The wrong way to fight opioid abuse

By WYATT EMMERICH,

As opioid deaths take center stage in the news, it was just a matter of time before we heard a horror story about a reputable doctor caught up in a bureaucratic crackdown. The law of unintended consequences reigns supreme.

In this case, Ripley physician Dwalia South’s name was dragged into a Mississippi Bureau of Narcotics news conference and scandalized for writing opioid prescriptions. She was never charged with a crime.

This is the same Dwalia South who is past president of the Mississippi State Medical Association and is a member of the Mississippi Board of Health.  She has been a family practice physician at Ripley Health Care Associates, a satellite campus of North Mississippi Primary Health Care, since 1995. In 2003, she was named Mississippi Family Physician of the Year and was listed as one of America's Top Family Doctors of the Year in 2004-05.

Writing in the Catholic UNA VOCE newsletter, South explained the situation and it was a far cry from that portrayed in the MBN news conference. In a nutshell, medical facilities often assign several nurse practitioners to work under physicians. Physicians review the work of the nurse practitioners and sign off. In this case, the nurse practitioner had let some of her certifications expire. South got caught up in the mess through no fault of her own. When the federal Drug Enforcement Administration (DEA) enforcers came calling, South naively answered all their questions without the advice of an attorney. The next thing she knew, her life was ripped apart.

South wrote, “It is the understatement of the year to say that I was mortified by this misguided public humiliation and maltreatment. Only then did we turn for legal representation to clarify things, but the public cannot unhear or unsee what has been so malignantly portrayed to them. Their vitriol was spewed out to the general public via television, radio and newspapers about the trophy witch hunt. A mug shot of our nurse practitioner was published, with a horrible photo of me immediately adjacent to it, giving the distinct but false impression to viewers I had been arrested for criminal activities.”

South had to surrender her DEA license for a year and resign as medical director of a hospice. Hundreds of patients suffered as a result.

What is missing here is judgment. The DEA and the MBN, under intense public pressure to take action against the opioid epidemic, rushed haphazardly to do something. South’s decades of service were not taken into account in this panic to prosecute. Over the years, there have been so many horror stories of bureaucratic prosecutorial overreach that South’s version of events rings true.

It is true that opioid deaths are a tragedy, but research indicates most fall under the categories of accidental overdose, intentional suicide, use of street opioids and young people who found opioids in someone else’s home. Destroying established physicians with impeccable resumes over some bureaucratic signature snafu may help some DEA and MBN officials look pro-active, but it does little to resolve this crisis. It is understandable that physicians are terrified.

Instead of ruining the reputations of established physicians, a better approach would be public education to the dangers of opioids and revised physician guidelines on lower-risk pain management — both of which are well underway.