Letter from the Publisher

Federal Government Bears Machine Guns in Raid of Pain Doctor

It is always a relief to see the days grow longer and daytime temperatures increase. This has been a long nasty winter, with the elements being particularly brutish not only here in the US but around the world. Flooding in Rio and Brisbane; alpine snow in London, Paris, and Atlanta; and freezing cold in Moscow and Montreal have caused great hardship. If we don’t hibernate, we usually watch television reality shows or movies. If our disposition turns dark, moody, even grisly, we might opt to experience evil, perhaps something like Freddy Krueger in A Nightmare on Elm Street. Of course, Krueger is a fictional character and Nightmare is just the imaginings of a Hollywood director, Wes Craven. After we watch Krueger’s horrors, we shake our head in disbelief but still enjoy a good night’s sleep.

Imagine the horror of awakening one morning to federal agents appearing unannounced on your doorstep, armed with machine guns demanding access to records, medical equipment, and supplies, treating the office like a crime scene. Imagine having your license to prescribe medication, the “controlled substance registration certificate,” seized without due process. Imagine having more agents show up at your private residence, again carrying machine guns, demanding your spouse to open the door for a full search. Imagine having such a raid with federal agents, state agents, and local police helping themselves to your computer and patient charts, carting away whatever they choose, with no copies left of patient records. Would this be a “real” Nightmare on Elm Street, except the nightmare goes on and on – there is no end for the doctor and his patients? Here Freddy Krueger is no fictional character, not even a mentally deranged individual. Krueger is our government acting out, heavy-fisted, mean, and intending to create monstrous upheaval and pain.

On Dec. 21, 2010, officers of the Drug Enforcement Administration (DEA) and local Washington State Narcotics Enforcement police raided the offices of Dr. James Kimber Rotchford. Dr. Rotchford is board certified in anesthesiology and addiction medicine. He is the immediate past-president of the Washington State Society of Addiction Medicine. He is a fellow of the American Academy of Preventive Medicine. He has been practicing pain management and addiction medicine for over 17 years. His practice includes acupuncture and nonmedication approaches to treatment of pain and addiction. His medical practice comprehensively diagnoses, treats, and monitors patients requiring pain and/or addiction care. He has not had patient deaths as the result of prescriptions he has provided. Nor has he been the target of malpractice action.

The DEA served a “sealed” warrant to carry out the raid. Hence Rotchford was not given a reason for the search, nor has there been any explanation since the raid was undertaken. Some agents have claimed that there may be Medicaid fraud; however, Rotchford is insistent that there has not been any fraud. All charges have been documented in his records with appropriate services provided. It is a mystery why the DEA raided Rotchford’s office, why it required the surrendering of his DEA certificate, why his hard drive with electronic medical records was seized, and why Rotchford now is left to practice with no patient records and no ability to write prescriptions. I can understand that if this were a “patient mill,” where patients walked in and left 15 minutes later with an opiate prescription, why the DEA might take umbrage and need to investigate. Rotchford’s clinic was no mill. He took his time evaluating patients seeking to optimize patient care and used nonprescriptive approaches to pain management. He even operated a “free clinic” one morning weekly to offer pain management care to patients too impoverished to be able to afford medical care.

It is clear that addiction to opiates has exploded over the past decade, and adverse effects, wrongful death, and suicide have resulted from excess dose and abuse. Physicians have been overprescribing pain medication, and drug-seeking patients have been receiving excess opiate prescriptions from their providers. Locally, in the state of Washington, the death toll from suicide and injury based on opiate use has increased dramatically in the past three years. Similar trends have been seen in other states. Physicians have been cautioned about overprescribing opiates, and continuing medical education classes have focused on the problems related to opiate prescribing. State medical boards are now focused on reining in the problem of overprescribing opiates.

The DEA controls the ability of the physician to prescribe opiates and is now seeking to tightly regulate a physician’s ability to write prescriptions. Yet it is clear that a large percentage of the population suffers from chronic pain, and treatment has largely been inadequate for many patients. Despite efforts to employ nonprescriptive approaches to pain, many chronic pain patients suffer without prescription support. Doctors are now challenged with attempting to treat chronic pain without the use of opiates and finding no straightforward answers. When patients experience severe pain and receive inadequate treatment, they seek care from physicians who are agreeable to providing long-term prescriptive care. Rotchford is a physician who understood the difficulties in controlling long-term pain without the use of chronic opiate prescriptions. Alternatives including Methadone and buprenorphine (Subutex) offer pain management support not requiring opiate use. Methadone requires careful prescribing and monitoring, which Rotchford offered. Buprenorphine prescription is only available to specially trained specialists in pain management for which Rotchford was certified. What prompted a raid of a caring, careful specialist?

Supporters of Dr. Rotchford have established a legal defense fund. Contributions can be made to Lane Powell Law Firm Trust Account for benefits of Dr. Kimber Rotchford. Send checks to Lane Powell PC, 1420 Fifth Ave., Suite 4100, Seattle, WA 98101. The Jan. 12, 2011, edition of the Port Townsend Leader (ptleader.com) carried three main news articles about the raid, including a frank interview by Rotchford of the event.

Jonathan Collin, MD