Pain patients from across the country are flocking to a boundary-pushing pain specialist in West Covina, California because they can't get the treatment they need in their home states.
A growing "opioid epidemic" in the U.S. has led law enforcement agencies to crack down on so-called pill mills, leading to the arrest of several physicians. Last year, the Drug Enforcement Agency (DEA) clamped down on painkillers, reducing the allowed production of opioid medications by about 25 percent. Some states have filed lawsuits against pharmaceutical manufacturers, and, earlier this year, the Center for Disease Control (CDC) issued guidelines advising physicians against prescribing high doses of these drugs, which can be particularly lethal when combined with alcohol or anti-anxiety medications. Many doctors will only prescribe opioids as a last resort.
Dr. Forest Tennant, 76, says this regulatory backlash is preventing chronic pain sufferers from getting the drugs they need to alleviate their conditions, and he refuses to go along. Critics have denounced his unapologetic style and unorthodox methods, but his patients depict him as one of the only physicians in America to put the needs of his patients first.
"[Tennant was] the first doctor to say, 'our goal is to relieve your pain,'" says Kristen Ogden, whose husband Louis Ogden has suffered from chronic pain for decades. They travel to Dr. Tennant's office from Virginia for treatment every three months. "Every other doctor had said, 'our goal is to get you off any opioid medications.'"
Many physicians have even begun to adjust the way that they think about pain.
In a New England Journal of Medicine article, one of the pain specialists advising the CDC recommended that pain patients "use coping and acceptance strategies that primarily reduce the suffering associated with pain and only secondarily reduce pain intensity." That opioids are never an effective chronic pain treatment is quickly becoming conventional wisdom, and the American Medical Association (AMA) has even begun to advise physicians to abandon the pain rating scale when assessing patients.
"I take the Hippocratic oath seriously, that my job is to relieve pain and suffering," says Dr. Tennant. "So when I see the AMA decide that they're not going to assess pain, I'm not with them."
Tennant has run a pain clinic since the 1970s when he mostly treated patients with pain resulting from cancer and polio. He's never shied away from the public spotlight.
In addition to serving as mayor of his city, he ran some of Los Angeles County's earliest methadone clinics to treat heroin addicts and in the late '80s served as a drug adviser for the NFL, NASCAR, and the Los Angeles Dodgers.
Controversy swirled around him in many of these roles.
He angered the NFL when he publicly disclosed plans to monitor several New England Patriots players for drug use. One NASCAR racer even accused him of colluding to falsify drug tests to target him.
Tennant simply told the New York Times that "[n]o mistakes were ever made."
Tennant says it's true that opioids were overprescribed in the past and should generally be a last resort for pain treatment. But he believes the media and government have now gone too far in demonizing them, and it's legitimate pain patients who are paying the price.