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Aug-12-2012 20:45printcomments

Doctor Under Senate Investigation Lashes Out at Journalist

Perry Fine, MD accuses me of "really really bad journalism" -- but I'm not the one who is under investigation by the U.S. Senate...

Perry Fine MD
Perry Fine MD Courtesy:

(MYRTLE BEACH, SC) - As a background to this article, there is a U.S. Senate investigation of the pharmaceutical industry focusing on companies such as the maker of OxyContin, Purdue Pharma as well as their funded pain organizations and physicians who advocate the use of addictive painkillers and possibly profiting from the prescription drug epidemic.

Senate Finance Committee Chairman Max Baucus of Montana and Senator Chuck Grassley of Iowa sent letters to Purdue Pharma, Endo Pharmaceuticals, Johnson & Johnson and nine pain organizations, saying “there is growing evidence pharmaceutical companies that manufacture and market opioids may be responsible, at least in part, for this epidemic by promoting misleading information about the drugs’ safety and effectiveness.”

The letters accuse industry supported pain organizations of playing a major role in spreading that misinformation.

“Improper relationships between pharmaceutical companies and the organizations that promote their drugs can put lives at risk. These painkillers have an important role in health care when prescribed and used properly, but pushing misinformation on consumers to boost profits is not only wrong, it’s dangerous,” Sen. Baucus said in a statement Baucus and Grassley asked the three drug makers for a list of all payments they’ve made since 1997 to nine pain organizations, including the American Pain Foundation, the American Academy of Pain Medicine, the American Pain Society and the Federation of State Medical Boards. In addition, the Senate will be asking for payments made to several prominent physicians in the field of pain management, including Russell K. Portenoy, MD, Chairman, Department of Pain Medicine and Palliative Care, Beth Israel Medical Center, New York, Scott Fishman, MD, Chief of the Department of Pain Medicine, University of California, Davis; Perry Fine, MD, Professor of Anesthesiology, Pain Research Center, University of Utah School of Medicine; and Lynn Webster, MD, Medical Director and Founder of the Lifetree Clinical Research & Pain Clinic in Salt Lake City, Utah. My article last week focused on Perry Fine, MD and also someone the Senate does not have in their radar for some reason -- Curtis Wright, MD. Wright was not named in the Senate investigation, but neither was another physician I referenced named J. David Haddox, MD. It doesn't seem fair that Dr. Fine should be named, but Drs. Wright and Haddox who were so instrumental in the push of opioids to the medical profession resulting in a rise of approximately 300% in the last decade in opioid prescriptions being written -- and neither one is currently under Senate investigation. Dr. Fine sent an email to my boss at indicating in the subject "really really bad journalism."  I decided to respond to Dr. Fine's criticism of my journalism by answering his email in italics and blue type in the hope that the U.S. Senate doesn't investigate me for "really really bad journalism."

Dr. Fine's email is as follows:

