Back from the Abyss: A Recovered Doctor's View of the Opioid Epidemic

One afternoon, in February 2005, I was enjoying a productive if hectic primary care clinic at the academic hospital were I was employed. As I came back from a noontime lecture, I was surprised to find the DEA and the state police waiting for me in my office, ensconced like a Venus flytrap, ready to spring and capture. I tried to engage them in polite conversation, but they cut me short, "doc, cut the crap, we know you've been writing bad scrips."

The authorities charged me with three felony prescription violations, for "fraudulently prescribing a controlled substance," and graciously invited me to the courthouse the next day for fingerprinting. They were courteous enough not to arrest me in front of my patients and my staff.

What tripped me up was a prescription I had written for the powerful opiate Vicodin, in the name of our former nanny, who had long since left the country. I had been writing prescriptions for her and picking them up for my own use for months. The pharmacist eventually became suspicious and phoned me. When I didn't know my own birthdate, it was obvious that I wasn't who I was pretending to be. She should have called America's Dumbest Criminals, but, instead, she called the police.

In truth, I had become increasingly addicted to prescription painkillers over the previous ten years. I had been using opiates to medicate away the stress and emotional pain I felt as a medical student, a medical resident, and a physician newly minted into practice.

I can say with perfect honesty that I never got high while working, which would have put patients in direct jeopardy. Though, due to my addiction, I was rarely at my clinical or personal best. There's something about staying up all night snorting Oxycontin that inhibits you from putting in your most compassionate and conscientious effort the next day.

To feed my addiction I would beg, borrow and steal medications at every opportunity. Under the guise of "professional courtesy", I took advantage of my colleagues by hitting them up for prescriptions over and over again. I did suffer from chronic migraines, and would milk this to no end to obtain Vicodin. I would pillage from supply closets. Eventually, I started to abuse the power of my prescription pad.

The criminal charges that were filed by the police unleashed a firestorm of consequences in my life. The medical board effectively suspended my medical license. I was sentenced to two years of supervised probation with a probation officer who appeared, to me, to be clinically paranoid, and distrusted everything that I did. My marriage continued to crumble, and my soon to be ex-wife, out of an innate sense of vindictiveness, did everything in her power to maximize how much trouble I landed in, including feeding false reports of drug use to the medical board and to my probation officer. I ended up living back with my elderly parents, unable to consistently see my small children.

Out of options, I was railroaded by my care-givers, by my family, and by my attorney, into attending ninety days of rehab. I went to a facility that specializes in treating addicted healthcare professionals, who tend to suffer enormously from guilt and shame. I was so opposed to this idea of rehab that they practically had to drag me, with my fingernails clawing the floor. For me, hell was not other people, as Sartre had suggested, but rather, hell was being brainwashed into a twelve-step religious cult.

Medical professionals are at exceedingly high risk for addiction to drugs and alcohol, due to the stress we are under, and the access we have to prescription medications (which is why I called my memoir 'Free Refills'). It is estimated that ten to fifteen percent of physicians suffer from addiction, which is higher than the nine percent rate that is often cited for the general public. For doctors, it is a perfect storm of stress and access.

While in rehab, I was treated as if I had a disease...