PROJECT: COMMUNICATE AND COOPERATE 7/2/17, 10(32 AM

1601 N. Tucson Blvd. Suite 9 Association of American Physicians and Surgeons, Inc.
Tucson, AZ 85716-3450 A Voice for Private Physicians Since 1943
Phone: (800) 635-1196 Omnia pro aegroto
Hotline: (800) 419-4777

PROJECT: COMMUNICATE AND COOPERATE

AAPS 3-POINT PLAN TO STOP THE "DRUG WAR ON PHYSICIANS" &
REDUCE Rx DRUG ABUSE
Tucson physician, Jeri Hassman, M.D., and the national Association of American Physicians and
Surgeons have developed the 3-point "Communicate and Cooperate" campaign to encourage
physicians and law enforcement to work together to prevent prescription drug abuse.

Work together to track and report potential drug abusers.

Joint reviews of potential cases before charges are filed.
Mutual training to advise law enforcement of current trends and cutting edge treatments.

REPORTING. Physicians and pharmacies report potential "drug-seeking" patients to law

enforcement, yet are never advised by law enforcement which patients it believes are "drug
seekers" trying to take advantage of physicians or pharmacies. Currently, communication is only
flowing in one direction. Law enforcement should set up a notification process to advise
physicians of suspicious behavior by patients (using more than one pharmacy or more than one
physician for prescriptions, contact with known dealers or addicts, etc.).

REVIEW BOARD. Physicians are willing to work with law enforcement officials and the
Department of Justice to review potential cases before charges are filed. The DOJ should
establish a procedure to assess a physician's practices by a review board of medical professionals,
rather than relying upon their own laymen's judgments.

MUTUAL TRAINING. Attitudes toward, and the treatment of pain are rapidly changing. What
was unacceptable a few years ago is now considered appropriate, both in medicine and in public
opinion. For example, investigators frequently look at the volume and duration of drug use as the
primary trigger for an indictment. This is no longer appropriate, as accepted treatment has
changed, and leads to indictments of pain specialists simply due to the volume of their
prescriptions. And finally, in the art of medicine, investigators must be able to distinguish
between a difference of opinion in what is proper treatment, and specific criminal intent.

SUGGESTED LEGAL REFORMS

To protect physicians against unwarranted prosecution, to protect patients' access to medications,

and to encourage physicians to make chronic pain management available in their practices, AAPS
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PROJECT: COMMUNICATE AND COOPERATE 7/2/17, 10(32 AM

and to encourage physicians to make chronic pain management available in their practices, AAPS
recommends the following legal reforms:

1. TRAINING. Investigators should be trained in pain management standards and rapidly

changing approaches to pain management to be able to discern between drug diversion and the
extremes of legitimate medical necessity.

2. EVIDENCE STANDARD. Establish a high evidentiary standard for prosecutions under drug
kingpin laws: no hearsay evidence, no partial tape recordings of encounters with physicians, no
government experts who have not examined the patients, no testimony by nonlawyers about legal
obligations. The prosecution must not be allowed to shift the burden of proof of criminal intent.
The prosecution must prove specific intent to violate narcotics laws, not just general intent to
prescribe.

3. ELIMINATE BOUNTY INCENTIVES. All forfeited assets must be turned over entirely to
the U.S. Treasury; no bounties for getting convictions.

4. PROFESSIONAL INTEGRITY. An independent office must be established to investigate

allegations of intimidation of witnesses, knowing use of false testimony, or concealment of
exculpatory evidence with severe sanctions against agents or officers of the court found to be
engaging in such tactics.

5. JURY EDUCATION. Jury instructions must make it clear that the standard of proof for
conviction is beyond a reasonable doubt and that an essential element must be that the physician
knowingly prescribed controlled substances for reasons he knew to be inappropriate.

6. TRACKING. The Department of Justice does not track the number of cases it investigates or
prosecutes for drug prescribing, nor do most state medical boards. Officials claim the numbers are
low, but cannot back that up with data of the number of physicians investigated, delicensed,
prosecuted, fined, and jailed because of an error or disagreement with established authorities and
a doctor who is attempting to provide pain relief.

7. ELIMINATE DUAL PROCESS. Frequently, physicians are tag-teamed by an administrative

investigation by a state medical board or a DEA administrative action as well as a criminal
investigation. In the course of the board or administrative action, they are forced to give up their
constitutional rights and divulge information that could harm them in the other, or threatened with
a second action if they don't plea bargain the first.

8. CORRECT PAST ERRORS. To persuade physicians of the genuineness of reforms, a

mechanism is also needed to correct past errors. Physicians who have been convicted need to
have the right to file a motion for a new trial under the higher evidentiary standard, and this
motion must be granted if there is reasonable doubt that the higher standard could be met.

Other Links:
A Former DEA Agent Responds to the Medicine Men Articles
The Medicine Men - The Painful DEA Part II - 7/1/2003
The Medicine Men - The Painful DEA Part I - 5/6/2003

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