Dear Mr. King:
I trust that as an editor and journalist you subscribe to the journalistic code of ethics that above all endorses the essential tenet of fairness and truthful representation of facts.
Whatever credibility Marianne Skolek may have had by way of patient advocacy, she has lost it with her August 5, 2012 article “Two Physicians and Their Motives Leading to Financial Gain”.
Not only was I never interviewed, nor given the opportunity to respond to her accusations and labeling as a “criminal”, she did not do any reasonable form of fact-checking.
My reference to "criminal" was Dr. Fine posting on the Purdue Pharma "In the Face of Pain" website (complete text below in "red") that "Meanwhile, all clinicians who treat people living with chronic pain need to revise their classically taught view that pain is merely a symptom of some other underlying condition in order to accommodate the current science that increasingly suggests that the panoply of chronic pain conditions resemble disease states in and of themselves."  I do consider any clinician being encouraged to view pain as a disease and not a symptom as criminal. 
First, and somewhat trivially, but meaningfully and emblematic of her poor journalism, is her misnaming the American Academy of Pain Medicine. More relevant is the fact that I have never had anything to do with Oxycontin development, sales, marketing or promotion; I have never been a Purdue Pharma speaker. I have never had any relationship with Curtis Wright, and I fail to understand the association that is being implied by linking us. In inciting the powerful negative emotions that many of Ms. Skolek’s readers attribute to this pharmaceutical company and this product, and connecting them with my name, your readership will jump to false conclusions that may have a seriously negative impact on both my reputation and-- due to the highly inflammatory nature of her choice of words-- my personal safety.
Yes I am guilty of "really really bad journalism" I was dealing with so many pain societies funded by pharma to push opioids that I referred to the American Academy of Pain Medicine (AAPM) as the American "Association" of Pain Medicine.   The U.S. Senate is, in fact, investigating the American Academy of Pain Medicine.  I didn't realize that Dr. Fine was never a "Purdue Pharma speaker."  Maybe someone posted Dr. Fine's quotation on the Purdue Pharma website and he just was not aware of it.  And posting on the website of Purdue Pharma does not qualify as a "speaker" -- not verbally at least. 
In addition, the Medscape Education website contains the following information:
Perry G. Fine, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Ameritus; Johnson & Johnson Pharmaceutical Research & Development, L.L.C.; MEDA; Purdue Pharma L.P.; King Pharmaceuticals Inc.; Covidien
I'm happy to provide Dr. Fine with this information so he can explain this to the Senate Finance Committee. You know Medscape posting something untrue.  But then I am just a really, really bad journalist so I will defer to the U.S. Senate to sort out truth from falsehoods.
I am sure there are tens of thousands of family members who would like to testify in front of the Senate on the "personal safety" of their sons and daughters who are either dead or hopelessly addicted to the opioids that were pushed causing this prescription drug epidemic and necessitating a Senate investigation. 
Furthermore, to decry bringing attention to, no less a fervent call to arms for necessary research and healthcare professional education in the area of pain care when it is well-recognized now that both are sorely lacking makes no sense. I and the American Academy of Pain Medicine have repeatedly gone on record as advocating for mandatory prescriber education before being able to prescribe controlled substances, especially opioid analgesics of any sort. The epidemic of prescription opioid misuse/abuse/morbidity/mortality in this nation is directly linked to the fact that physicians are inadequately trained to manage pain effectively, that there are few highly effective treatments for those with debilitating, crippling, intractable pain---especially neuropathic pain—caused by cancer and its treatment, HIV-AIDS and its treatment, diabetes, and many other rheumatologic, autoimmune and ischemic diseases. In addition, there is inadequate access to competent pain care and very low reimbursement for the time it takes to evaluate and treat patients with complex medical/psychological/psychiatric conditions which has a powerful impact on the care patients receive.
The below videos -- specifically #11 entitled Medications - Opioids" as recorded of Dr. Fine may be of interest to the Senate Finance Committee.  In particular, the quotation "True addiction -- a small portion of the population and the risk of addiction to opioids is extremely low."  But I'm no expert on pain.  I'm just a "really really bad journalist" so maybe I heard this wrong.  I encourage the U.S. Senate Finance Committee members to view these videos presented by Dr. Fine - and in particular Video #11.
#11 - Medications - Opioids
In addition, my role in the Anna Nicole Smith case was as an expert testifying solely with regard to the accused physician’s role in her care that preceded her death by at least 6 months. She died of a combination of sepsis from injecting drugs to induce weight loss combined with chloral hydrate, an antiquated and relatively dangerous sleep-inducing drug, the same drug that Marilyn Monroe overdosed on. Neither were prescribed by the accused doctor in this case. The quote about numbers of pills is contextually meaningless in the way it is presented in this blatantly libelous article.
During the trial, Dr.Fine said he believed Smith had a "high tolerance for drugs" but was "not addicted." "She woke up and functioned from day to day," Fine said. "She was in recovery from rib fractures, and anyone's function would be highly limited." 
Ms. Smith taking 1,500 pills, opioids, painkillers call it what you will is not "contextually meaningless" -- it is a killer and defies any reasonable person disputing this fact.  But then I'm not under Senate investigation and I will leave that decision making to the Senate.  I'm no expert on anyone having a "high tolerance for drugs", but I do know we are crippled in every state with addiction and death due to the push for painkillers.  Will wait it out to see if those as "uneducated about pain" feel as strongly as I do about the loss of life to addiction and death -- and who should be held accountable.  
Lastly, Ms. Skolek reveals her disinterest in clinical/scientific accuracy and deprives her readership of important knowledge by not only scoffing at but calling the critically important insights from the neurosciences over the last decade “criminal”.
Perhaps she and her readership might benefit from her doing a lot more reading and a little less writing.
I can only hope and pray that you will exercise your authority to take appropriate corrective action with regard to the content of the article and Ms. Skolek’s failure to measure up to an even minimal level of journalistic professionalism, and respect the rights of your readership to high quality factual reporting.
I and the families dealing with this prescription drug epidemic hope and pray every day that the U.S. Senate investigates exactly what I have been writing about for years -- ties to the billions of dollars pharma earns by pushing opioids -- and the physicians and pain societies profiting by using propaganda such as pain not being classified as a symptom but rather a disease to fuel the prescription drug epidemic. 
Perry G. Fine, MD
Professor of Anesthesiology
Pain Research Center
School of Medicine
University of Utah
Immediate Past President, American Academy of Pain Medicine
So if I am guilty of "really really bad journalism", I apologize -- but to the tens of thousands of people who pray that their loved ones wake up every morning -- or find a rehab facility to treat their addiction.  I do not and will not apologize to doctors, pharmaceutical companies and pain societies who encourage the medical profession to prescribe dangerous drugs and minimize the consequences to these actions.  If I used the word "criminal" in the wrong context, again I apologize.  Unfortunately I couldn't come up with another word stronger than "criminal."  After all I'm no expert on pain -- I thought anyone prescribed 1,500 pain pills/opioids/narcotics a month was addicted.  Having been accused of "really really bad journalism" and learning so much from Dr. Fine's email to my boss -- I can only hope the Senate Finance Committee learns as much as I did. 
Dr. Fine was quoted on Purdue Pharma's "In the Face of Pain" website as saying “Advances in neurobiology over the last decade have taught us that acute and persistent pain-inducing events can transform the nervous system, leading to chronic pain states. The challenge before us now is to figure out how to prevent and reverse these pathological processes. Meanwhile, all clinicians who treat people living with chronic pain need to revise their classically taught view that pain is merely a symptom of some other underlying condition in order to accommodate the current science that increasingly suggests that the panoply of chronic pain conditions resemble disease states in and of themselves. More than ever, these scientific discoveries–coupled with the prevalence and impact of chronic pain–call for far greater attention to basic and clinical research and renovations in systems of care to improve treatment outcomes.”
LP -- I have never been as proud of you as I was on Thursday night -- the high road always leads us to where we are meant to be and led us to each other -- I am so thankful to be loved by you. 

