Medical doctors who oppose opioid use face threats from sufferers Oklahoma Information
One patient threatened to find Dr. Shoot Terry Hunt when physical therapy wasn’t as effective at relieving his pain as opioids. Another harassed his co-workers and roamed a hospital looking for Hunt after being told he was being weaned from pain medication he had been using inappropriately.
Hunt was unharmed, but shaken enough to ask the central Illinois hospital system where he was working to discharge both patients.
When he heard of the attack Tuesday at a medical clinic in Buffalo, Minnesota, in which one person died and four were injured, “the first thing I assumed was something to do with pain medication,” said Hunt, who is now they work for the Mayo Clinic in Rochester, Minnesota, and a health care facility at the Mayo Clinic in Red Wing, Minnesota. “It makes us ask about our own workplace: How safe are we?”
Authorities said 67-year-old Gregory Paul Ulrich was upset about his medical treatment before shooting five workers and detonating three apparent pipe bombs at an Allina Health clinic. According to a police report, he threatened a similar mass shooting in 2018, allegedly in revenge on people he said had “tortured” him with back surgery and prescribed drugs.
A former roommate said Ulrich was upset when a doctor stopped prescribing pain medication and Ulrich was also taking other medications and had untreated mental health issues. Law enforcement and the health system did not address the specifics of Ulrich’s treatment or medication.
Doctors who treat pain say the threat of violence has increased significantly in recent years as increasing legal and regulatory pressures from the deadly opioid epidemic caused many to prescribe alternatives and discourage their patients from addictive pain medication.
While some patients benefit from careful opioid use and doctors don’t want to stigmatize them, many are better off using other therapies to manage pain, experts say. But many become addicted to drugs, often for short-term use after surgery.
“It hijacked your brain,” said Dr. Carrie DeLone, Regional Medical Director at Penn State Health Community Medical Group. “You don’t see yourself as a problem.”
The pain specialist Dr. Andrew Kolodny, professor at Brandeis University and founder of Physicians for Responsible Opioid Prescribing, said patients are convinced that opioids treat their underlying problem because when they try to skip a dose or when their previous dose wears off, ” They feel awful and in pain “when it may be the withdrawal that is causing the pain hypersensitivity.
“It’s much easier to give the patient what he wants. You write the recipe … they walk out the door happy and there are no problems. It is much more difficult to help a patient rejuvenate… ”said Kolodny.
And when a doctor says no, things can get ugly.
“We had patients waiting in parking lots for doctors to harass them. They said, “We’re going to shoot you” or “We’re going to burn your house down,” DeLone said.
Nearly half of pain specialists interviewed during a violence education session at a meeting of the American Academy of Pain Medicine in 2019 cited opioid management as the reason for their threat, said Dr. W. Michael Hooten, President-elect of the Organization.
In response to threats, doctors have fired patients. But they also installed alarm systems and panic buttons and set up examination rooms so that the doctors are closest to the door. Some even advocate carrying guns, Hooten said, noting that smaller clinics are at the greatest risk because they may not be able to afford safety.
After his threat in 2018, police took Ulrich for a psychological examination and Allina took legal action to have him excluded from the company’s property. An injunction forbade Ulrich from contacting the doctor or entering the clinic and the nearby Buffalo Hospital, run by Allina, where he once frightened a nurse so much that a colleague pressed a panic button for help.
Police said they had not had any recent interactions with Ulrich, who raised the alarm prior to the attack in Buffalo, a small town about 40 miles northwest of Minneapolis.
St. Joseph County, Indiana, prosecutor Ken Cotter said he was unaware that such threats were common until 2017, when a man shot and killed a doctor who refused to prescribe opioids for his wife. Michael Jarvis attacked Dr. Todd Graham in a parking lot hours after the appointment, Cotter said, adding there was evidence that Jarvis was also using opioids. Jarvis took his own life soon after.
Before that, Cotter said, “I can’t remember ever reading a threat report,” Cotter said after receiving calls from about 20 doctors after the shooting, telling him how common they were. “They took (threats) as a business expense.”
According to Cotter, about a dozen meetings were held with doctors, law enforcement officers, and others to discuss how doctors can be protected, including de-escalating stressful situations, but also alternatives to opioids, disposing of old drugs, and tackling the addiction problems that are theirs Plague communities.
“When doctors call to say we have to do something, this is … literally the crusade of our entire community,” said Cotter.
Kolodny, from Brandeis, said he was compared to Hitler, threatened on Twitter, and a bag of nails was sent to his home. Protesters carried signs near his office last month sacking him for working to reduce opioid use and help states bring lawsuits against opioid manufacturers.
The threats have “gotten really scary,” he said. “It just got really hot.”
Webber reported from Fenton, Michigan. Associate press writer Amy Forliti was from Minneapolis.
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