Opioids

DEA Raids California Pain Doctor Featured in a Reason TV Video

Search warrant lists probable cause for distribution and possession with intent to distribute a controlled substance and health care fraud.

|

The Drug Enforcement Administration raided the office and home of California pain specialist Forest Tennant on Wednesday. The incident may foretell a new chapter in the federal approach to opioid prescriptions in California, which has a more permissive framework than other states.

Tennant, whose West Covina clinic attracts pain patients from across the country who claim they can't get treatment anywhere else, was featured in a Reason TV video in July.

The DEA search warrant lists probable cause for distribution and possession with intent to distribute a controlled substance and health care fraud. Agents seized Tennant's medical records, computers, medications, and financial records. The warrant also names United Pharmacy, which has supplied many of Tennant's patients with their medications. The DEA quotes consultants who speculate that he may be running a "pill mill," over prescribing pain medications for profit.

The DEA also alleges that Tennant may be taking kickbacks from the pharmaceutical company Insys, which manufactures a fentanyl-based medicine called Subsys. Tennant admits to earning speaking fees from Insys, which recently settled a lawsuit in Massachusetts for similar pay-for-play allegations. But, according to Tennant, his last paid speech for the company was in 2015 and he's prescribed Subys before and since this "short speaking endeavor."

Fentanyl is a powerful opioid considered by some to be deadlier than heroin as a street drug, but in a medical context the FDA approved the use of Subsys as a palliative for cancer patients. The warrant singles out two patients prescribed Subsys by Tennant, one of whom doesn't have cancer. Tennant says he was prescribing the drug off-label, or in a way not explicitly approved by the FDA, which is legal. The FDA, however, recently added additional restrictions on fentanyl medications.

"Is prescribing off-label or accepting speaking fees a crime?" Tennant said in a statement emailed to Reason.

Many opioid overdoses occur from a combination of three drugs: narcotics, benzodiazepines, and the muscle relaxant Soma. A consultant quoted in the warrant says a number of Tennant's patients were prescribed this "holy trinity" and called it a "red flag."

Tennant says his clinic is known for accepting difficult patients turned away by other doctors, and that the DEA failed to throughly examine his treatment methods. Tennant says "in recent years" his clinic "has not had an overdose death," something the warrant does not allege.

The warrant also makes note of Tennant's outspoken public defense of opioids, noting that he helped draft California's Pain Patient Bill of Rights, which states that "opiates can be an accepted treatment for patients in severe chronic intractable pain who have not obtained relief from any other means of treatment" and that "a patient suffering from severe chronic intractable pain has the option to request or reject the use of any or all modalities to relieve his or her pain."

Tennant, who's published scathing critiques of the government's approach to the opioid problem, believes the DEA is failing to recognize the harmful effects persecuting doctors who prescribe opioids is having on legitimate pain patients.

"I take the Hippocratic oath seriously, that my job is to relieve pain and suffering," says Tennant.

Watch Reason's video profile of Tennant:

NEXT: More on libertarian skepticism about democracy - a rejoinder to Will Wilkinson

Editor's Note: We invite comments and request that they be civil and on-topic. We do not moderate or assume any responsibility for comments, which are owned by the readers who post them. Comments do not represent the views of Reason.com or Reason Foundation. We reserve the right to delete any comment for any reason at any time. Report abuses.

  1. I hope these drug thugs all get stomach cancer.

    1. Without access to painkillers. It’s only fair.

    2. Bone cancer is more excruciating.

  2. Search warrant lists probable cause for being viewed in a favorable light by people who made fun of Preet distribution and possession with intent to distribute a controlled substance and health care fraud.

    FTFY

  3. They’re watching.

    Watch your back.

    1. Top Men are watching it for you.

  4. “The warrant also makes note of Tennant’s outspoken public defense of opioids, noting that he helped draft California’s Pain Patient Bill of Rights.”

    At least they included the actual reason for the bust, because there were no OD deaths by this doctor, in spite of getting the 500(est) hardest cases around.

    Now that all his people will be instantly cut off from meds, I’ll bet that a minimum of 2-5% of his patients will die w/in 5 years by either OD on street drug replacements(fentanyl), suicide or stroke from instant cut off of medications.

    I can withstand unrelenting, chronic pain in other people without the need of relief.
    If I’m the one with severe pain, I want relief, not some bozo playing a harp

    Virtually everything I see them do seems likely to increase the number of people that die, and I’m starting to think that’s a feature, not a bug. The best part of the Opiate epidemic is the very obvious trail of bodies, each of which is worth $1 million in extra funding. Why would the DEA try to lower the number of Overdoses? People who eat too many Vicodin end up with a gruesome death because the Tylenol is toxic to the liver in doses of about 6 grams/day (2 pills – 4x daily), especially if consumed with alcohol. So they tell those people that it was the Vicodin which killed them, when it was really the Tylenol that killed their liver. This problem could be solved by education, but I think they prefer the bodies to deter drug use.

    1. You nailed it the first time. They prefer the bodies to increase funding for their bureaucracies. Like in the Inquisition (cue Mel Brooks), some may be true believers, but most are in it for the power.

