www.novusdetox.com

There is a group of people who have been betrayed by the policy of putting heroin addicts on methadone as the first step to being drug-free.  In theory, these people were to be on methadone only for a short time and then be off all drugs.  In fact, rarely has this happened.  Most of these people have found that they are now hooked on methadone even more firmly than they were on heroin. 
 
   Since many methadone clinics are encouraging people to keep increasing their intake of methadone “to help them”, more and more people are finding themselves on over 100 milligrams a day of methadone. After a few months of going to the methadone clinic every morning before work and standing in line for an hour or more and not being able to go on vacation or visit a friend for more than a day or so, they decide that they are now addicted to an even more deadly drug than heroin and they have to handle their addiction.  They start calling detox facilities and rehab facilities and find that most will not accept them unless they are below 40 milligrams a day.  Many try to wean themselves down but the pain is too great and almost all are unsuccessful.  They are truly trapped and, as many have told us, have given up hope of ever being free of this terrible drug.
 
   Novus is one of the few detox facilities in the country that has developed a protocol that allows these trapped methadone users to escape the trap of addiction.  We have helped people on very high doses of methadone and other opioids to withdraw in about two weeks and then they can go to rehab and finally escape the pain of addiction.  We wanted to share with you some of our success stories.

However, many studies also indicate that factors such as love, laughter, winning, etc. lead to longer life, greater health and recovery from illness.  The “will” of a patient to survive is often an “inexplicable” motivating force for complete recovery.

I am curious if anyone knows of any study that has been done to determine true causation.  Which is the source point?  Is the beginning of a disease brought on by a shift in perception which allows the apparent cause – a disease agent – to grow?  Or, rather, if it’s a change that originates in the body, then why would finding humor in a situation alter one’s predisposition to, or recovery from, disease?

In the recent feature animated film Wall-E you had all these fat vidiots which was part of the message of the film: “Don’t let machines do your thinking for you.  Man’s purpose is to build, to create and to be active.”   

I guess we don’t need to worry about the fat part, we can stay as slim as Jack LaLane chowing down on chips and beer while we watch the Olympics.   We won’t have a thing to say about anything.  We won’t DO anything, but, hey, we’ll look great!  

Drug gives couch potato mice

benefits of a workout

By MALCOLM RITTER | Thursday, Jul 31 2008 5:52 PM

Last Updated: Thursday, Jul 31 2008 9:12 PM

Here’s a couch potato’s dream: What if a drug could help you gain some of the benefits of exercise without working up a sweat? Scientists reported Thursday that there is such a drug – if you happen to be a mouse.

Sedentary mice that took the drug for four weeks burned more calories and had less fat than untreated mice. And when tested on a treadmill, they could run about 44 percent farther and 23 percent longer than untreated mice.

Just how well those results might translate to people is an open question. But someday, researchers say, such a drug might help treat obesity, diabetes and people with medical conditions that keep them from exercising.

“We have exercise in a pill,” said Ron Evans, an author of the study. “With no exercise, you can take a drug and chemically mimic it.”

Evans, of the Salk Institute for Biological Studies in La Jolla, Calif., and the Howard Hughes Medical Institute reports the work with colleagues in a paper published online Thursday by the journal Cell.

They also report that in mice that did exercise training, a second drug made their workout much more effective at boosting endurance. After a month of taking that drug and exercising, mice could run 68 percent longer and 70 percent farther than other mice that exercised but didn’t get the drug.

Both drugs have been studied by researchers for other uses. The no-exercise drug is in advanced human testing to see if it can prevent a complication of heart bypass surgery.

Evans noted the drugs might prove irresistible for professional athletes who seek an illegal edge. He said his team has developed detection tests for use by the World Anti-Doping Agency. Evans said he has no financial interest in either drug or the test.

Resveratrol, a substance being studied for anti-aging effects, has also been reported to enable mice to run farther before exhaustion without exercise training. But the drugs in the new study appear to act more specifically on a process in muscles that boosts endurance, the researchers said.

Still, it takes more than just altered muscles to turn a sedentary mouse into a distance runner, Evans said, and “honestly, I just don’t know how that happens. Whether it would happen in a person, I don’t know. I think it’s a small miracle it happened at all.”

In fact, Evans said that when the experiment with sedentary mice was suggested by an outside scientist who was reviewing the lab’s research, “I didn’t think it was going to work.”

