As a former prosecutor of MDs for the Florida DOH I saw this all the time. It’s not that unusual at all to see docs trading prescriptions for sex and/or street drugs like cocaine. I probably had ten cases a year when I was just a mainline senior prosecutor and was only one of about 12-15 MD prosecutors. Later I exclusively prosecuted pain docs and licensed pain facilities for overprescribing, but back when I was just a “regular” prosecutor I had dozens of cases just like that across every age group from 20 yo nubes to 40 yo docs in their prime to geezer docs like this one. Age seemed to have no impact. That is different than generic overprescribing/“pill mill docs” where younger docs usually treat the opioids and benzos carefully while the geezer docs give them out like candy.
Opioid crisis...
- Thread starter 12Nole
- Start date
As a former prosecutor of MDs for the Florida DOH I saw this all the time. It’s not that unusual at all to see docs trading prescriptions for sex and/or street drugs like cocaine. I probably had ten cases a year when I was just a mainline senior prosecutor and was only one of about 12-15 MD prosecutors. Later I exclusively prosecuted pain docs and licensed pain facilities for overprescribing, but back when I was just a “regular” prosecutor I had dozens of cases just like that across every age group from 20 yo nubes to 40 yo docs in their prime to geezer docs like this one. Age seemed to have no impact. That is different than generic overprescribing/“pill mill docs” where younger docs usually treat the opioids and benzos carefully while the geezer docs give them out like candy.
I wish they wouldn't prescribe anti-depressants for every damn thing. Those pills can mess you up long term - bad...
It's none of my business, as I believe everyone deserves the right to commerce, but you seem to work and profit from both sides of this issue.
You’re right. Everyone who prosecuted pill mills and works to save addicts should do it for free. I mean that’s what America is about right? Car mechanics and plumbers all working together for free to fix the cars and houses so that doctors and lawyers are able provide services for free to the farmers that feed us all for free.
Last edited:
Feel the Bern! Right?! SMH
Tribe, I'm in your corner on this one.
Did you read Tribe's post?
I’m an administrator, lawyer and risk manager not a behavioral health specialist
He uses purple drank. Much cheaper that sblowhatever.
True, but I asked my medical director about whether we would be using it and we do have some in stock in our pharmacy but it will likely not see much use. The insurance companies won’t pay for sublocade unless you have proven other modalities won’t work. And patients hate it because it’s a thick paste like injectable that needs a big gauge needle and is usually injected into the fat of the stomach over a long period. It does seem to work quite well but because it’s expensive so no one will pay for it and it’s painful/uncomfortable for patients we won’t likely use it much.
Naw, worst thing Tribe did was muse on here about paying lobbyists to keep the drug war going as it would help his bottom line.
I was a president of an organisation that provided education and training to chronic pain physicians because the FMA had dropped the ball and provided little to no training in the area. Because there are almost no fellowships available and little to no CMEs available in the area until the last two or so years but at the same time there is/was a big need for legitimate chronic pain physicians what you ended up with were a lot of older but inexperienced in the area doctors in the field. It’s overblowing it to say that before the PDMP half of pain patients were illegitimate but it is probably safe to say that half of pain patient visits were illegitimate because while maybe one out of 20 patients were “doctor shoppers” supplying the oxyexpress, one “doctor shopper” would visit 20 doctors or even more. So in a short time the number of visits far outstripped the number of doctors who had quality training.
So I would periodically take on some defense work for doctors I believed were well-meaning and simply untrained or elderly and being taken advantage of. That’s why to this point (knock on wood) I never lost a case against DOH, any true pill mill doctors I simply didn’t represent. Nor did I advertise myself as a defense attorney, I simply took cases from former students who were charged for issues before I trained them that I believed were acting honestly.
The DEA and DOH frequently fail to see the difference between a truly criminal enterprise and a poorly trained and/or elderly doctor who could get hoodwinked by a couple of savvy doctor shoppers. A true expert can easily tell the difference because it’s about volume, adequate testing and referrals, reviewing and responding to behavioral red flags of patients etc..., but the DEA and DOH frequently tried to treat wellmeaning but hoodwinked docs the same way as actual pill mills.
So yes, I did periodically take on some defense cases I believed in and then proceeded to win them, but my conscience is 100% clear. I didn’t take on the cases unless I had been in their practice and observed their treatment and intake before they were charged for several years old even decade old charges. And quite frankly it wouldn’t be tooting my own horn that much to say that I single handily saved more people from drug overdose by shutting down the worst pill mill offenders and by providing education to poorly trained docs who literally had no or very poor protocols in recognizing doctor shoppers than anyone in the state other than possibly the folks who got the state PDMP up and running. My opening new addiction treatment Centers with the guy who just won the Florida Drug and Alcohol Abuse Association’s professional of the year, just continues my commitment to saving lives.