_______________________________________ Investigative Reporter Marianne Skolek, is an Activist for Victims of OxyContin and Purdue Pharma throughout the United States and Canada. In July 2007, she testified against Purdue Pharma in Federal Court in Virginia at the sentencing of their three CEO's - Michael Friedman, Howard Udell and Paul Goldenheim - who pleaded guilty to charges of marketing OxyContin as less likely to be addictive or abused to physicians and patients. She also testified against Purdue Pharma at a Judiciary Hearing of the U.S. Senate in July 2007. Marianne works with government agencies and private attorneys in having a voice for her daughter Jill, who died in 2002 after being prescribed OxyContin, as well as the voice for scores of victims of OxyContin. She has been involved in her work for the past 8-1/2 years and is currently working on a book that exposes Purdue Pharma for their continued criminal marketing of OxyContin.

Marianne is a nurse having graduated in 1991 as president of her graduating class. She also has a Paralegal certification. Marianne served on a Community Service Board for the Courier News, a Gannet newspaper in NJ writing articles predominantly regarding AIDS patients and their emotional issues. She was awarded a Community Service Award in 1993 by the Hunterdon County, NJ HIV/AIDS Task Force in recognition of and appreciation for the donated time, energy and love in facilitating a Support Group for persons with HIV/AIDS.




