KOLD INVESTIGATES: Prescription for death - Tucson News Now

KOLD INVESTIGATES: Prescription for death

Michael Elliott was one of 790 people who died from drug overdose in Arizona in 2016. (Source: Family) Michael Elliott was one of 790 people who died from drug overdose in Arizona in 2016. (Source: Family)
TUCSON, AZ (Tucson News Now) -

The story of Andrea Bryant’s son turns the table on Arizona’s opioid epidemic.

Bryant’s only boy, Michael Elliott, was a star football player, prom king and one of the most popular students in the Class of 2001 at Catalina Magnet High School in Tucson.

Elliott's love for football took a dark, dangerous and ultimately deadly turn after a serious leg injury.

"He was literally taken off the field in an ambulance," Bryant said.

Following surgery, Elliott's doctor prescribed him a powerful narcotic known as Percocet.

“It was one of the huge bottles, 50 to 100 pills,” Bryant said.

After several refills, Elliott's mom said she likes to think that’s when his taste for "real dope" set in.

“That’s truly where I see the turning point,” Bryant said.

In an exclusive interview with Tucson News Now, Bryant said her son's taste for painkillers only intensified as the years passed.

“Michael had a huge propensity to ease some type of pain,” she said.

That pain eventually ended when he died of an apparent drug overdose in March 2016.

“He was found dead with a needle in his arm,” Bryant said.

He spent more than a decade fighting a drug addiction — and died at the age of 33.

(Source: The Javorac / Flickr)
 

Sobering Statistics

Elliott was one of 790 people who died as a result of a drug overdose in Arizona last year.

His death shines a light on a problem killing more people under the age of 50 than car accidents, according to the Centers for Disease Control.

Looking back to the late 1990s -- when Michael was first prescribed painkillers -- his mom doesn’t believe doctors knew the potential for addiction.

"If it were now, absolutely, I would be throwing a huge fit," she said.

It is a different story now with Arizona Gov. Doug Ducey declaring a public health emergency over opioids.

“As the number of opioid overdoses and deaths increase at an alarming rate, we must take action. It’s time to call this what it is -- an emergency," Ducey said at the time.

Since the start of the year, several Tucson doctors have been disciplined by the state medical board for inappropriately prescribing drugs to patients.

(Source: CDC)

Disciplined Doctors

The medical license of Dr. David A. Ruben of the Fourth Avenue Health Clinic was suspended and the board claimed he "exposed patients to the risks of long-term opioid use and placed them at risk for drug abuse and addiction."

Tucson News Now's Jenna Lee visited Ruben to ask him about his suspended license.

Over the course of a half hour, Ruben explained he was “just trying to care for patients” and “do a good job.”

He went on to say he's not "a pain pill pusher," calling the state medical board "unethical and out of touch."

In 2014, Ruben's office was raided by the DEA as part of an investigation into prescription drug abuse. Read more about that incident HERE.

According to the state’s interim findings, Ruben was put on probation in 2009 for "prescribing high-dose opioids without proper indication and for failure to timely use objective measures to assess compliance with treatment, even after being aware of a patient’s cocaine addiction."

The 2009 probation order required Ruben complete several hours of pain management education. The board later found he was in violation of that order when he prescribed opioids to his patients.

The board found from Sept. 19, 2016 to March 16, 2017, Ruben wrote 25 prescriptions for pain medicines for 11 patients.

Dr. Mark R. Austein’s license is under certain restrictions. In February 2017, the board began to investigate after receiving a complaint alleging Austein "engaged in a sexual relationship for 18 months with a patient in exchange for providing Subutex or Suboxone prescriptions."

The board never found evidence of a sexual relationship, but it did find Austein "perpetuated and/or facilitated patients' substance abuse in more than a dozen cases."

In one case, the board claimed Austein "only prescribed Suboxone to a patient on two occasions." It later found evidence through the Controlled Substances Prescription Monitoring Program database that "13 prescriptions for Suboxone and one prescription for Xanax were written to that one patient without proper monitoring."

The board also found Austein’s "medical records for 22 patients were grossly inadequate and did not provide sufficient information for another practitioner to assume continuity of care of the patients."

Read more about the board's findings against Austein HERE.

