Money is a vicious motivator, and the need to make more and more of it, can be – in and of itself – an addiction. In this particular scandal, it was an addiction to encourage other addictions.
The Las Vegas Cocktail
On the street, it is called a “Las Vegas Cocktail.” It is not available in any legitimate bar, but through a physician’s office or a drug dealer. James Pierre, M.D. and his physician’s assistant, wrote hundreds of prescriptions for hydrocodone and carisoprodol (the “cocktail”). The cocktail of opioids and nervous system relaxants not only addicts, but can kill.
As with any other opioid or opioid cocktail, this combination can destroy not only the person taking it, but crushes their families and friends. Of anyone who should know that, it should be an internist and one with a specialty in addiction medicine. The mild-mannered looking doctor who had been practicing medicine for more than 20-years, ran a Houston-based pill mill in addition to his more “legitimate” work.
For about a year (until the feds closed him down) he prescribed millions of opioid combinations to the mock patients. Each week, he and his P.A. (under the physician’s license) wrote prescriptions for opioids to people who they knew were posing as patients. In the drug trade, they are known as “runners,” who are not much different than typical traditional drug dealers.
When the fake patients (runners), showed up at the clinic, the government claimed that the runners put down anywhere from $220 to $500 in cash.
Allegedly, the scam netted about $1.8 million, split between the pill mill and pharmacy dispensing the cocktail. For about a year’s work, Pierre (and his P.A.) pocketed more than $300,000 in cash.
On June 27, 2022, Pierre will be sentenced for unlawfully distributing and dispensing controlled substances. He is facing up to 20 or more years in prison for each count of distribution.
It might have been the perfect scheme, had not the police arrested one of the runners who, in turn, saved their hide by whistleblowing.
An entire chain of fraud
The arrest of James Pierre, M.D. and his physician’s assistant show the flaws that can and do, exist in ethical training of medical professionals, however, I would be remiss if I didn’t mention that pharmacists and many pharmacy technicians also undergo such training. Therefore, the entire chain, from the man who prescribed the drugs to the technicians who counted out the pills and stuck them in vials, were unethical participants in this scam.
The millions of opioid-addicted in this country are enabled by the unethical in the system who see addiction as little more than a payday. It happens with enough regularity for me to question the effectiveness of the current system of medical, ethical training.
While this case may be seen as “dramatic,” I wonder how many fraudulent cases may be brewing just under the radar. When observers talk in sweeping generalities about “the vast majority,” I question “how vast” that majority might be?
James Pierre will go to jail, no doubt, and he indirectly caused addiction and possibly death; no doubt as well, but he is hardly alone. Other than wringing its collective hands, what else are the medical and pharmaceutical industries doing to ethically train its practitioners?
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