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Erich Curnow August 17, 2012 5:26 pm (Pacific time)

Perry, Perhaps you and your constituents should do more reading and less over prescribing. You claim to know a great deal about pain but you know nothing about the pain caused by addiction. Addiction (which is a disease) is something you should venture to understand more fully before you attempt to defend your actions and the actions of other doctors like yourself. Doctor is not another word for God and you sir, do as much harm as good from what one can gather in researching your background. In the future, perhaps you should attempt to contain your ignorance more fully instead of profiting from it at the expense of others. Erich Curnow PA State Certified Recovery Specialist Program Specialist Forensics/Advocacy

Gayle Newman August 16, 2012 10:24 am (Pacific time)

What an arrogant (or maybe just plain ignorant) condescending person (Dr?)Fine is. He and all his cohorts should be forced to answer for their participation and compliance in this crime against humanity. Marianne, we honor you for your honesty and integrity, and of course your tenacity in this ongoing injustice.

Lisa August 15, 2012 9:53 pm (Pacific time)

Dr. Fine appears to be suffering from "Caged Rat Syndrome". I did make that syndrome up-but I figure that if people like Dr. Fine can create and endorse their own versions of made-up medical diagnosises, such as "pseudoaddiction",in order to minimize the addictive qualities of opioids and thus maximize their sales and profits, then it's only fair that I can make one up too! "Caged-Rat Syndrome"......the behavior displayed by a desperate person who has been caught-up in their lies and actions and feels the need to lash-out at someone else in a futile attempt to divert the blame and try to preserve their integrity, even if they have none. Yes, Dr. Fine, you are trapped. The damage is done. The Senate has you and your co-horts under investigation. You have aided in a crime against humanity. You have some explaining to do, and we are waiting to hear it. Marianne is the voice of the thousands of parents who have followed their childrens caskets to their graves, and the thousands of children left orphaned from these pain pills. We have lived the nightmare caused by these drugs. We won't stop until people like you get your head out of your hind end and your hands out of the pockets of Big Pharma.

Ada Giudice-Tompson August 15, 2012 6:51 pm (Pacific time)

COT for CNCP has never been shown to be safe nor effective in the long-term, especially in high doses and yet prescriptions for opioids continue to increase causing more destruction. Deceptive marketing of such powerful and dangerous heroin-like drugs along with conflict of interest and misinformation have created an iatrogenic epidemic of human suffering which you Perry Fine MD could and should help end… and yet you question Marianne Skolek's journalistic code of ethics; well sir how about the dictum of medicine "to first do no harm"? Thank you Marianne for your relentless dedication and passion to uncover the truth and help end this “man-made” epidemic.

Suzanne Lee DNP, APRN-BC; CARN-AP August 15, 2012 1:35 pm (Pacific time)

I have studied this problem of prescription opioid abuse/diversion epidemic for the past 4 years, and I directed an intervention into a rural Minnesota county that had red flags for an epidemic of prescription opioid addiction in the area fueled by local doctors' excessive and liberal prescribing of chronic opioids for chronic noncancer pain. I am sure these doctors felt safe in such a wanton practice because the Minnesota Medical Board declares that the doctor is as much responsible for the undertreatment of pain as for the overtreatment of pain. This declaration is made without any direction or guidelines as to what that means. The Federation of State Medical Boards sat at the University of Wisconsin Policy Planners meeting in 1996 when doctors, advocacy groups and pharmaceutical companies planned a strategy to create consensus on the treating of chronic noncancer pain with chronic opioid therapy. This practice change was initiated without any solid science to support such a practice. The outcome of these measures launched the epidemic of prescription narcotic addictions, deaths, overdoses, treatment admissions and emergency department admissions that are destroying lives and families today. Marianne Skolek has, and continues to serve a vital mission in informing the public about this problem and relentlessly pursuing those who are responsible for this medical catastrophe, and demanding an arrest to this problem so that the practice of liberal prescribing of narcotics for chronic noncancer pain stops!