The no-exercise drug is called AICAR. Previous experiments suggest that it might protect against gaining weight on a high-fat diet, which might make it useful for treating obesity, Evans said. But it would have to be taken for a long time, he said, so its safety in people would have to be assured.

Experts who study muscle agreed that a drug like AICAR may prove useful someday in treating obesity and diabetes. Many drug companies are working on such drugs in diabetes because in animals, AICAR stimulates muscles to remove sugar from the blood, noted Laurie Goodyear of the Joslin Diabetes Center in Boston.

People who can’t exercise because of a medical condition like joint pain or heart failure might also benefit from such a drug, experts said.

But Eric Hoffman of the Children’s National Medical Center in Washington, D.C., noted that AICAR mimics only aerobic exercise, not the strength training that might be more useful to bedridden people or the elderly, for example. He also cautioned that it’s not clear whether the new mouse results can be reproduced in people.

Goodyear said exercise has such widespread benefits in the body that she doubts any one pill will ever be able to supply all of them. “For the majority of people,” she said, “it would be better to do exercise than to take a pill.”

The Mother’s Act –

A Bad Idea

By Steve Hayes, Director, Novus Detox

     All of us have heard that Congress’ approval rating is falling and now hovers between 10% and 15%.   We hear about the millions spent on building a bridge that only a few people will cross and wealthy farmers being paid to not grow food.  We hear about $1,000 hammers and shoddy work done by government contractors with seemingly no repercussions to the culprits.

   However, our biggest problem with Congress is that their solutions seldom provide good results.  They have “good intentions”, but their solutions seem to reward the lobby that contributes the most to their campaigns or makes the most noise, and there is little attention paid to whether the legislation actually produced the intended product. 

    It is for these reasons that most of us agree with Will Rogers’ observation about Congress, “This country has come to feel the same when Congress is in session as when the baby gets hold of a hammer.”

    Is there anyone who is not concerned that there are mothers who feel not joy but sadness or depression after the birth of their child?   If the mother is not happy, what kind of life is in store for the child?  We all want to help the mother and the child. 

    None of us would oppose legislation that would really help.  The answer lies in the definition of the word “help.”  This proposed legislation in Congress has the stated intention of helping mothers and young children who are depressed, by providing grants to “public or nonprofit private entities for projects to establish, operate, and coordinate effective and cost-efficient systems for the delivery of essential services to individuals with postpartum depression or postpartum psychosis and their families.” 

    Besides being invasive, this is the first step on the “slippery slope” to requiring all of our expectant mothers and new mothers and their children to submit to “evaluations” by people who will be making determinations that are based not on scientific studies but subjective opinion. 

    Then if these evaluators determine that treatment is needed, it will be a treatment not based on successful procedures but on failed treatment protocols.  Like many of the acts of Congress, the real beneficiary of these laws will not be the mothers and their children but the “mental health” workers who will be handsomely paid and the drug companies that are behind this legislation. 
 
THE MOST IMMEDIATE PROBLEM

    Melanie Blocker-Stokes Postpartum Depression Research and Care Act has already passed the House of Representatives and is being considered, without the opportunity for debate, in the Senate.  Harry Reid (D-NV), the Senate majority leader, has tried to put the legislation to a vote without the usual process of allowing amendments and debate.

    Senator Tom Coburn, M.D. (R-OK) criticized Reid’s plan, stating, “What the staff members are saying is we want to bring a bill, but we don’t want to debate it. We don’t want to vote on it. We don’t want to have it amended. We don’t want the American people to know what we would rather do in secret.”

    In plain English, this legislation will insert government into the lives of our citizens and mandate the use of antidepressants by people that are determined by “professionals” to need “treatment.”

    Of course, this legislation ignores:

    · The fact that the proposed “treatment” using antidepressant drugs on pregnant women can create dangerous side effects for these women and their unborn children;

    · The fact that recent real scientific studies show that antidepressants are no more effective than sugar pills;

    · The fact that almost all of the school shooters were taking antidepressants;

    · The fact that Andrea Yates was taking antidepressants when she killed her children;

    · The fact that in the past ten years, numerous scientific studies and international drug regulatory warnings have documented the dangers of antidepressant drugs, ranging from suicidal and homicidal ideation to premature births, spontaneous abortions and birth defects;

    · The fact that Melanie Stokes was “treated” with these same drugs and given electroshock, and she is no longer depressed because she committed suicide and her child lost her mother to these ineffective treatments;

