When the DEA Raids Buprenorphine Doctors

 

 

I had another blog post ready to go this week, but I’m postponing it to blog about another situation.

So far this year, two well-known and respected Addiction Medicine physicians have had their offices raided by the DEA.

The first one occurred in March of this year. Dr. Stuart Gitlow, the past president of ASAM (American Society of Addiction Medicine), who has a small buprenorphine (Suboxone and other name brands) practice in Woonsocket, Massachusetts, was raided by the DEA.

According to news reports, [1] the DEA raided his home and office, looking at patient records for evidence of wrongdoing. They wouldn’t tell him what they were looking for, and wouldn’t comment to reporters later because, they say, the raid was part of an ongoing investigation.

I searched the internet for some sort of follow up story, but found none.

Dr. Gitlow is an unlikely target for a DEA raid. He is so famous for his work in the field of Addiction Medicine that he has a Wikipedia page. According to that page, he is a psychiatrist specializing in the treatment of addiction. He earned an MBA from University of Rhode Island, and went to Mt. Sinai School of Medicine where he earned his M.D. degree. He did a psychiatry residency at University of Pittsburgh, along with a Master’s degree in Public Health. Then he went to Harvard University for a forensic fellowship.

I’ve heard him give lectures at ASAM meetings and he’s as good as lecturers get. He teaches at the University of Florida, and he’s on the editorial board of the Journal of Addictive Diseases.

Dr. Gitlow confirmed in an interview that the DEA looked at patient records, but he had no idea what they were looking for.

Then in early May of this year, the offices of Dr. Tom Reach were raided by the DEA. Dr. Reach, like Dr. Gitlow, is an outspoken advocate of medication-assisted treatment.

A news article [2] described how Dr. Reach’s nine treatment centers were closed for the DEA inspection, disrupting patient care. Dr. Reach’s home was also raided. In the interview, he said he heard the DEA thought he was doing something wrong, but he had no idea what it could be.

They also looked for controlled substances, but Dr. Reach, like most buprenorphine physicians, has never stored these drugs on-site. The record keeping that is necessary for storing controlled substances is considerable. He doesn’t contract with public insurance, so it couldn’t be problem with that.

Dr. Reach said the DEA took hard drives and cell phones, making it harder to continue with patient care.

Dr. Reach was the past president of the Tennessee chapter of ASAM. Dr. Reach was one of several physicians who were on the expert panel convened last year to draft Tennessee’s new guidelines around physician prescribing of buprenorphine. He’s spent his own time at the Tennessee statehouse, advocating for patients with opioid use disorder and their physicians.

Thus far, no charges have been filed against either physician.

Both physicians are politically active. Dr. Gitlow ran unsuccessfully, twice, for state representative in Massachusetts, as a Democrat. Dr. Reach contributes money – some would say a large amount of money – to political candidates he supports. [3]

These two leaders in addiction medicine are far from the only doctors being raided. Dr. Larry Ley, who had several treatment programs in Carmel, a suburb of Indianapolis, was ultimately acquitted of felony drug charges that he faced. Law enforcement personnel, posing as patients, lied about their need for opioid use disorder treatment. Dr. Ley was then charged when he issued prescriptions for Suboxone. [4]

I thought it was a felony to obtain a prescription for a controlled substance under false pretenses. How can a DEA agent pose as a patient and lie about their substance use history to obtain a prescription? Wouldn’t that be an illegal act? Maybe that’s why Dr. Ley was acquitted.

In this case, it seems the county’s head of drug task force didn’t agree with the idea of medication-assisted treatment, saying, ““This type of ruse of a clinic perpetuates the problem because people are still addicted to the drug, and this is what is happening,” said the head of the drug task force, in a press conference held after Ley’s arrest. “This is not fixing the problem.” [4]

Dr. Ley had to close his treatment centers, was left penniless due to legal fees, and is now suing both the city of Carmel and the DEA for conspiring to force him out of business.

Meanwhile, the opioid overdose death rate in Indiana has risen by double digits.

The DEA is authorized to inspect buprenorphine practices at any time. If you are a long-time reader of my blog, you’ll recall my office was inspected in late 2012. I wrote about the experience in a blog post on 12/16/12. The agents were pleasant and cordial. They were willing to meet with me when patients were not scheduled, so it didn’t interrupt my practice at all. They asked about how many patients I had, asked to see copies of patient prescriptions, and asked if I stored any controlled substances on site (of course not). The two agents were polite and cordial.

What happened to Drs. Reach and Gitlow was very different. They were both raided by the DEA, with a warrant that says material can be seized. In a raid, the DEA is so convinced that there’s criminal activity that they take computers, cell phone, and records. Inevitably this disrupts the medical treatment of patients. For both Dr. Reach and Dr. Gitlow, patients had to be turned away from scheduled appointments because of the raids. As Dr. Reach pointed out in a newspaper interview, this can have very real and possibly fatal outcomes for patients depending on buprenorphine to provide stability and keep them from using illicit opioids like heroin.

For a DEA raid to take place, investigators have expectations of finding criminal activities. They would not raid for issues like overprescribing, substandard care and the like. These types of problems would be handled by the state’s medical board.