Patricia Mcdonald August 14, 2012 2:40 pm (Pacific time)

Dr. Fine is blowing smoke - perhaps trying to save his own conscience. I would like him to tell me face to face that the opioids my daughter was prescribed had nothing to do with her addiction... I would also like him to tell me her death had nothing to do with her addiction to said opioids... Dr. Fine you are responsible for a lot of beautiful lives lost.

Bridget Demmy August 14, 2012 9:43 am (Pacific time)

I applaud and give thank Marianne Skolek for her great efforts in shining a light on this enormous problem of corruption at the cost of thousands and thousands of lives. Government can no longer close their eyes to corrupt companies and Drs who value financial gain over human lives.

Larry Golbom August 14, 2012 4:31 am (Pacific time)

Dr. Fine remains in denial or delusional. My thanks to Marianne for exposing his past actions and deeds.

Dr. Fine's only defense is personal accusations with no explanation of the increasing addictions and deaths being created from the biggest hoax in our lifetimes - "opium for chronic pain".

As a radio show host, please forward to Dr. Fine to appear publicly to defend his past actions either directly or indirectly on behalf of the legal "opium pushers". My first question for him is to answer to the thousands who have left comments on the BanOxyContin petition.

Thank you Marianne for your excellent portrait of Fine. The "criminals" can no longer hide in secrecy and silence who have been part of the marketing to help addict and kill millions of people since the introduction of OxyContin.

Larry Golbom - Prescription Addiction Radio Show -Breaking the Silence

Lisa Micich August 14, 2012 2:15 am (Pacific time)

Keep up the fight Marianne. I applaud your efforts exposing the truth regarding big Pharma and the havoc caused by the over prescribing of opiates. I have seen my beautiful daughter's struggle with opiate addiction for 3 years now, the physical and emotional toll and a battle that she will face the rest of her life. I've seen 40 of her classmates/friends struggle with opiate addiction, rehab, court, jail time, loss of jobs, friends and family. I'm grateful to have my daughter here every day because she came close to losing her life more than once, all for the love of the drug.

Stephanie's Mom, Joan Ketchen August 13, 2012 7:44 pm (Pacific time)

Many do not truly understand what a service Marianne is doing for the public. I do as my brilliant and beautiful daughter who was my only child died after taking multiple prescription drugs in 2009. At that time, no one had stepped up to provide the kind of information such as Marianne provides so freely now. She is dedicated, well-informed, outspoken, and brave. One way or the other, the public will eventually become informed as I did at my child's death but hopefully with Marianne's efforts it will get done before it is too late for many other children. Generally people will do nothing UNTIL they are convinced that a problem is real. Thank you Marianne for your investigative work and for informing us all!! Countless young lives will be saved through your efforts.

Avi Israel August 13, 2012 6:38 pm (Pacific time)

Marianne has been a voice for the people who have suffered from this epidemic. My son Michael was prescribed into addiction by a reckless doctor. He took his life at the age of 20. If it wasn't for Marianne my son would just be another statistic. Doctor Fine has contributed to this epidemic. He really has no defense in this case.

Pete Jackson August 13, 2012 5:09 pm (Pacific time)

Dr. Fine should be ashamed for picking on a bereaved mother and a tireless advocate trying to save lives. Marianne Skolek is a bereaved mother who has dedicated her life to saving the lives of others; it is all too clear what Dr. Fine's agenda is. Thanks for calling him out Marianne!

Avi Israel August 13, 2012 6:01 pm (Pacific time)

Marianne has and is a voice for us the parents and kids who have sufferd from this epedimic. My son Michael took his life at the age of 20. A Doctor prescribed him in to addiction. If we don't stand up and point fingers at people like Mr Fine. Our kids would be just another number. Marianne lets the world know of the wrong that was done to my boy. Mr Fine you have blood on your hands.