    · The fact as expressed by Dr. Dan Fisher, a psychiatrist, that “A superficial screening by overworked pediatricians would likely result in many false positives with devastating consequences for the children and their families. These quick-fix screening tests invariably end up with quick fixes of kids by labeling them and placing them on medication, without a comprehensive psychosocial evaluation and assistance to the children and their interpersonal environment. As a psychiatrist who has evaluated children in schools, I know that myriad factors can cause what appear to be symptoms of mental illness”;

    · The fact pointed out by Dr. Karen Effrem that, “One commonly used screening instrument has a 73% false positive rating, meaning that for every 27 children supposedly correctly identified as having an emotional problem on this screening test that follow admittedly ‘subjective’ criteria that are ‘value judgments based on culture’ according to the Surgeon General, 73 other families are falsely told that something is wrong with their child and referred for further evaluation and treatment which more and more commonly involves ineffective and sometimes lethally dangerous drugs”;

    · The fact pointed out by Dr. Effrem that studies in 1999, 2004, and 2005 showed that home visiting programs did nothing to decrease child abuse rates but cost up to $47,000 per family in 1999 dollars and did nothing to improve the cognitive development of the children;

    · The fact that many of the bill’s strongest supporters have financial connections to Big Pharma;

    · The fact that an estimated 2,900 babies died via spontaneous abortion because of SSRI antidepressants given to pregnant women;

    · The fact that babies exposed to SSRIs in pregnancy have a six-fold increased risk of persistent pulmonary hypertension (PPHN), a potentially fatal lung problem;

    · The fact that nearly one-third of women who take SSRIs during pregnancy have a baby who dies, is premature or underweight, or who has seizures;

    · The fact that women being screened are not guaranteed sufficient data to allow the women to give “informed consent.”  (This is because if they were given all the data about the side effects created for them and their babies, few women would ever take the drugs.)

 CONCLUSION 

    Big Pharma has no conscience and could care less if people die or become more ill-if they can sell more drugs.  At Novus Medical Detox Center, we could choose to view the Mother’s Act and the other bills attempting to “treat” people by putting them on these dangerous drugs as guarantees of our beds being always full of people needing medical detox.  In the same way, undertakers could choose to view these bills as good for business because more people will die before their time through suicide or mass murder.

    The drug store chains will expand more because more people will be hooked on these dangerous drugs.  Doctor’s offices will be more crowded because we know that these dangerous drugs often lead to serious health side effects that will require medical treatment.

    The real problem is that we could have legislation that makes available real and proven medical and nutritional tests to actually find the cause of the depression in most people.  Others who are depressed because they have no way of effectively providing for their child and themselves because they are not trained in any skilled position could be helped through the provision of training to allow them to become more productive. 

    Instead, we ignore the likely causes for the great majority of depressed mothers and treat them with failed treatment options.  This is not only cruel but unnecessary and will create far greater costs for society and far more problems for the mothers and their children.

    This bill and the other bills pending in Congress seeking to “treat” mothers and their children are good examples of why more and more of us are agreeing with the American Indians saying that the biggest lie is, “I am from the government and I am here to help you.”

 NOTE: This email is provided for general educational purposes only and is not intended to constitute  (i) medical advice or counseling, (ii) the practice of medicine including psychiatry, psychology, psychotherapy or the provision of health care diagnosis or treatment, (iii) the creation of a physician patient or clinical relationship, or (iv) an endorsement, recommendation or sponsorship of any third party product or service by the sender or the sender’s affiliates, agents, employees, consultants or service providers.  If you have or suspect that you have a medical problem, contact your health care provider promptly.  

The results: Normal or High Normal but NOT in a range that indicates I should be on blood pressure meds.

I do it the way one is supposed to, I take three readings and average them out.  It’s kind of fun in a way.  Our local Vons has a blood pressure machine that is free.  Almost always the first reading is highest, then it’s a bit lower and my pulse drops too.  It’s all pretty predictable.

Hey, and if it were consistently high? I would go see a doctor.  I’m not against medicine, just against OVER medicine.

think you get stories like this one.  A

drug is created that creates side

effects and then other drugs are

tested or created to counter those

side effects.  The original drug is

never truly tested to see if it cures

anything; that would be too logical

and would cut in on profits and call

into question the entire practice of

solving our problems with drugs.

Note, far down in the article that the

reason this is a “good thing” is that it

“May help them to stay on the

drugs…”

Who benefits? I wonder… Oh, I see!, 

this was a study sponsored by, you

guessed it, Pfizer.  I wonder if they

make Viagra?

