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Increasing Fear in Pharmacists?

Richard Ozar still owns and operates the Victoria Village Pharmacy in Ventura. With a 33-count federal indictment hanging over Ozar's head, however, the pharmacist may find his days as a local proprietor and free man numbered. A grand jury in November accused Ozar of conspiring with Oxnard physician Michael Huff to unlawfully distribute prescription painkillers like Oxycontin.

Sympathizers claim Ozar is the latest victim in the federal government's immoral war against pain-care professionals. Patient advocates say that doctors, and an increasing number of pharmacists like Ozar, are being persecuted for treating chronic and severe pain aggressively, as state medical boards recommend.

Victor Sherman, a veteran defense attorney who represents Ozar, said that including a respected community pharmacist in the prescription-drug crackdown is outrageous. All Ozar did was fill legal prescriptions, written by a licensed doctor, Sherman noted. "This is a man who's never had a traffic ticket," Sherman of Santa Monica's Sherman Sherman said recently. "He thinks he's doing the community a service, then he turns around, and they indict him. It's devastating. "It's an example of Big Brother coming in after the fact, seeing the new hot drug and trying to teach the medical profession a lesson."

Both men pleaded not guilty after their December arrests and are free pending the outcome of the case. Huff, too, claims to be a victim of a misguided prosecution. Young conceded that the Ozar prosecution is unusual ... Critics see increased attacks on pharmacists as an unfortunate but inevitable evolution of the federal government's campaign against pain-management professionals, led by the Drug Enforcement Administration and the Justice Department under Attorney General John Ashcroft.

For the most part, these cases have focused on doctors, who often are portrayed as drug kingpins.

The prosecutions have made it increasingly difficult for patients to find practitioners willing to prescribe effective amounts of pain medication, said Siobhan Reynolds, the executive director of the Pain Relief Network, which supports pain doctors facing prosecution. Going after pharmacists, Reynolds said, will only make things worse. Patients lucky enough to find doctors willing to write the prescriptions may not find pharmacists bold enough to take the risks.

"The chilling effect will be terrifying," Reynolds said.  "If you were a pharmacist and you knew you could face criminal prosecution because a doctor you didn't even know wrote a prescription to somebody who turned out not to be a legitimate patient, why would you ever fill prescriptions for controlled substances?"

The Drug Enforcement Administration's Oxycontin "action plan" dates to 2001... Doctors' groups routinely have questioned the DEA's dire statistics on [Oxycontin], noting that most Oxycontin-related medical incidents occur when users recklessly combine the drug with other medications or alcohol. Nevertheless, the action plan called for increased cooperation by federal, state and local authorities to halt abuse of the drug.

In a March announcement, the Bush administration's drug czar, John Walters, head of the Office of National Drug Control Policy, promised an unprecedented and "comprehensive effort," including increased investigative work by the DEA, to combat the diversion of prescription drugs to the black market.

The Pain Relief Network has followed a hundred state and federal prosecutions against pain doctors in the past three years. As in the Huff-Ozar prosecution, Reynolds explained, authorities in most of these cases discover illegal behavior on the part of a small number of patients, then work their way backward to the medical professionals who were the source of the medications.

"We will continue to pursue vigorously physicians, patients and others who are responsible for turning Oxycontin from a legitimate painkiller to a vehicle of addiction and death," Ashcroft said in September ...

Last fall, the Association of American Physicians and Surgeons issued a statement ... urging federal authorities to work with medical professionals on controlling drug abuse instead of pursuing legal actions that compromise the treatment of patients and equating doctors with terrorists.

Beck said his client was never put on notice that any of his patients were diverting the drugs to trafficking, however. Like Ozar, the attorney pointed out, Huff is not charged with taking kickbacks from alleged dealers. Prosecutors only allege that his practice benefited from his willingness to write the prescriptions. "He got $80 per office visit," Beck of Beck, De Corso, Daly, Kreindler Harris explained. "He wasn't doing anything to line his pockets." Beck conceded that it may sound like his client prescribed a whole lot of pills. Huff prescribed more painkillers than other doctors because he was willing to put his patients first, even if doing so risked his profession and his freedom, Beck said.

Beck said he plans to put the federal government's war against pain doctors on trial. The central issue, he said, is whether cops and prosecutors should be practicing medicine. "I would trust the doctors before I would trust John Ashcroft to determine what's appropriate," he said.

Sherman said he also plans to confront Ashcroft's campaign head-on. He noted that neither the DEA nor the state Medical Board have placed upper limits on the amount of painkillers a doctor may prescribe, so long as there is a legitimate need for pain treatment.

But even assuming Huff did something wrong, Sherman said, liability should not extend to a pharmacist merely for filling out what appeared to be valid prescriptions ...

"We're not saying [Ozar] didn't make any independent judgments, because he did," Sherman explained. "These kinds of medications are legitimate ways to fight pain, and he believes that pain medications can be given in these quantities. Maybe other pharmacists would have made different judgments. But that doesn't make our guy a criminal. Certainly, there's no criminal intent."

Sherman acknowledged that medical experts for the U.S. attorney's office will suggest differently. "So the government's medical opinion will be that he shouldn't have written the prescriptions," Sherman said. "But who are they? Are they the doctors now?"

"The price
of freedom is
constant vigilance."
Thomas Jefferson

All these small excerpts are from a useful article that can be read in full at: www.cpmission.com/main/painpolitics/drhuff.html

The article and excerpts came from: John Ryan, Daily Journal Staff Writer, June 11, 2004.

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