Richard Marshall August 13, 2012 10:55 am (Pacific time)

I support Marianne and this article for telling the truth. I am tired of hearing "if you take it for pain you won't become addicted". It sickens me to see my relatives and friends become addicted through medical prescriptions. When is it that doctors will treat injury and sickness with something other than heroin-like substances? It is because of articles like Marianne's that make us realize that our health care system is being manipulated by Big Pharma and pain societies in their promotion of the use of opioids. It saddens me greatly to see profit placed above patient welfare. Promoters of "pain is a disease and is under treated" by doctors such as Perry Fine has destroyed my faith in the medical system.

Stephen G. Gelfand, MD August 13, 2012 10:27 am (Pacific time)

It defies logic that Dr. Fine acknowleges in his very defensive e-mail that "the epidemic of prescription opioid morbidity/mortality in this nation is directly linked to the fact that physicians are inadequately trained to manage pain effectively [and need] mandatory prescriber education before being able to prescribe controlled substances, especially opioid analgesics of any sort", and yet makes the untrue statement on the AAPM "Patient Education" website that "the risk of addiction is extremely low" if you have "bonafide chronic pain" and your doctor has determined that an opioid should be started. At the very least, extreme selectivity and caution before prescribing any opioid is mandatory, especially in view of the mounting toll of addiction, overdose and death related to prescription opioids, and the lack of scientific evidence for the long-term benefit and safety of chronic opioid therapy for chronic noncancer pain.

Steve Hayes August 13, 2012 7:18 am (Pacific time)

As a director of a medical detox center in Florida, I saw the ravages of OxyContin and other forms of legal heroin on a daily basis. It is an epidemic and doctors like Fine are promoting it. Instead of looking for the real cause and addressing that, iti is easier and more profitable for these drug pushers to just give a pill. Bad medicine and inhumane. Please go to ban and read the stories. Marianne is doing a courageous job of exposing this epidemic and of course will be attacked by those who profit from it.

Ellen Arnold August 13, 2012 6:42 am (Pacific time)

I am the parent of an OxyContin addict. I am one of the "lucky" ones. My daughter is still alive and is now in recovery thanks to the use of yet another opioid drug, Suboxone which allows her to function as a human. The wreckage of her life from her use of these drugs will follow her for the rest of her life. She has four felony convictions stemming from crimes committed to get these drugs. She is a graduate of no less than 20 inpatient rehabs, IOP programs, sober and halfway houses, and religious organizations that treat addiction. She spent a year in jail. This has destroyed our entire family, not just my daughter. How any "doctor" can write the garbage that Dr. Fine is putting out here is beyond criminal. It is so called "professionals" like him who have continued to push these drugs out on an unsuspecting public while taking money from the very drug companies that are manufacture these dangerous drugs and foist them off on desperate people. How many chronic pain patients have no underlying cause for their pain? Please don't ask anyone to believe that debilitating pain just appears out of nowhere in an otherwise healthy person. Why are these pharmaceutical companies, pain societies, and doctors not looking for better ways to control pain that DOES have an underlying cause. How about trying to control it with something other than heroin? I think I know the answer: Money. There is big money in addiction. There is big money in "pain management" with drugs. Has Dr. Fine ever looked at the statistics of how many of his pain patients are now on government funded disability? And how many of them sell the pills that we the tax payers are buying for them to addicts to supplement their government income? Not to mention the carnage and death caused by the epidemic of addiction that has been directly caused by big pharma, the FDA, the DEA, the AMA, and the JCAHO. If I were a physician I would put as much distance between myself and these drugs as possible. No good can ever come from their use. The evidence supporting this is overwhelming but it just continues. How many more people have to die? How many more families have to be ruined? What ever happened to "first do no harm?" The greed that is propelling this machine is beyond criminal. It is the work of the devil.

Amy Graves August 13, 2012 5:35 am (Pacific time)

I think Mr Fine made himself look even worse and I cannot wait until the senate investigation is through. Do you have a email for him so I can let him know my opinion personaly? Keep up the good work Marianne in making these creeps squirm!

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