Viagra Helps Women on

Antidepressants?

By CARLA K. JOHNSON

AP

CHICAGO(July 22) – Viagra’s effect in women has been disappointing, but a new small study finds those on antidepressants may benefit from taking the little blue pills. The research involving 98 premenopausal women found Viagra helped with orgasm. But the benefits did not extend to other aspects of sex such as desire, researchers report in Wednesday’s Journal of the American Medical Association.

“For women on antidepressants with orgasm problems, this may provide some wonderful relief,” said psychologist Stanley Althof, director of the Center for Marital and Sexual Health of South Florida in West Palm Beach, who was not involved in the study. “But it will not improve their desire or arousal.”

Antidepressants can interfere with sex drive and performance even as the drugs help lift crippling depression. Switching drugs or reducing the dose can help. But many people, men and women, stop taking them because of their sexual side effects.

The complaints are common. More than half the people who take antidepressants develop sexual problems, prior studies have found, especially for people taking Prozac, Paxil, Celexa and other drugs that work by increasing the chemical serotonin in the brain. Serotonin is thought to slow down orgasm, perhaps by diminishing the release of another brain chemical, dopamine. Viagra increases blood flow to sex organs.

Pfizer Inc. spokeswoman Sally Beatty said the company currently has no plans to pursue FDA approval for using its drug Viagra as a treatment for female sexual dysfunction. The company ended its internal research on Viagra for women in 2004. While Viagra was found to be safe, the results were inconclusive, Beatty said in an e-mail.

The search for a Viagra equivalent for women has been disheartening. A testosterone patch was sent back for more safety study by the Food and Drug Administration. A handheld vacuum device that increases blood flow to the clitoris does have FDA approval, and BioSante Pharmaceuticals Inc. is testing a testosterone gel called LibiGel.

The new Viagra findings are based on an eight-week experiment. The 98 women were using antidepressants successfully but were having sexual problems. Their average age was 37.

The women agreed to attempt sexual activity at least once each week. Each time, they took a pill, not knowing whether it was Viagra or a matching dummy pill.

While 72 percent of the women taking Viagra reported improvement on an overall scale, only 27 percent of the women taking the placebo reported improvement.

Althof said it’s “worrisome” that 43 percent of the women on Viagra experienced headaches, compared to 27 percent of the women on dummy pills. Indigestion and reddening of skin (flushing) also were reported more often by the women taking Viagra.

Psychologist Leonore Tiefer of New York University School of Medicine said industry-funded research has oversimplified women’s sexual experience. She noted the new study, funded by a Pfizer grant, found more side effects than benefits.

“Where’s the question to the women: Is it worth it?” Tiefer said.

An earlier study in men taking antidepressants found more pronounced sexual benefits with Viagra than the benefits found for women, said lead author Dr. George Nurnberg, a psychiatrist at the University of New Mexico School of Medicine in Albuquerque.

But the message for men and women who need antidepressants is that Viagra may help them stay on the drugs, he said.

“We’re not talking about a lifestyle issue. We’re talking about a medical necessity issue,” Nurnberg said.

Pfizer had no influence on the design, findings or manuscript, Nurnbergsaid. He and several of the other authors disclosed financial ties to Pfizer and other drugmakers.

Drug companies must be behind this one.  I read in the paper today that a certain medical group is recommending Cholesterol drugs for children, YOUNG children.

“Here’s you bottle, sweetie and here’s you pill.”

PK

Recall: Two prescriptions, both unnecessary, one potentially lethal to take for the rest of my life… You get the idea.

The total tab just for the office visit was $130 of which I was on the hook for $46.85.

Not too bad if I had gotten something out of it.

Okay, let’s do the math.  Let’s suppose that the financial pain is no worse than the above, which is highly unlikely, but just to low ball the costs.  Let’s suppose that there were no costs other than this office visit, just take a look at that.  No prescription costs, just the doctor visit.  How much was wasted?

$130 per patient, the full amount because I do pay for the insurance, of wasted service leading to bad prescriptions: And let’s say that just 10% of office visits result in such a false outcome!  10%!  That’s an assumption that 90% of office visits result in a correct dianosis and prescription.  Unlikely, but let’s be generous.  Now, let’s say that the average person goes once per year, all very low estimates, yes?  350 million people go once per year.  So, 35 million (10% bad visits) times $130 (wasted on bad doctoring) that’s $4,550,000,000.

Or, Four Billion Five Hundred and Fifty Million in wasted money. 

