A physician’s career as an opioid prescriber and addict

I sat in the back seat of a police patrol car handcuffed with a mind imprisoned by addiction. My day had finally arrived after months of a manhunt by state detectives for operating a fraudulent prescription enterprise to support my obsession and compulsion with cocaine. No more unmarked police cars staked outside the crack houses that I frequented or my mother’s home or in pharmacy parking lots waiting to capture me. No more paranoia as I wrote fraudulent prescriptions for Percocet, Xanax, Vicodin and cough syrup with codeine using names of doctors who didn’t know me nor I them. My medical license had been revoked for failure to maintain adequate sobriety in the state of Pennsylvania and New York after surrendering my license in New Jersey a few years earlier. I sat in shorts, tee-shirt, no underwear, and $10 in my pocket. I had been on my way to a late-night pharmacy to fill a prescription for Vicodin and Xanax. It was supposed to have been a 10-minute transaction, but it would be three years before I would experience freedom again.

With three county bench warrants and a fresh warrant by the state, I was fearful but also felt relieved because the stress of being a wanted criminal was overwhelming. Just six years ago, I was a fully-licensed physician working in an extremely lucrative seven office practice. The fear of going to prison was surpassed by my desire to live a drug-free life.

However, as I attempted to falsify my identity by presenting fake identification cards, I was still was dubious about going to prison because I had worked in prisons as a physician earlier in my career. I had examined male rape victims, sutured lacerations from shanks (homemade knives) and treated head injuries sustained from metal mop wringers. I knew prison could be a violent, vicious place.

The holding cell was crowded, and I still had the anesthetic property of cocaine in my body. I recalled from my prison doc days that fingerprints could be distorted by heat or clear fingernail polish — I had neither, but I did have teeth. Out of raw fear of being identified by fingerprint analysis, I began biting my fingertips. I had accomplished the distortion of nine of them before my name was called for processing. It was the print of my right thumb — the intact tenth finger — that initiated my confinement and my foray into the criminal justice system.

For four years, without a medical license, I had survived by doing the only thing that I knew well enough to make a living — writing prescriptions. It started by rewriting prescriptions for patients who had no insurance in the name of someone else who had insurance, for medicine that was medically indicated. One day I rewrote for a prescription of Percocet for a patient in severe pain, and the pharmacist filled it. I did it again, this time out of curiosity, and the pharmacist filled the prescription again. It was the early 2000s, and Percocet was just a sprouting seed at a maximum 5 mg pill.

What began as a one-day-a-week indulgence began to morph into a criminal enterprise as my appetite for cocaine grew commensurate with the money I was making with wholesaling pills. I developed a system with minimal overhead costs that was difficult for law enforcement authorities to track, by using computer databases and the skills of a wayward printer. Before I knew it, I had gone from a full-time physician to a full-time criminal. I never wrote for an unnecessary narcotic as a licensed physician, but now with no income, six children, student loans, and a voracious crack cocaine appetite, my morals were compromised. I was fully immersed into the world of crime and drugs where there were no rules, and money was king. Even after being stabbed, burned, and shot, I continued to maintain my citizenship in the cocaine kingdom. My arrest saved me from being killed or much more likely, killing myself. I hated the person that I had become.

While in the county jail for relatively minor criminal charges, the state charged me with 234 counts of insurance fraud; 76 counts of (medical) identity theft; 97 counts of forgery and four counts of obtaining controlled substances by fraud. My bail was set at $100,000 cash only.

That was equivalent to a one-million-dollar bail with a 10% requirement for release. The charges were all felonies with a maximum sentence of three-and-a-half to seven years each — you do the math. I was petrified because I had no money or assets for a defense attorney; it had all been spent on drugs.

My experience as a prison doc proved invaluable as an inmate. Now there was no going home after the end of a shift, the gates were locked, and I had to learn how to survive in the prison subculture where only the fittest minds and bodies survived.

My first cellmate (cellie) was a young Laotian drug dealer. It was my first encounter with an Asian drug dealer. He knew the jail culture much better than me, so I listened to his advice and modeled his behavior. It was ironic that an Asian guy was teaching a black guy how to survive in prison — it shattered the typical ethnic stereotypes. He taught me three main unwritten rules of prison survival: 1. mind your business 2. don’t gamble, and 3. avoid homosexual behavior. He taught me about the Asian underworld in Philadelphia that trafficked in drugs, sexual slavery, and extortion.

I was convicted of eight charges for a total of 27 counts and sentenced to state prison. Not long ago, I relished acceptance to every medical school that I applied and matching with my first choice for residency training.

When I sought help for my addiction, I was offered a templated approach to treatment with no regard for the nuances of my addiction. Individuals with substance use disorders deserve the best treatment that is available, and they should be respected and managed as part of a collaborative effort to bring the pieces back to a whole. The paths to addiction are varied and numerous — and so should be the paths to recovery.

The author is an anonymous physician. 

Image credit: Shutterstock.com

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