We need to start this post with a terrible truth: opioid deaths continue their march across the American landscape. Despite the understandable pre-occupation we all have with COVID-19, according to the CDC in a report released in early December 2021:
“…(M)ore than 53,000 opioid-related deaths have been reported thus far in 2021, a number that demonstrates the persistence and severity of the country’s opioid overdose epidemic that federal health officials say started in the 1990s.”
Opioids are a plaque of immense proportion. According to the U.S. Health & Human Services, since 1999, more than 760,000 have died from opioids. However, that is only one small piece of the tragedy. Nearly every major city is flooded with homeless camps – and many in those tents are opioid-addicted. Addicts commit crimes. Cities are stretched to limits. Hospitals are jammed with opioid addicts desperately trying to “get clean.”
Who is to blame?
We can ascribe opioid addiction blame to all kinds of conditions but to ignore and absolve the healthcare and pharmaceutical industries themselves would be sheer madness. For, within the ranks are unethical bottom-feeders, who thrive while killing the addicted and vulnerable.
I want to give everyone a brief illustration of a case that has just been adjudicated by the Department of Justice. This information was taken from a document released on December 21, 2021:
“Three Houston-area pharmacists, a doctor, and a pharmacy technician have been arrested for allegedly running three pharmacies and two clinics as ‘pill mills;’ distributing hydrocodone, oxycodone, and other controlled drugs without a legitimate medical purpose.”
They were running their operation starting January 2018, far after the opioid crisis had exploded and the dangers of opioids had long been established. The pharmacists were arrested in early December 2021, and booked in the U.S. District Court for the Southern District of Texas. They distributed the drugs through pharmacies and “clinics.”
They were charged with illegal distribution and in order to create some type of separation, worked through “crew leaders” who were not much different than drug dealers. We’ll get to them in a moment.
The participants purchased “the highest-strength, short-acting hydrocodone and oxycodone pills commercially available.”
In order to show some kind of medical paper trail, the pharmacists had to recruit a physician willing to write scripts. They succeeded, and on December 2, 2021, Shivarajpur Ravi, M.D., 65, of Houston, was arrested. I might argue he was the most unethical and despicable person of all.
Sophistication?
Part of the proceeds from the operation were laundered through a “facility for children,” which is a major irony. They deposited cash amount under the $10,000 maximum so it would not have to be reported. Then those funds would be transferred to other accounts to obscure the origins of the money.
We are talking about millions of pills. Here is where the so-called “crew leaders” instructed dealers in the proper way to fill out paperwork to submit to the pharmacies. In this manner, the scripts looked legitimate. All of the defendants are looking at decades in prison if convicted.
However, as sophisticated as the operation appeared, the multi-million-dollar scam distills down to three general principles.
The pharmacies, pharmacists, pharmacy technicians, and physicians designed the scam in such a way that they believed it escaped oversight. Given the script paper trail from physician to the three pharmacies, it had the look of legitimacy. Further, as the scam yielded so much money, they worked out a financial web that also seemed to obscure oversight.
Their downfall was one of quantity. That many high-strength pills and vast, Houston-based distribution center obviously began to work its way back up the ladder to the crooked physician and pharmacies.
The need was one of cash – and lots of it. Addicts are desperate for pills and they were willing to pay dealers whatever they asked. The dealers, in turn, kicked back up the ladder.
It is in the rationalization that I find the most disturbing. My hunch is that all of the so-called “healthcare professionals” viewed the deaths and the addictions of the victims as nothing more than collateral damage. Whether one wants to view the deaths and the addictions through a lens of class or poverty or race, it runs contrary to every principle of decency and ethics a healthcare professional should stand for and indeed, was trained to uphold. They did not care.
I am a strong advocate of mandatory ethical training, renewable bi-yearly, for pharmacists and pharmacy techs and by extension for physicians. This case, is about ethical behavior which seemed to be sorely lacking. I am angered that this ethical shame was ultimately responsible for death, addiction and heartache.
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