Now, if you then calculate the cost of the drugs you don’t need per person who follow the bad advice?  Let’s say, being generous, it’s like the antibiotic I took that wasn’t indicated or needed: $35.00.  It’s not a chronic condition misdiagnosis like the blood pressure meds, which would have lead to Thousand of dollars, just from me, one person.

Let’s say it’s no worse than that $35:

That’s an additional One Billion Two Hundred and Twenty Five Million dollars wasted for a grand total of Six billion seven hundred and seventy five million dollars wasted PER YEAR. 

And it’s pretty obvious that these estimates and figures are very, very generous to the medical field.  Hey, if they were absolutely right 90% of the time, which is what this math assumes, we would take it, right?

What are the real figures I wonder?  What is the real cost?  More than just dollars, no doubt.

PK

JOURNAL SENTINEL WATCHDOG REPORT

Legal drugs, lethal access

Improperly prescribed pain medicines result in deaths, little discipline for doctors

By GINA BARTON
gbarton@journalsentinel.com

Posted: Feb. 23, 2008

Third of three parts

Daryl Collie lived with pain most of his life.

The Milwaukee man, who worked as a cook and waiter, fractured a vertebra in a car accident when he was a teenager and never fully recovered.

In April 2005, Daryl’s father, Alfred Collie, found his 35-year-old son dead. Near Daryl Collie’s body were bottles for seven kinds of pills prescribed by several doctors, according to the medical examiner’s report.

Daryl Collie overdosed on a combination of painkillers oxycodone and diazepam, the report says. Daryl Collie’s other prescriptions included more painkillers, anti-depressants and anti-anxiety drugs. He also was drinking vodka shortly before he died.

Alfred Collie said he knew his son took prescription pain medications but had no idea Daryl Collie was abusing them.

“I figured he’s got a doctor that he trusts and relies on,” he said.

What he had, though, was a host of doctors with troubled pasts.

Daryl Collie’s primary doctor had struggled with addiction herself and would later go to prison for selling prescriptions in a department store. Another doctor was flagged by investigators for prescribing huge amounts of addictive painkillers. A third had been targeted by law enforcement for his prescription-writing more than a decade before.

Authorities agree there is a fine line between the legitimate treatment of pain and improperly prescribing drugs. When doctors cross it, they almost always avoid criminal charges and often keep their medical licenses. Yet for their patients, the consequences can be grave: prison, addiction and even death.

“What defines a physician is that they’re acting solely for the benefit of the patient,” said Scott Fishman, president of the American Academy of Pain Medicine. “When that is no longer the case, they’re no longer a doctor. They’re a drug dealer or a criminal.”

Unlike other street drugs, addictive narcotics such as OxyContin can hit the streets two ways: either someone steals them or gets a prescription, said Milwaukee police Capt. Timothy Burkee of the vice control division.

“These are not things that Bubba can make in the garage or basement,” he said.

OxyContin is a painkiller that addicts snort for a heroin-like high. It is meant to be absorbed by the body over 12 hours. Crushing and snorting it delivers all of the medication at once. Its generic equivalent, oxycodone, is also addictive but has a lower street value.

In Milwaukee, authorities say they saw abuse of the drugs spike about five years ago. Prescription painkillers have been in the news again lately, with the revelation that actor Heath Ledger died in January of an accidental overdose of prescription drugs, including oxycodone and diazepam.

Three of the doctors who wrote prescriptions for Daryl Collie – Robin Ferron, Marc L. Smith and Robert J. Wetzler – have been repeatedly sanctioned by the state’s Medical Examining Board in connection with other cases. Only Ferron has lost her license.

Michael Berndt, attorney supervisor in the enforcement division at the state Department of Regulation and Licensing, said that when a doctor practices badly, the board’s goal is rehabilitation, not punishment.

“Poor medical practice doesn’t mean a criminal violation,” he said.

Rarely prosecuted

Area physicians are almost never criminally convicted for incorrectly prescribing OxyContin and other potentially dangerous drugs.

In fact, they’re almost never prosecuted. Over the past seven years, the Milwaukee County district attorney’s office has not charged a single doctor with the crime, according to Assistant District Attorney Mark Sanders.

The U.S. attorney’s office for the Eastern District of Wisconsin, which covers 28 counties including Milwaukee, has investigated three cases since 2000. Only one resulted in a conviction. Another doctor paid civil penalties but avoided criminal charges. A third was charged but found incompetent to stand trial.

