeJame - Orlando Litigation Attorney; David Jancha contributed to this article.

Pill bottles with pills spilling outOver the past few years there has been a significant amount of media attention regarding the State of Florida and prescription drug abuse. Most of the attention seems to be focused on pain medications such as oxycodone. Florida has been called the “epicenter” of the problem and Interstate 75 has been labeled the “oxy express”. In 2011 it was reported that doctors in Florida prescribed 10 times more oxycodone pills than every other state in the country combined. However, changes in the law and prescription databases are approaches which law enforcement has used as tools to “fix the problem.”

It goes without saying that avoiding overdoses, illegal drug abuse, and any related crime is obviously very important to all of us. At NeJame Law, our attorneys have represented many doctors and been able to see first hand doctors who have rightfully and wrongfully been the target of governmental investigations. The investigations have included accusations that doctors were conspiring with patients to traffic in pain pills, trafficking in pain pills themselves, and even money laundering.

With the potential for a criminal accusation looming over a doctor’s head -treating a patient with any controlled pain medication can make the practice of medicine a little scary. These accusations have a potential criminal penalty such as a 25-year minimum mandatory sentence for a total pill weight of 28 grams (1 oz.) or more. To put this into perspective, this is the same penalty for having ‘one ounce’ of heroin! Even if entirely innocent, these accusations irreparably affect a doctor’s reputation, the doctor’s license, and even affect his or her personal life. They ultimately affect the doctor’s entire practice, including, the other patients in need of medical treatment.

Which brings us to an interesting dilemma: Where is the balance between a doctor’s obligations to his or her patient AND addiction/the associated side effects of prescription pain medications?

“With the potential for a criminal accusation looming over a doctor’s head -treating a patient with any controlled pain medication can make the practice of medicine a little scary.”

Just like a client comes to an attorney regarding a legal matter; a patient comes to a doctor looking for help and guidance regarding one’s health. An attorney may refer to the Oath of Attorney to resolve an ethical dilemma. A doctor may turn to the Hippocratic Oath for guidance. Depending on the translation and version; there is a portion of the Hippocratic Oath which states that a doctor will “prescribe regimens for the good of my patients according to my ability and judgment and never do harm to anyone.”

The Hippocratic Oath does not appear to give clear guidance. Like all humans, not all doctors agree. On one side, a doctor should not treat a patient with chronic pain using the most effective prescription pain medication because it may cause harm: addiction and side effects. On the other hand, a doctor should treat a patient with chronic pain using the most effective prescription pain medication because the regiment is “good” for the patient and outweighs any harm: potential addiction or side effects.

Some have been very caring and concerned. Although the risks of addiction are there, seeing a patient in chronic debilitating pain is not acceptable. The painful truth seems to be that because there is no clear solution both patients and doctors alike must be extremely cautious before taking or prescribing pain medications. Addiction or incarceration are just two possible alternatives without exercising caution.

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