Of course, I don’t know the circumstances that lead to these DEA raids. It’s remotely possible that a Harvard-educated physician leader of ASAM is slinging dope on some corner of Woonsocket, Massachusetts, in his free time…but I doubt it.

The trouble with these DEA raids is that while they make the papers when they happen, no news releases state what was found. If no wrongdoing was discovered in the masses of material seized by the DEA, the public won’t hear about this. All that remains is the taint of criminal investigation.

I’ve been working with some organizations to try to get more office-based physicians interested in treating patients with opioid use disorder with buprenorphine, a potentially life-saving medication. I’ve reassured worried doctors that they won’t become DEA targets just because they prescribe buprenorphine. I told them that unless they store medication on premises, the chances of getting raided are very small.

I hope I haven’t erred in telling new doctors this. I legitimately thought the nation’s leading health experts are pushing treatment for opioid use disorders, to stem the tide of opioid overdose deaths we’ve been having oer the past twenty years.

Now, with raids on well-respected practitioners, I don’t know what to think.

  1. http://www.woonsocketcall.com/news/city-doctor-s-home-office-raided-by-fbi/article_1e4270a0-2bb5-11e8-be84-b7f0c2501d63.html
  2. http://www.wjhl.com/local/dea-agents-raid-watauga-recovery-centers-in-tn-va-and-nc/1156361147
  3. http://doctorsofcourage.org/ralph-thomas-reach-md/
  4. https://www.thedailybeast.com/addiction-doctor-dea-shut-me-down-so-mayor-could-clean-up-town?ref=scroll
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9 responses to this post.

  1. Posted by michaelwalker on June 13, 2018 at 1:38 am

    This happened to our local physician, in 2016, 82 years old for petes sake.. no charges, and now he helped so many people.. it’s all gone.. just plain stupid..

    Reply

  2. Posted by Alan Wartenberg MD on June 13, 2018 at 3:21 am

    Not mentioned in Jana’s post is that Stuart Gitlow, whom I have known for many years (since he was a resident and a fellow) is the son of one of the founders of the American Society of Addiction Medicine, Dr. Stanley Gitlow. Stan Gitlow was one of the “young Turks” in the early days of the New York Society on Alcoholism, a physician primarily trained and interested in internal medicine and hypertension, who turned his considerable intellect and clinical acumen to the disease of Addiction. I am outraged by his treatment, and hope that justice will prevail.

    Reply

  3. Posted by William Taylor, MD on June 13, 2018 at 5:15 am

    Your blog arrived at the same time as a self-congratulatory e-mail from SAMHSA, celebrating the increase in the number and capacity of waivered practitioners. It took all my restraint to avoid replying with a nasty e-mail stating that the first priority in encouraging physicians to become waivered should be to rein in the DEA thugs.

    At the March AATOD meeting in New York, the DEA representative spoke, saying that doctors with legitimate practices had nothing to fear. So much for veracity from the feds.

    Reply

  4. Posted by Sparky on June 13, 2018 at 6:49 pm

    Dea are bunch of liars looking to get headlines by going after good caring drs,they been doing this now since 2000,if they can’t get a dr with opiate misuse then now it be buprenorphine misuse(something made up is most of it)

    Reply

  5. Posted by Clarence VERDELL on June 26, 2018 at 7:46 pm

    At this point it is plainly clear that the DOJ and its governmental agency(DEA) are not interested in criminality but has put in place a conviction machine to ensnare innocent doctors throughout the nation.I was one of the first doctors to be attacked for treating with suboxone and Dr.Gitlow was my expert witness.The investigation itself has driven many innocent doctors to suicide.They will never admit any mistake and will use the conspiracy laws or the Rico statute to destroy any physician who practices addiction or pain medicine. This is not normal.We are trying to normalize extreme government overreach.This explains why they routinely attack senior citizen or elderly physicians. They are physically and emotionally fragile. Therefore, they are less likely to speak out. The DEA must eventually face a congressional hearing and audit if we come together politically.Any Nation that would set up an operation to attack devoted physician and to brand them as common drug dealers is evil. This is what is happening and the American people are in denial. Write to your health issues staff persons or join the ” Doctors of Courage” so that we can speak in one unified voice and stop this insanity. Doctors today but who will be next?

    Clarence R. Verdell, MD

    Reply

  6. Anyone reading this blog should join the membership of Doctorsofcourage.org. We are only going to make a statement if we work together and expose what is happening.

    As to your comments on Buprenorphine, Dr. Burson, it is an opioid just like every other opioid, and can still be abused. Are you aware that Suboxone is the #1 drug of abuse in prisons? Also, using MAT doesn’t cure addiction, it only substitutes the drug used. You can learn the REAL cause of addiction on DoC (Doctors of Courage).

    Increasing the patient load for treating OUD and expanding MAT is just giving the government more fodder for their DOJ mill. Doctors need to get their heads out of the sand, wake up, and join us to stop government overreach into medicine.

    Reply

  7. Posted by Ida on June 30, 2018 at 8:30 am

    Woonsocket RI…..NOT Massachusetts.

    Reply

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