“Trying to balance the appropriate treatment of pain versus the damage that can be done by addiction is hard,” Sanders said. “These cases require tremendous amounts of time and resources.”

Ferron, 51, was convicted on a federal drug dealing charge in December 2006 and is serving a three-year prison term. Court records indicate that she continued to see “numerous” patients after being sanctioned by the medical board. Just two are named in the records. Daryl Collie is not one of them, but records indicate that she wrote him more than 20 prescriptions for painkillers, anti-depressants and anti-anxiety drugs over an eight-month period shortly before his death.

“He was my life,” said Alfred Collie, who raised his son alone from the time Daryl Collie was 12. Back then, the two played baseball and went to high school football games. As Daryl Collie got older, he often put his culinary skills to work for his father, whipping up stuffed hamburgers, barbecued chicken and homemade pizza.

“I’m fighting to stay alive now that he’s gone,” Alfred Collie said.

Ferron declined to be interviewed. Her attorney, Randal Arnold, called his client “a very capable and caring doctor who should be allowed to return to practice when she can safely do so.”

In 2003, Ferron, who had a long history of substance abuse, was convicted of bank fraud. She was sentenced to six months in prison but was allowed to keep her license, according to medical board and court records. When Ferron was released, the board allowed her to keep treating patients as long as she continued with substance-abuse treatment and screenings and regularly reported her progress. Within three months, she had failed to live up to the conditions, and her license was suspended in December 2004.

After that, Ferron began working with another doctor, Jerry Yee of Wauwatosa, according to court records. At first, Ferron consulted with Yee, and he wrote her patients prescriptions for medications such as OxyContin, Percocet and Vicodin. Yee told authorities he grew concerned about the large numbers of patients and prescriptions and told Ferron he could no longer work with her.

Even so, Yee gave her a pad of signed, blank prescriptions, he told police. He said he did it because Ferron complained that her patients would suffer withdrawal.

Assistant U.S. Attorney Matt Jacobs, who prosecuted Ferron, said he was able to make the case largely because of what happened next: On Dec. 16, 2005, Ferron was captured on surveillance video placing some of those prescriptions, which she wrote for OxyContin, on a stack of shirts at a Kohl’s department store in Brookfield. A man took the prescriptions and handed her a wad of cash.

Yee is under board investigation in connection with Ferron’s case, his attorney confirmed. It’s not the first time. He was sanctioned by the medical board for improper prescribing in 1990.

Yee declined to comment. The attorney, Pat Knight, said many patients can’t afford pain specialists, which leaves family practitioners such as Yee struggling to navigate a complex, new field.

“You get a lot of regular neighborhood practitioners that are being held to standards that didn’t exist not long ago,” he said.

12th victim

Nationwide, prescription painkillers such as oxycodone are more likely to cause overdose deaths than heroin or cocaine, according to a study released last year by the federal Centers for Disease Control and Prevention.

But the traditional methods used to investigate drug crimes are ineffective when it comes to prescription drugs – even when doctors can be linked to fatal overdoses.

Street drug dealers often get busted because they can’t explain where their money came from. In prescription cases, however, doctors are able to charge for office visits, which enables them to account for large amounts of cash. Doctors can claim they trusted patients’ reports of pain and didn’t know they were addicted or faking, claims that would be ludicrous if uttered by a crack dealer.

There also are no hard-and-fast rules for how much of a certain drug is too much for a given patient, because each person’s body has its own way of metabolizing the chemicals, said the American Academy of Pain Medicine’s Fishman, a physician.

Most people will not become addicted to painkillers, but they might need more of the drugs over time to allow them to function, he said.

“If people are abusing these drugs, they don’t function,” he said. “If they use too much, they get side effects. If someone comes into my office and they’re sleepy and unable to walk and they say, ‘This is the best I’ve ever felt,’ this is not treatment success.”

Many doctors simply have not been well-educated on how to manage pain, so they make mistakes, he said.

To differentiate between a mistake and a crime, prosecutors have to demonstrate that a doctor’s actions fall outside legitimate medical practice, which is a difficult standard to meet, Jacobs said.

Federal authorities were unable to meet that standard during an investigation of Richard I.H. Wang, a clinical pharmacology specialist linked to 11 overdose deaths in Milwaukee and Waukesha counties between June 2000 and April 2004, according to a search warrant. Six were Wang’s patients. Authorities said some of those patients were selling or sharing pills, resulting in five more deaths.