Dr. Feldman ran a known pill mill, but whatever.
https://appsmqa.doh.state.fl.us/MQASearchServices/Document/Mjc1MTM2MTE=
https://appsmqa.doh.state.fl.us/MQASearchServices/Document/Mjc1MTM2MTE=
Feldman is a sad case, he was quite elderly (late 80s) and being abused/misused by the individuals who ran the facility. I assumed speaking only as a layperson and not as a medical expert that he was suffering from dementia or Alzheimer’s.
I didn’t represent him on his criminal charges only his mostly unrelated licensing issues. At his first trial, the prosecutors committed either a purposeful mistrial or were grossly incompetent so the case was thrown out. They polled the jury and he would have been found innocent. At the second trial on the same subject, Dr Feldman apparently talked himself into being found guilty or purposefully threw himself on the bomb as it was his much younger wife who was one of those running the clinic he was working at.
Should Dr Feldman have been practicing when he was being easily taken advantage of? Probably not nor should a lot of elderly docs. Should he have been found guilty of a crime with his lessened mental acuity, I don’t think so nor did the first criminal jury.
I knew him from when he took some of my CME classes, and he was honestly concerned in my opinion about the standard of care but I don’t think by this stage of his life he was capable of following it as I would have to repeat instructions repeatedly and he would forget protocols in between our discussions.
Last edited:
One of my previous doctors (who was cool as ____) was diagnosed with dementia after it was discovered the crazy amounts of drugs he was prescribing.........evidently patients were coming in and asking for the craziest things and he was prescribing it because he was extremely susceptible to suggestion. Ironically, he's the one that started me on methadone.......and no, I didn't ask for it.
Unfortunately the biggest problems with the overprescribing are primary care doctors in general and elderly docs who practice in chronic pain but usually come from unrelated backgrounds.
Thank you for the call. To update the concerned posters, he is sober since 8/25/2018. He is charged with 2nd degree felony Retail Theft and 2 other charges plus he was placed on probation in August for possession of drug paraphernalia. I am not bonding him out and instructed the bondsman to let him sit. I found out a lot about him and it is very ugly. He has a very law abiding family and this is just scary thinking he will be incarcerated. Just trying not to think what can happen to him because he is so weak and frail from too many drugs and undernourishment and poor hygiene. People tell me this might be a wake up call for him and he might turn his life around. I don't put any belief in that statement. It is possible, but I see no evidence when he just wants out of jail. May the Lord bless you all and God's will be done.
Thank you very much for your concern and sympathy. I am really down today and am looking for some good news from any where, but your post is very appreciated.
That's terrible news, but you're absolutely doing the right thing. He's in jail, not prison. I don't think you have much to worry about.
You’re welcome. I was very sorry to hear he got himself in legal trouble before we could help him. The good news is that leaving him in jail will safely detox him and when it’s time for him to be released even if we can’t help him at that point my program manager is now well connected in the recovery community in the panhandle and we should be able to find a good fit for him.
That’s great that access to help is available. Hopefully he will want to help himself
My older brother died last summer from an opioid overdose at age 41.
It was almost a miracle he lived that long because he was addicted to drugs for 20+ years, was deeply disturbed and was always causing trouble and in-and-out of jail. I'm actually relieved he's gone.
My friend's Stepson died at age 28 from a heroin overdose two years ago. His Mom found him dead in the basement and shs has been severely depressed since then.
The Stepson had a circle of friends and at least 2 died from overdoses.
Sorry for the buzkill post
It was almost a miracle he lived that long because he was addicted to drugs for 20+ years, was deeply disturbed and was always causing trouble and in-and-out of jail. I'm actually relieved he's gone.
My friend's Stepson died at age 28 from a heroin overdose two years ago. His Mom found him dead in the basement and shs has been severely depressed since then.
The Stepson had a circle of friends and at least 2 died from overdoses.
Sorry for the buzkill post
absolutely no buzz to be had in this thread Lurker... I'm just sorry it hit so close to home for you and everyone else who has had similar experiences both posters and readers... I just wish there was an easier solution to all this... I tried opioids three times in my life... each time I was terrified how much I liked it and the pull to take another the next few nights was there... which is exactly why I completely resisted it. I just loathe how some are perfectly fine profiting from the misery of others... it more than disgusts me, it makes me lose faith that much more in humanity itself. Most of the time it just feels like those with noble intentions are absolutely inundated by the problems the corrupt cause and no matter how much the ship is bailed out... it's still sinking... THAT"S the buzzkill man... sorry for that ya'll... Bless you ALL who actively improve the world we live in... please stay the course but please don't sacrifice yourselves either... love you all, may God shine in and through ya'lls lives
BTW, @Imtotallynottribe... I saved the link of your website... I'm a peer specialist in training and I know I'm going to have clients to recommend to ya'll. I've also been toying with an idea. I definitely want to start a non-profit that gives community, solace, and even seclusion for mental health patients who have accepted treatment, yet aren't ready to face "the world" again yet while their brains, emotions, etc heal from the trauma they've experienced through their condition. I do want to start something that they can participate in that is productive and serves multiple functions. I've been leaning towards a joint non-profit that connects churches in wealthier districts with churches in more impoverished areas to unite in refurbishing the homes/grounds of the elderly with struggling means. The other idea was to establish some sort of rehabilitation facility much like ya'll are doing in Panama City. So I am definitely going to keep tabs on the success of your program in the future. How open would ya'll be (once you have the numbers) to branching out in a franchise-type thing? I will be relocating to North Carolina in the somewhat near future. I think you can contact me privately by clicking on my profile. Look forward to correspondence.