  5. Thugs gotta thug

  6. Pissing on the 10th Amendment’s grave again, I see.

    If California doesn’t properly regulate its doctors, that’s on California, the feds aren’t responsible for coming in on their white chargers and “correcting” California’s regulation of the practice of medicine.

    But like, that argument is so retrograde, we’ve moved on as a country from that whole federalism thing. Of course the medical system is the responsibility of the feds, it’s right there in the Constitution’s penumbras and emanations. And in the We Must Do Something Clause of the U. S. Constitution (which is right next to the FYTW clause).

    And that’s assuming this doctor is behaving badly – but I’m not just going to take the feds’ word on that.

    1. No way! The Feds still drive white chargers?

    2. In all seriousness (why?), Hicks hit the nail on the head. This is about funding a bureaucracy, plain and simple. You have to crack down on these doctors, see? They’re prescribing legal pain meds! We need more troops, more guns, more surveillance equipment, more lawyers! The more they catch, the more they show they need. It’s textbook Bureaucracy 101, Lesson 1 (Empire Building).

  7. OT: Anyone currently reading/subscribing? BS meter rating?
    Prolly got on their mailing list from other history reading lists, but here’s the link to the essay I got:
    “Do civilisations collapse?”
    https://aeon.co/essays /what-the-idea-of-civilisational- collapse-says-about-history
    Anecdote to catastrophist readings of history, notably debunking (without naming) Jared Diamond and his malthusianism.
    But the next essay ( https://aeon.co/essays /what-does-small-business-really- contribute-to-economic-growth ) blames “Reaganism” and “Thatcherism” for promoting small business which was really about promoting big business and big business is b-a-d, BAD! Standard lefty crap; not paying some wage = exploiting, etc.
    Comments?

      1. I think you mean gilt-edged $100. Gold plated wouldn’t burn.

    1. Reads like a typical professor who wouldn’t know the first thing of how to start, run and make a successful small business. All hung up with all that bull shit makes me wonder sometimes. And he quotes John bloody Oliver. Ugh.

      I guess we can equally ask. Academics. What value are they to society?

      At least my father fed a family and provided for a great life with his small business. If the family unit is strong then our communities are strong too.

      What more does he want? Besides, of course, screaming Reagan and Thatcher.

  8. This is disgusting. The DEA is not going to be satisfied until opiates are restricted to inpatient use for surgery and people dying within 24 hours, everyone else can just deal with their pain. I hope that the supervisor who ordered this raid gets to watch a loved one kill themselves because they can’t take the pain that opiates could have easily relieved. These sadistic thugs would prefer 100 people bedridden and screaming all day, instead of playing with their kids, just to prevent 1 person from getting high from a prescription product instead of a street drug.

    1. I would rather the supervisor get the crippling but not mortal pain himself, and be denied ANY painkillers.

  9. Tens of thousands of OD deaths = Seen

    Tens of millions of pain sufferers denied relief = Unseen

    (tens of thousands of additional fentanyl deaths from prescription crackdown = ? does not compute, must just need more funding/mandatory minimums)

  10. Nooooo! I have adhesive arachnoiditis, broke my ass after parachute didn’t open. One year in spinal cord injury clinic, etc etc. Twenty years later, diagnosed with incurable, intractable spinal cord inflammation.

    I’m not on high dose opioids, went the ketamine route with nine infusions and a one week hospital stay with 24/7 ketamine infusion. Yet Dr Tennent is like the patron saint of lost and forgotten crips like me. People who lived bedbound, homebound lives. These are dark, middle age like times when it comes to pain medicine.

    This is beyond unjust. Months ago I posted the Reason vid to one of the arachnoiditis FB groups it got hundreds of likes. This guy fought hard for pain patients. This country is becoming unrecognizable as a force for good. It’s over.

    1. Arachnoiditis?

      Have you tried Stingimine? Dr. Baggins is usually generous with his prescriptions, and if he’s out of the office Dr. Gamgee can help too…

  11. Lumbosacral adhesive arachnoiditis and central Neuropathic pain syndrome are two of the worst pain syndromes known to mankind. Let’s add CRPS and trigeminal neuralgia/suicide headaches.

    In my case, also an obliterated sacrum (tailbone), ripped off sacral nerves and T4 spinal cord injury from vascular tumor causing central Neuropathic pain. And yes, this, all of these cause bone cancer like pain. For me from breast level down to my legs.

    1. TN doesn’t respond to opiates. In fact, one of the diagnostic methods involves prescribing opiates, and checking their effectiveness.

      1. What I am saying is, and it was unclear from your post, but it seemed like you were saying you have TN.

  12. Dr Tennant is one of the few pain management physicians willing to stand up for his patients who suffer chronic pain. It seems if you stand up for what’s right and speak against DEA’s new policy of going after pain management physicians, you risk arrest.

    In the 1990’s pain was under treated and patients were ending their lives to end the pain. Then the Joint Commission on Health care Accreditation told physicians they needed to take pain seriously and Pain the 5th Vital Sign was posted in all emergency rooms.