Before the federal investigation started in April 2004, the state’s Medical Examining Board had dismissed five complaints against Wang without discipline, according to Berndt, of the Department of Regulation and Licensing. A pharmacist also said he had called the state about 10 times over the years with concerns about Wang’s ever-increasing numbers of prescriptions.

At the beginning of the three-year investigation, Wang agreed to stop prescribing certain drugs, according to court records. He kept his license.

Onetime Milwaukee mayoral candidate Sandy Folaron and her husband, John, consider their son to be Wang’s 12th victim.

John R. “JR” Folaron committed suicide in June 2004. JR Folaron was a motivated kid and an Eagle Scout, according to his parents. As a teenager, though, he rebelled, dropping out of high school and getting a job in construction. A knee injury at work led to surgery. After that, he sought pain treatment from Wang.

At one point, Wang was prescribing between 300 and 400 pills to JR Folaron each month, his mother said. Her son had lost a lot of weight and looked sick. He reassured his parents, saying he was under a doctor’s care.

“You grow up to believe you need to respect people in these professions,” Sandy Folaron said. “Then you realize they’re just as crazy as the next person. They’re not without fault by a long shot.”

By the time Wang lost prescribing privileges, JR Folaron was addicted. His mother said the doctor did nothing to help him. With the painkillers cut off, JR Folaron started using heroin. Within a month, he had killed himself by drinking antifreeze. He was 24. In writings, he blamed his addiction for his inability to go on.

JR Folaron’s parents complained to federal and state authorities after his death, while Wang already was under investigation in the 11 other cases.

In the end, Wang wasn’t criminally charged with improperly prescribing drugs to anyone. The federal investigation against him ended in March when he agreed to repay the federal government $509,000 in overbilled charges to Medicare and Medicaid and to give up his license.

Wang, 83, did not return telephone calls for this report. At the time of the settlement, the doctor said he had planned to retire anyway and blamed patients for selling and abusing their medications without his knowledge.

Wang’s case is typical in that it took years to investigate, yet didn’t result in criminal charges.

That’s a source of frustration for the Milwaukee police’s Burkee. Charging more doctors, he said, would stop others from writing prescriptions for painkillers likely to end up on the black market.

“But those are decisions that prosecutors make,” he said. “Not police officers.”

Keeping their licenses

The Medical Examining Board has allowed several doctors to keep their licenses despite repeated investigations of inappropriately prescribed drugs – even when patients were harmed.

Marc L. Smith, a Milwaukee osteopath who wrote Daryl Collie at least two prescriptions in 2005, first caught the attention of the board and of law enforcement in 1993.

An undercover police officer posing as an exotic dancer went to his office and asked for the anti-anxiety drug Xanax. She told the doctor she was healthy but needed the pills because of her late nights on the job, according to medical board records. Smith gave her a prescription for 60 pills.

The woman returned to his office 2 1/2 weeks later, saying the pills were gone because she had used some of them to come down from a cocaine high and had shared some with a friend.

Smith wrote a prescription for 90 more pills, records say.

“There has to be a legitimate medical reason to prescribe something,” said James F. Bohn, assistant special agent in charge of the Drug Enforcement Administration’s Milwaukee office. “If there’s not a medical reason, that’s cause for a criminal investigation.”

But the case against Smith stalled when the undercover police officer returned a third time, and he said he could no longer treat her, according to records. He was not charged.

A 1997 incident involving Smith’s then-girlfriend, whom he met at the clinic where they both worked, triggered another board investigation. Smith and other doctors gave the woman numerous prescriptions for painkillers, which she filled at different pharmacies, records say.

In October 1997, Smith took the woman to a hospital emergency room. At the time, the 5-foot-3-inch woman, unidentified in board records, weighed 91 pounds. Smith did not tell doctors about the woman’s “history of chronic drug abuse” or a previous emergency room visit, medical board records show. She died of complications from pneumonia eight days later.

In February 1999, the medical board suspended Smith’s license for 30 days and imposed several other sanctions based in part on those two cases. The board also determined that Smith had improperly prescribed pain medication to other patients and had trouble diagnosing certain conditions.

By 2002, Smith was back to the same sort of prescribing that got him in earlier trouble, according to board records. He repeatedly prescribed Norco (a painkiller similar to Vicodin) and other drugs to a female patient who complained of a different problem almost every time she came to his office. First it was an old car accident, then another car accident. Anxiety and a fall also made the list. In some cases, Smith prescribed higher doses than he recorded on the patient’s chart. He also did not adequately record details of her pain, treatments or medical history, the board found.