BTW, @Imtotallynottribe... I saved the link of your website... I'm a peer specialist in training and I know I'm going to have clients to recommend to ya'll. I've also been toying with an idea. I definitely want to start a non-profit that gives community, solace, and even seclusion for mental health patients who have accepted treatment, yet aren't ready to face "the world" again yet while their brains, emotions, etc heal from the trauma they've experienced through their condition. I do want to start something that they can participate in that is productive and serves multiple functions. I've been leaning towards a joint non-profit that connects churches in wealthier districts with churches in more impoverished areas to unite in refurbishing the homes/grounds of the elderly with struggling means. The other idea was to establish some sort of rehabilitation facility much like ya'll are doing in Panama City. So I am definitely going to keep tabs on the success of your program in the future. How open would ya'll be (once you have the numbers) to branching out in a franchise-type thing? I will be relocating to North Carolina in the somewhat near future. I think you can contact me privately by clicking on my profile. Look forward to correspondence.
Last edited:
You can reach me at the number listed on our partially completed website found here
www.Floridaspringsrecovery.com
Just leave a voicemail and I'll get back in touch with you.
I will say putting together a facility is not cheap, for a full service detox to aftercare you're talking about a minimum of $6 million to start it up and we're probably closer to $7. But it is doable if you have the right connections.
For detox which is the most expensive we officially bill $3k a day I believe or close to it, but the average insurance payout is about $900. The commercial insurances pay from about $460-$1300 depending on the plans not just originator of the loan so you cab have one Humana patient that pays $500 and another . that pays $1300. For self-pay there's a sliding fee scale that varies depending on how much the individual makes with the highest I believe being $1500 I believe and the lowest being $100 which is a loss of about a hundred dollars a day. We do not currently accept Medicaid, medicare or tricare not because we have anything against it (Medicaid pays substantially better than low income uninsureds that don't have it), but because we are primarily commercial insurance based and we haven't found a government insurance biller willing to work on only 8-10 residential patients and 10-20 partial hospitalisation which is the most we would have. So until we find a government biller willing to work part time we won't be offering that.
Residential treatment is about 90-95% of the detox rate, partial hospitalisation is about 50-60% and intensive outpatient is pretty small, maybe 15-20% if that and aftercare/weekly followups is just a break even proposition probably even a loss once we have a lot in it but of course we are doing it to provide a high degree of patient care with a hopefully low failure rate of recovery.
Very cool. Can I use your gym when I'm visiting my in-laws?
FYI - Your Google map at the bottom of the page drops you in Southern CA when you click on it.
Thank you. Yeah there's a lot of things that need to be fixed like they used our logo with a white background rather than a translucent background by accident and then half-astericks tried to edit out the white background. I've just got to get back with them on fixing it and I've been too busy with other matters at the monent (technically we are open and treating local referrals only but not advertising, the website is not even supposed to be live yet). We're doing that for two more weeks and then throwing open the advertising.
Do you have any data on what percentage of alcoholics and hard drug addicts fully recover?
I just assume that the vast majority of them die from it.
It's tough to say because to my knowledge there haven't been a lot of large studies done over a long period most are small studies done over a relatively short time. So I've seen studies that range from a recovery rate as low as 30% up to 80% over a long time. The real problem is that the long term studies equate someone who underwent addiction therapy in a prison the same as someone who went through it in an indigent nonprofit and the same as someone who went to a high end for profit facility and these do NOT have the same success rates. So I don't have a statistics I would quote specifically and say this is accurate.
There are a couple of recent studies that have pertinent info I do think is accurate enough to quote. 1) Half of opioid deaths are due to fentanyl which is in my mind too dangerous to be used outside of the surgical setting and should be more tightly regulated than other opioids. 2) The number of pregnant women with addiction issues have quadrupled (up 400%) in the last ten years. 3) Patients who undergo medically assisted detox without subsequent residential rehab had an 80+% failure rate.
Updated quick story. I have been thru some tough times with my son. He gets out of prison July 2020. I was surprised to learn so many people that have been going thru the same nightmare. Nearly all end up in prison for theft and drugs possession. The stories are just a repeat of what I went through. I learned that I cannot love my son to sobriety. Sadly one young person passed away from fentanyl. I learned about a couple of my long time friends were needle junkies along with their own children. Should I call them my friends? How did I not know? I must really be naive. One young person overdosed and is an invalid in a wheelchair with his head strapped in place to hold up his head. Another friend of mine is going thru what I have already been through. This is insane. I am part of the collateral damage of my sons choices.