    Pain patients were taken seriously and received the treatment they needed. Unfortunately some patients abuse their medications. Dr William Hurwitz was my pain management physician in 1996 when he supported opioids for chronic pain. DEA objected and he went to prison for 8 years. PLEASE Read the Police State of Medicine something I’m afraid we are going to see again in 2017.

    If a physician drops a patient with no warning it’s patient abandonment. Yet when a physician like Dr Tennant is arrested his patients get no warning, no help from DEA to find a new pain management physician. When DEA causes patients to lose their physician without notice it’s patient abandonment too. The first time Dr Tennant’s patients will know there’s a problem is when they show up and find his office closed with a note from DEA.

    The Police State of Medicine by Dr Willian Hurwitz http://www.aapsonline.org/painman/hurwitz.htm

    1. The campaign to remove pain as the 5th vital sign reveals the barbarism and sadism of the people behind this. It’s the very definition of sadomoralism, they find drug abuse morally wrong and don’t care have much suffering and destruction is required to fight it. Some people are going to abuse their meds to get high.. but this too is a medical issue that should be handled by doctors. The damage to someone who gets their drugs legally is minimal; opiates don’t cause severe damage to the body, insurance means someone doesn’t need to commit crime to pay for them, and their doctor can help them keep it under control. But the fact a few percent of people might go that route is so absolutely intolerable that they instead want to cause 50x as many people to suffer in severe pain. They’re telling doctors they must act like medieval barbarians– ignore how much pain your patient is in, it’s ok if they suffer in pain, because otherwise they might use their meds to feel good, even though you could help them if that causes problems.

      I know the DEA has put doctors in an extremely difficult position, but at the end of the day they’re obligated to put their patients first. Do no harm: Ignoring pain and letting your patient suffer needlessly because of anti-opioid propaganda and DEA legal pressure is immoral and a violation of the Hippocratic oath, and any doctor who does this should be ashamed of themselves.

  13. 70% of DEA’s business was marijuana enforcement before legalization. What are you going to do with a huge federal law enforcement agency with nothing to enforce? It seems to me the “Opioid Crisis” came along just in time to give a lot of DEA agents something to do…..

    100,000,000 Americans suffer chronic pain. Some need opioids and don’t abuse their medications.

    If an opioid medication makes your life worse causing problems in your relationships at work and with friends, you may have a drug problem.

    If an opioid medication makes your life better allowing you to get up get out and do things, you’re a pain patient….

    1. There’s a fine line between the two though, or maybe more like a hazy grey area in between.

  14. Pain doctors seem like the perfect case for the DEA. Just take a look at pharmacy records and decided, ‘eh looks like this guy prescribed more than I like and go arrest him. No interacting with dangerous criminals, no undercover work, or informants, no searching for hidden evidence, or intercepting shipments, or trying to work your way up from street level guys to the boss. Just get the records off the computer, arrest some peaceful doctor, and try to convince a jury that he’s really a drug pusher. If you win great, if not you still got to futz around making a show of activity to justify your job.

  15. Some of these bureaucrats need to be given “severe chronic intractable pain” and then be denied any way to treat it.

  16. Once again Tony is absent from real liberty theft stories. He claims to be all about the little guy and protecting a simple way of life, but as soon as the goons show who they really are he isn’t here to explain to us how it is actually for our benefit.

    I can’t decide if he even knows it is bullshit or if he just hasn’t figured the exact phrasing to explain to us why this is benevolence.

  17. What’s getting just as bad is the media. The story that has been making me absolutely infuriated lately is talking about how this one doctor is prescribing a huge amount of opiates for a town of a couple thousand people. And not a single mention of the fact that pain doctors aren’t like regular doctors and don’t just serve their town, people have to go thousands of miles and even to other states to find a good pain doctor. That office may be in a town of 1000 people, but that doctor is likely serving an entire region because people can’t get treatment anywhere else.
    And then there’s the deliberate misleading stories about overdoses. First of all, nobody ever ODs if they’re taking their meds as prescribed. The media always lumps in people who get pain pills illegally- those people make up the large majority of ODs. Not to mention the long-standing trend of failing to note it’s not opiates alone in the vast majority of ODs, and *never* opiates alone in long-term patients. And dead silence when it comes to pointing out the fact that even if a chronic pain patient starts developing an abuse issue, rare to begin with, they’re *more* likely to OD and get worse if they’re kicked out of the medical system and forced to switch to street drugs.
    They’re massively increasing suffering in this country, all because we still haven’t learned our lesson about what does and does not work to reduce drug abuse.

  18. the DEA is a communist front.

  19. He should have thought of that 50 years ago.

  20. Well the obvious answer, as always, is to get the fucking government out of deciding what people are allowed to put inside their own bodies. If you could buy heroin, one of the safest drugs ever used by human beings, at a drug store without the state’s approval in the form of a prescription, there would be no opioid epidemic. Some people would get high and waste a lot of time. Others would relieve their pain and be productive. Others would relieve their pain and die something like a peaceful death. We would all be better off.

    OT: Black woman points out the obvious, has to go.

    https://tinyurl.com/yakzoztg

Please to post comments

Comments are closed.