Preferential treatment

        It is, to me, simply astounding that pharmacies (or some less legal outlet in Sumter County) received and, apparently, dispensed, either oxy or hydrocodone to the tune of 39.2 pills for every single resident of the county. Can we now stop hypothesizing about why there’s an opioid epidemic?

        Of course, compared to Mingo County, West, (by Gawd-uh) Virginia, that’s a pittance, as the hillbillies, apparently in great pain, gobbled down more than 200 pills per capita per year (203.5 to be specific). These aren’t being manufactured in some back-yard lab like Meth or smuggled in, like Fentanyl or Cocaine, but are manufactured by “reputable” drug companies, who have profited greatly by the misery of others, while lobbying Congress. While every so often we see a doctor chastised for running a pill mill, they are too frequently simply slapped on the wrist in the form of being prohibited from prescribing opioids, and then, sometimes only for a specified period of time. In like manner, the manufacturers, semi-isolated from culpability by simply claiming to fill a “legitimate demand for prescribed medication,” keep on pumping out pills.  

         This sort of half-hearted punishment of doctors (excluding recent long overdue questioning of the manufacturers’ massive marketing schemes) is symbolic of a greater ill. We, or should I say the criminal justice system, look at similar crimes through different lenses based on race, social standing and “class.” There is no better evidence of this than the disparate punishments, or lack thereof, meted out to persons accused of sexual assault. The instant a crime’s consequences are evaluated by the desire not to “ruin a promising young man’s life” for raping an unconscious girl behind a dumpster, the system has broken. When consequences to the perpetrator take precedence over equal standing before the law, we are in trouble. This has been documented ad infinitum along racial and class lines and I won’t repeat what has, sadly, become common knowledge, since drug abuse and prescribing abuse are the topic du jour.   

        One example of the “Our kind of people” tolerance offered doctors, is the case of a pill mill with offices in Central and South Florida. Richard McMillan operated a Florida pain clinic company which benefited as millions of oxycodone pills were prescribed and sold to customers who traveled from Ohio, Kentucky and other states. Examination of the financials revealed that these "pill mills" run by McMillan took in about $10 million in just over one year before raids closed the illegal enterprise. Federal Drug Enforcement Administration officials calculated that the clinics, including locations near Orlando and Jacksonville, sold more than 2 million oxycodone pills to customers before the crackdown.

        The scam was typical of such operations, in that McMillan, neither an MD nor a pharmacist, simply created the methodology and the physical venues. Customers usually paid $200 or $300 in cash or with credit payments to see doctors on staff. Oxycodone pills, sold for $5 or $6 each, and were dispensed from an in-house pharmacy, prosecutors said. After listening to tearful remarks from McMillan's friends about his unselfish nature, and reading letters expressing love from his two children, the judge imposed a 35-year prison sentence along with an order to pay $600,000 in fines. Now the rest of the story. What of the “doctors” knowingly prescribing the opioids after five minutes or less? How many licenses were revoked? What of the dispensing Pharmacists? How many licenses were revoked? How much jail time? The hesitance of judges to punish physicians is shameful and is classism at its worst. An individual facing jail time for “possession with intent to sell” of a banned substance gets no such consideration unless, of course, they are socially “connected.” To be specific, a private individual convicted of offering to sell 100 oxycodone tablets would almost certainly incur jail time. A licensed physician dispensing 1000 of them per day to persons he or she knows, or should know, are addicts, faces no consequences in almost all instances.

        Any objective look at who and how many individuals are incarcerated in America on drug charges alone reveals the same data skew. So, yes, let’s hold manufacturers accountable, let’s hold non-medically qualified pill mill operator/predators like Richard McMillan, accountable. Finally, let’s cut through the bullshit of “good old boy” bias in punishment for doctors who took an oath to “do no harm” and then prescribe, apparently with little consequence, the mountain of pills which addicts crave. Of course, with an individual in the US Senate who was, at a minimum, “involved” in allegations of $8 billion in Medicare fraud, and escaped “Scott free,” maybe Florida isn’t on the moral high ground, huh?