Doctors and drug abuse

Dr Noel Blackman, a former Guyana minister of health, is soon to be sentenced in the United States for his role in providing a large number of people in that country with prescriptions for oxycodone, a drug known as an opioid, which while useful in providing pain relief, leads to addiction.

Dr Blackman, who was described by his attorney as a skilled vascular surgeon, operated clinics in Elmhurst in Queens County, Franklin Square in Nassau County, and Cypress Hills in Brooklyn, all in New York. According to the indictment, between 2015 and February 2016, Dr Blackman wrote prescriptions for more than 365,000 oxycodone pills. When he pleaded guilty to the crime, he admitted that he wrote oxycodone prescriptions for persons whom he knew had no legitimate medical need for them in exchange for cash. And as part of his guilty plea, Dr Blackman also agreed to forfeit US$503,200 attributable to illegal prescription sales.

Dealers who sell illegal drugs that destroy people’s lives—by making them addicted, damaging their health with the horrible side effects, or turning them into lying, stealing zombies who would do just about anything to get their fix—are reprehensible. But doctors who violate their oaths to heal and preserve life in order to fill their pockets? Despicable is a mild word to describe them.

Several doctors have been charged with illegally prescribing opioids in the United States and in almost every instance, once convicted, those doctors were relieved of their licence to practice and rightfully so.

In the instant case, Dr Blackman’s attorney, pleading for a lighter sentence for him, asked the judge to consider that he has forfeited his medical licence and will no longer be permitted to practice in the US. Dr Blackman, who is not a US citizen, would likely be deported to Guyana. His lawyer argued that a lighter sentence would allow an earlier return to Guyana where his skills as a vascular surgeon can be well-utilised. The question is, of course, is whether he should be licensed to practice here given the reason why he lost his licence in the US.

A nexus can be drawn to the allegation of misuse of opioids in Guyana, with seemingly no action on the part of the relevant authorities. This newspaper reported on April 19, this year that a nurse had lodged formal complaints twice last year about the seeming misuse of a habit-forming opioid at the Fort Wellington Hospital. The prescription pain-killing drug was being given regularly to former Region Five councillor Carol Joseph, and the nurse Sherlyn Marks was concerned enough about its overuse to raise an alarm.

Unfortunately, nothing was done and she raised the matter a second time before it finally entered the public domain. To date, it would appear that apart from the nurse being transferred, the status quo remains. This raises several questions, one of which would be whether the Public Health Ministry has a policy as regards the prescribing and dispensing of habit-forming drugs. Since the drugs being used are being derived from the ministry’s store/stock and purchased with public funds, surely something needs to be done urgently. Stocks of such drugs when procured for the public health system would not be sufficient for legitimate use if they are being used indiscriminately.

Other questions would surround the doctor who is/was prescribing the opioid and these should have long been asked by the Medical Council of Guyana, which has been waffling on the issue.

Opioids are classified as narcotics and can be dangerous when abused. In the US doctors who write prescriptions for persons abusing these drugs face federal charges, because it has also been found that this leads to the persons getting hooked on other narcotics such as heroin.

According to research, opioids can manage pain effectively when used for a short amount of time. With long-term use, people need to be screened and monitored because they are liable to develop an addiction disorder. Long-term daily use of opioids leads to physical dependence on them and when stopped withdrawal symptoms are experienced which also require medical treatment.

The situation at Fort Wellington was exposed because there was a diligent and conscientious nurse on duty. She was removed and according to reports it continues. What about other hospitals and clinics around the country? Are there likely nefarious practices in other areas also which are not being addressed because persons are afraid that they will be transferred or worse, fired? How many such situations are compounding the current drug shortages?

Former Medical Council Chairman Dr Carl Max Hanoman told this newspaper last week that while it is an issue that does not raise as many red flags in this country, “addiction to prescription pain medication is very, very common.” Surely there are others who are aware of this. Action needs to be taken. Now.