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Elite access vs. public scrutiny: Medication disparities exposed

L. Joseph Parker, MD
Meds
April 16, 2024
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A recent New York Times opinion piece detailed a lack of available pain medications. While the DEA claims that it is not purposefully restricting legitimate medication availability, even the names of its own operations belie this statement. On Halloween 2023, the DEA launched Operation “Bottleneck,” serving immediate suspension orders to six large pharmaceutical supply companies. These companies were accused of having failed to account for “a million doses” of opioids without stating over what period of time or what percent of its operations this compromised. The DOJ press release said, “These companies have a legal obligation to account for every dose and every pill to protect the safety and health of the American people … As we continue to face an unprecedented drug poisoning and overdose epidemic in the United States, which took 110,757 lives last year (2022) alone, DEA will continue using every available tool to prevent the diversion and misuse of opioids and other highly addictive controlled substances.”

However, this extreme dedication to opioid accounting accuracy does not seem to apply to the government itself. It turns out that while the U.S. government was locking up over a thousand doctors for practicing medicine in a way the DEA didn’t like, the most blatant criminal prescribing was happening under its direct control, and so far, they’ve chosen to do nothing about it. According to Reuters, the White House Medical Unit did not comply with federal guidelines as it doled out controlled medications like a candy store. Some of it seems mild. From 2017 to 2019, as the federal government was trumpeting its dedication to the war on drugs, the White House spent $98,000 on Provigil, a stimulant that keeps you awake, and another $46,500 on Ambien because, as most rock stars know, if you use an upper to keep going, you’ll need a downer to get some sleep later. Now, we can certainly understand why the twenty-four-hour White House schedule might leave the staff needing these, but they went name-brand instead of generic, which would have saved a lot of money. But these are schedule IV medications, and that was just the start of this scandal.

It turns out that while American citizens and physicians were being targeted for daring to need or prescribe pain medications, those in power had access to an unlimited supply of fentanyl, oxycodone, morphine, and hydrocodone. Not only was this done without valid prescriptions or records but, in many cases, without annotation as to who was getting the medication. Now, I can understand having classified records for the president and cabinet so our national enemies won’t know when they are off their game, especially when both candidates right now are octogenarians, but that’s not what this is about. According to the Inspector General’s report, complaints were made that a senior military medical officer was engaged in improper medical practices. Now, it is important to understand that most such complaints are made by disgruntled patients who were denied what they wanted or by angry staff members out for revenge over some workplace slight, but all must be looked into, and these were.

Site visits were accomplished, and over 120 officials were interviewed, including administrators, providers, and pharmacists. It was found by the OIG that, except for the White House Medical Unit, all of the executive medical clinics had avoided procuring, storing, or dispensing controlled medications, relying instead on military treatment facilities for this responsibility. All of these had functioned in accordance with Department of Defense regulations regarding controlled medications. But not the White House. The White House Medical Unit was found to have severe and systemic problems that had been overlooked by senior leaders, allowing ineffective controls and compliance to become standard operating procedures, “increasing the risk of diversion of controlled substances.” Civilian physicians charged with this transgression have been given decades and even life in prison, with U.S. attorneys gleefully pontificating about the “violation of their oath.” Where are they now when it’s one of their own?

We have known since the 1980s that the war on drugs was really a war on certain people in our society, mainly black people, but later, any poor white person was fair game also, but not the rich ones. Crack cocaine, predominantly used by the poor and minorities, was punished at 100 the rate of powder cocaine used by the elites and wealthy. Rush Limbaugh becomes addicted to oxycodone, and he’s a victim, later getting the Medal of Freedom. A poor single mother falls victim to the same drug, and she’s a worthless addict, sent away from her children into a dark cell for decades. But there’s something I want you to look at with me. On page 24 of the 80-page report, it seems to show that cocaine hydrochloride was available to be dispensed. Correct me if I’m wrong, but this is only used for certain rhinoplasty procedures, is it not? Why would it even be there? Maybe it’s on all the controlled medication forms, but it wasn’t stocked. Let’s look further.

I see Provigil on the next page as a mild stimulant that’s not equivalent to meth or anything, but on the next line, we see what looks like 200 mg of liquid morphine dispensed. And on the line after that, 200 micrograms of fentanyl. Who got shot or was dying from cancer? Then, some hydrocodone and, a few lines further down, 500mcg of fentanyl! Here I am looking at prison time for giving a veteran with spinal fractures oxycodone, and someone in the White House is walking off with 500 mcg of fentanyl. Someone must have fallen through the hidden trapdoor in the Oval Office into the secret acid pool and suffered almost full-body burns. Poor soul. Then some Ativan and 800 Ambien pills? That seems a bit much. However, I see further down that 100,000 mg of Provigil was dispensed. That guy would have needed some serious amounts of Ambien ever to sleep again. Maybe I’m misreading this. Double-check me.

The report goes on to say that DEA policy requires that prescriptions for controlled substances contain the patient’s full name and address as well as the name, address, and DEA registration number of the prescribing practitioner. If a military member, it must also state their service branch and service ID number instead of a DEA number. The prescriptions in question here omitted much of this. Of the 11 prescriptions examined, none of them met all the DEA requirements. Out of thousands of prescriptions of mine reviewed from several years of practice, all of them complied fully. Strange disparity. Some of the White House prescriptions had a signature and nothing else to identify the prescriber. And like most physician signatures, it looks like someone was shot just as they started writing. The report concluded that “the White House Medical Unit dispensed non-emergency, controlled medications like Ambien and Provigil without verifying the patient’s identity” and “also dispensed Schedule II and Schedule III controlled substances, which were generally outside the scope of outpatient care.”

Well, that settles it. It was clearly criminal behavior. I’ll be breathlessly watching my television to see the Bearcats rolling up the White House lawn, the doors kicked in, machine guns pointed at everyone in the vicinity, and the staff forced to crawl out on their hands and knees as Dr. Hansen did because, after all, no one is above the law, right?

L. Joseph Parker is a distinguished professional with a diverse and accomplished career spanning the fields of science, military service, and medical practice. He currently serves as the chief science officer and operations officer, Advanced Research Concepts LLC, a pioneering company dedicated to propelling humanity into the realms of space exploration. At Advanced Research Concepts LLC, Dr. Parker leads a team of experts committed to developing innovative solutions for the complex challenges of space travel, including space transportation, energy storage, radiation shielding, artificial gravity, and space-related medical issues. 

He can be reached on LinkedIn and YouTube.

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Elite access vs. public scrutiny: Medication disparities exposed
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