In 2004, Smith prescribed OxyContin to a man, the man’s twin brother and the brother’s wife all within the same month, according to board records. Smith doubled the man’s dose after a week and increased the brother’s dose after two days. Over a period of months, Smith prescribed ever-increasing dosages to the three, according to medical board records.

This time, the medical board reprimanded Smith and substantially limited his ability to prescribe opiates. The restrictions, which were handed down along with several others in December 2006, remain in effect, according to board records. Smith was among the doctors who wrote prescriptions for Daryl Collie the previous year, but no claims of wrongdoing have been made against him in that case.

Smith did not return telephone calls.

Last year, Robert J. Wetzler, who works with Smith and who also wrote prescriptions for Daryl Collie, gave Smith signed blank prescriptions, which Smith used to prescribe opiates and other drugs, according to medical board records.

Some discipline

It wasn’t the first time Wetzler drew the board’s attention. He was disciplined in 1991 for inappropriately prescribing the depressant Quaalude to a female patient, according to records. The board also limited his license to practice and to prescribe controlled substances. The limitations were removed in 1998.

A medical board review of Wetzler’s prescriptions revealed that during April, he was the second-largest prescriber of oxycodone products in a five-state area that includes Wisconsin. In May, Wetzler was Wisconsin’s top prescriber of oxycodone products and of methadone, a painkiller used to wean addicts off other drugs. The findings were based on data from 80% of the nation’s pharmacies.

Oxycodone is often used to treat terminal cancer patients, who need strong pain relief and for whom addiction is not a concern.

Wetzler’s prescriptions raised red flags with the Medical Examining Board because he does not treat a lot of cancer patients or work in a hospice program. He also does not have any specialized training in pain medicine, according to board records.

The fact that more than 80% of his May prescriptions of oxycodone and methadone were paid for with cash also raised questions with the board, because prescriptions for those drugs are almost always paid for through insurance, according to board records.

Fearing for patients’ safety, the board suspended Wetzler’s license immediately for 30 days in July and opened an investigation.

In an interview, Wetzler, a former state medical society Physician of the Year, said he came out of retirement to open Milwaukee’s Riverwest Clinic a few years ago because there were many uninsured people in the area who needed care.

Wetzler said he has learned a lot about how to monitor patients. The clinic counts patients’ pills, communicates with pharmacies and conducts drug tests, he said. He employs a full-time staffer to keep tabs on patients and has dismissed hundreds of patients for not following the rules, he said.

His problems with the board arose primarily due to two patients who were getting prescriptions from several other doctors without his knowledge, he said.

“When somebody overuses medicine or uses it inappropriately, that is a medical problem. Maybe they’re still in pain. Maybe they don’t know what they’re doing,” he said. “When somebody puts in a false prescription, doctor shops, or sells prescriptions, that’s a legal problem, and we are quick to turn these people over to the cops.”

Wetzler said he initially referred Daryl Collie to Ferron for pain management. At the time, he was unaware of her problems. When Ferron lost her license, Daryl Collie returned to the Riverwest Clinic for a short time, Wetzler said. Records confirm that Daryl Collie received most of his prescriptions from Ferron.

Wetzler contended that Daryl Collie’s abuse of alcohol was a big part of the reason he died.

In January 2007, the medical board disciplined Wetzler in connection with Daryl Collie, but not for improper prescribing. Instead, the board found that Wetzler did not document Daryl Collie’s care adequately and ordered the doctor to take a course in patient-records maintenance.

By December, Wetzler had been disciplined again, this time for prescribing medications to his wife and sons without keeping sufficient records. In one case, his wife ended up in intensive care because an injection administered by her husband interacted with pain medications other doctors had prescribed for her and with alcohol, according to board records.

As a result, Wetzler’s license was limited again. He was barred from treating family members, except in an emergency. Like Smith, he was ordered to submit to a skills evaluation and, if necessary, get continuing medical education. The board also ordered Wetzler to pass certain exams and to work under the supervision of a professional mentor.

Under another part of the agreement, Wetzler has stopped prescribing OxyContin and other drugs like it.

That’s not enough for Alfred Collie, who has written to everyone from the police to the governor, trying to get Wetzler criminally prosecuted for giving his son a prescription for painkillers two weeks before Daryl Collie died in 2005.

“It’s not just Daryl, it’s a lot of other people’s loved ones,” Alfred Collie said. “We can’t bring Daryl back. We’ve lost him. But we can save other children.”