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Oxycontin, a drug in the opioid category, which the DEA says is being over-prescribed. It claims that prescriptions for this medication frequently end up being illegally sold on the street by drug dealers.
The DEA-State campaign has resulted in the widespread arrest and jailing of both doctors and their patients - many for long sentences. The DEA defends the campaign as an important part of the "war on drugs," but it has been widely criticized by State attorneys general, professional medical associations, and pain management advocacy groups.
Dr. Jackson's case was part of a prosecution known as "The Myrtle Beach Eight." The eight physicians were all associated with a pain clinic in Myrtle Beach, South Carolina. The accused also included Dr. Michael Woodward, the owner of the clinic, the Comprehensive Care and Pain Management Center.
According to Dr. Jackson, "Dr. Woodward was coerced into plea bargaining against the other physicians including myself. He perjured himself by implying that there was a conspiracy to distribute opioids illegally. As a result of this conspiracy charge, a motive to commit a crime does not have to be proved."
Jackson was charged in June 2001 with manslaughter, over-prescribing of opioids, prescribing opioids without a legitimate medical reason, and prescribing the drugs to patients with whom he had no legitimate doctor-patient relationship.
The first step in his prosecution was revocation of his DEA registration, effectively putting an end to his medical practice - and his income.
He was forced to use his house as collateral to raise the $25,000 bond that has kept him out of jail for the past five years while his appeals moved forward.
He was found guilty after a jury trial in Federal Court in Florence, South Carolina, between January 31 and February 10, 2002, and sentenced to 25 years in prison. The verdict was upheld on appeal to Fourth Circuit Court of Appeals, but the 25-year sentence was reduced to 2.5 years when the prosecution dropped the manslaughter charge when it was revealed that the patients who overdosed and died from multiple drug abuse were not his patients. Dr. Jackson appealed to the US Supreme Court, but the high court declined to review the case.
Dr. Jackson claims the DEA often charges physicians with more serious crimes such as manslaughter so they will have an excuse to revoke their DEA registration.
Other physicians associated with the "Myrtle Beach Eight" have also been prosecuted. Dr. Deborah Bordeaux received a sentence of eight years and one month for being included in an alleged conspiracy to prescribe medications such as Oxycontin. Her sentence was based on working for only 57 days at the pain clinic. Drs. Deborah Sutherland and Thomas Devlin received two years each. Dr. Benjamin Moore, who pleaded guilty, committed suicide prior to sentencing. And Dr. Ricardo Alerre, who is 74 years old, was sentenced to 19 years and seven months.
In response to a plea for a reduced sentence based on his age, US District Judge Weston Houck, shackled by mandatory minimum sentencing guidelines, said the law doesn't allow it: "I'm convinced in my mind that Dr. Alerre is a good person, and you'll never see him in jail again, but I'm not going to break the law."
"I believe and I hope that this case has sent a clear message to the medical community that they need to be sure the controlled substances they prescribe are medically necessary," said Assistant US Attorney Bill Day. "If doctors have a doubt whether they could get in trouble, this case should answer that."
One of the DEA'S few Congressional critics is libertarian Republican Representative Ron Paul of Texas. Says Paul:
"Faced with the failure of the war on drugs to eliminate drug cartels and kingpins, prosecutors and police have turned their attention to pain management doctors, using federal statutes designed for the prosecution of drug dealers to prosecute physicians for prescribing pain medicine.
"Many of the cases brought against physicians are rooted in the federal Drug Enforcement Administration's failure to consider current medical standards regarding the use of opioids, including OxyContin, in formulating policy. Opioids are the pharmaceuticals considered most effective in relieving chronic pain. Federal law classifies most opioids as Schedule II drugs, the same classification given to cocaine and heroin, despite a growing body of opinion among the medical community that opioids should not be classified with these substances."
The DEA and its state and local associates have been equally tough on both doctors and patients.
According to Rep. Paul: "Unfortunately, patients often must consume very large amounts of opioids to obtain long-term relief. Some prescriptions may be for hundreds of pills and last only a month. A prescription this large may appear suspicious.
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