In June 2017, the board ordered to prohibit Dr. Celia R. Elias of Old Pueblo Healthcare Clinic from prescribing controlled substances in Arizona pending the outcome of a formal interview or formal hearing.

The board’s interim findings, which can be read HERE, claim Elias "prescribed high dosages of opioid medications without appropriate monitoring and safeguards." As a result, the board said Elias’ patient became addicted to his pain medication and suffered side effects of large doses of opioids.

According to the case file, the patient had a near-death occurrence requiring Narcan and emergency treatment. It went on to say "the patient was at unreasonable risk of potential harm including opioid and/or cardiac related death."

In June 2017, the board prohibited Dr. Michael S. Kuntzelman of the Wellbeing Institute from prescribing controlled substances in Arizona.

This came after the board received a complaint regarding Kuntzelman's "care and treatment of several patients at a methadone/Suboxone clinic where he was employed, alleging failure to properly treat the patients and inappropriate prescribing."

You can read more about the board's decision about Kuntzelman HERE.

A medical review of "six patient charts found deviations from the standard of care with regard to five of the patients," according to the case documents.

He was forced to enroll in an intensive, in-person Continuing Medical Education course. The matter is set to be reviewed at an August board meeting.

Dr. Gregory J. Porter of Westside Wellness is prohibited from prescribing controlled substances in Arizona based on evidence presented to the board. The board said it began to investigate after receiving a complaint regarding Porter's care and treatment of a patient, alleging failure to properly prescribe medications resulting in the patient's death.

According to the board's report, which can be read HERE, the patient had a history of chronic pain and received morphine and oxycodone.

Later, the patient was put on methadone. The board said Porter "started the patient at a dose well above what would have been recommended. An autopsy found the cause of death was a mixed drug toxicity: methadone and amitriptyline."

What can be done?

So what’s being done to prevent doctors from inappropriately prescribing medications?

Tucson News Now reached out to the State Medical Board for comment.

In an emailed statement, Executive Director Patricia McSorley said:

"As you can see by reviewing the recent disciplinary actions, when the Arizona Medical Board (AMB) takes disciplinary action against a physician for inappropriate prescribing, the Board orders significant continuing medical education in prescribing to remediate any fund of knowledge deficits. In addition, the AMB follows up with chart reviews to ensure that the physician implements the proper and safe prescribing practices taught in the course.

"At the request of Gov. Ducey, the Board has begun the rule making process to mandate that all Arizona physicians take a minimum of one hour of the required 40 hours of continuing medical education in the safe and effective prescribing of opioids."

The AMB Chair, Dr. James Gillard, AMB Board Member, Dr. Edward Paul, and AMB Chief Medical Consultant, Dr. William Wolf are participating in the Governor’s Goal Council 3 established to reduce opioid deaths. This group is engaged in the development of strategies to reduce opioid related deaths and overdoses.

Other actions taken by the State Medical Board in the past 24 months against Tucson-area doctors:

  • March 2016: Dr. Rinly Gecosala agreed to give up his license. According to the board's report, which can be read HERE, "Gecosala prescribed several prescriptions for controlled substances during a personal relationship with a male patient over a nine-year period."
  • June 2016: Dr. Mohamed I. Elyan received probation and a letter of reprimand. According to the board's finding, which can be read HERE, Elyan "prescribed controlled substances to his wife while she saw multiple other providers who managed her medications, failed to generate and/or maintain a medical record relating to her care."
  • August 2015: Dr. Gordon Joseph Cuzner agreed to a practice restriction after he "admitted to using methamphetamine on a regular basis through oral injection and nasal insufflation and to using marijuana infrequently," according to the interim consent agreement. The board's filing can be found HERE.
  • November 2016: Dr. Laurance Silverman, license surrendered. According to the board's order, which can be read HERE, Silverman "prescribed controlled substances in absence of an established doctor-patient relationship and failed to maintain medical charts on multiple patients."

If you have questions about your doctor, you can look them up HERE. To review recent actions by the State Medical Board, go HERE

The Arizona Department of Health Services has a dashboard, which can show you real-time data about how the opioid problem is affecting the state.

As of 3 p.m. Thursday, Aug. 3, 184 people have died of suspected opioid overdoses in Arizona this year. Even scarier are the 87 children born with neonatal abstinence syndrome.

You can read more about dramatic increase in children born with drug addictions HERE.


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