In 2002 Perry T. Dobyns, M.D. sought help for his Alcohol and Opiates use after a suicide attempt and was hospitalized in the "confidential" rooms of Rehab and his license to practice was suspended indefinitely. He has managed to stay clean until a slip in 2008. Dr. Dobyns life is now an open book and it has followed him from Oklahoma to North Carolina to Indiana. To understand how administrative law judges delve into a physicians past and mandate both Alcoholics Anonymous and Narcotics Anonymous and make their lives an open book read this excerpt from the doctors judicial file where he is identified as a "Respondent."
Respondent's Addiction History
In late 2001, the Respondent's medical practice in Oklahoma was failing. The Respondent's alcohol intake increased at home, and he began taking a controlled substance, hydrocodone, "to help (him) during the day." [Tr. 44]. The Respondent used hydrocodone samples given to the clinic by drug representatives. [Tr. 45]. He failed to maintain distribution records for these controlled substances. [Tr. 88].
In 2002, the Respondent moved to Indiana. He continued to drink during the night and use narcotic prescription medications during the day. [Tr. 44-45]. The narcotics were taken from the practice's sample cabinet. [Tr. 46]. In November of 2002, the Respondent's "depression, exacerbated by the alcohol and drug dependence, came to an extreme, and (he) attempted suicide." [Tr. 46]. His employers at the Harrison Family Practice referred him to the Indiana Physician Assistance Program, (PAP), who recommended that he seek inpatient treatment. [Tr. 46-47].
In late 2002, the Respondent was admitted to the Rush Memorial Behavioral Health program in Chicago, Illinois, which was a specific program for impaired physicians. [Tr. 47]. The Respondent attended this in-patient program for 10 weeks. [Tr. 20, 47, 87]. He was initially diagnosed as chemically dependent on opiates and alcohol along with a diagnosis of depression. [Respondent's Exhibit ("Resp. Exh.") D].
The Respondent enrolled in the Indiana PAP and signed a Continuing Care Contract ("Contract"). [Tr. 48; Resp. Exh. D]. He was required to have regular contact with the PAP through in-person meetings in Indianapolis. [Tr. 48]. He was also required to attend regular meetings of Alcoholics Anonymous or Narcotics Anonymous three times per week. [ Id. ]. He was also to attend weekly meetings of the Caduceus Group, a treatment group for doctors with substance abuse issues, in Indianapolis. [ Id. ]. The Contract also required the Respondent to participate in random urine drug screens. [Tr. 48-50]. While in Indiana, the Respondent remained in compliance with the Contract. [Tr. 49].
In 2007, the Respondent moved to North Carolina, enrolled in the North Carolina PAP, and signed a new five-year contract. [Tr. 51; Resp. Exh. D]. Similar to the Indiana PAP, this program is intended to "help physicians overcome an addiction issue." [Tr. 19]. As a requirement of this program, the Respondent was to refrain from consuming any controlled substances that were not legitimately prescribed to him or given to him for medical purposes. [Tr. 20]. He was also to submit to urine drug screens as dictated to by the program. [ Id. ].
While in North Carolina, the Respondent worked in Chapel Hill during the week and spent his weekends in Fayetteville with his family. [Tr. 52-53]. He was also caring for his dying brother. [Tr. 53]. The stress of caring for his brother contributed to his relapse. [Tr. 21-22]. This was his first relapse since beginning the recovery process in 2002. [Tr. 22, 93]. The Respondent's brother used medical marijuana, and the Respondent used it in October of 2008. [Tr. 53-54]. The Respondent also consumed oxycodone from his brother's prescription, and subsequently he issued a prescription to himself using another doctor's DEA number. [Tr. 22]. This doctor did not know of the Respondent's conduct until the DEA informed him. [Tr. 22]. The Respondent also wrote a prescription for his sister using his DEA registration and consumed the controlled substances himself. [Tr. 94].
The Respondent then had a positive drug screen for marijuana in October of 2008, and another positive drug screen for oxycodone and oxymorphone in November of 2008. [Tr. 55-56, 88-89]. The North Carolina PAP reported these positive test results to the North Carolina Medical Board. [Tr. 56]. Ultimately, the Respondent's North Carolina medical license was indefinitely suspended. [Tr. 22].
The DEA did not know about the Respondent's sobriety between November of 2008 until November of 2009, when he reentered the Indiana Physician Assistance Program. [Tr. 31, 58]. He then applied to renew his Indiana medical license. On the application for such renewal, the Respondent disclosed the action that had been taken against his North Carolina medical license. [Tr. 58-59]. The Indiana Medical Board renewed the Respondent's medical license with probationary conditions. [Tr. 23]. In August and December of 2009, those terms and conditions were altered slightly. [Resp. Exh. A]. The Respondent is to remain compliant with the Indiana's Physician Assistance Program (PAP), and he is to notify the Indiana Medical Board within twenty-four hours of any relapse. [Tr. 23]. The Respondent is only allowed to work a forty hour work week, and, prior to the Board's removal of this condition, there had to be another physician on-site when the Respondent was working. The Respondent has remained compliant with the terms of his probation. [Tr. 23, 28].
On November 23, 2009, the Respondent signed a second Continuing Care Contract with the Indiana PAP. [Resp. Exh. D]. This is a five-year agreement. [ Id. ]. The Respondent agreed, among other provisions, to participate in supervised urine/hair/blood drug screens, and agreed to abstain from mood- changing chemicals except those prescribed by a treating physician. [ Id. ]. In the event of a relapse, the Respondent is to notify the PAP. [ Id. ]. The Respondent also agreed to attend Caduceus meetings and to attend "mutual self- help meetings"such as AA or NA at a frequency of three times per week. [Tr. 68; Resp. Exh. D]. The Respondent also agreed to attend individual therapy bi- weekly for a period of time and to see a psychiatrist for medication management. [Resp. Exh. D; Tr. 69-70].
[Page Number 45659]
In August of 2010, Diversion Investigator (DI) Gary L. Whisenand *2 interviewed the Respondent. [Tr. 19]. I find DI Whisenand's testimony consistent with the documentary exhibits and credible. DI Whisenand credibly testified that Indiana's Physician Assistance Program was a reliable program that cooperated with the DEA. [Tr. 30]. During the interview with DI Whisenand, the Respondent admitted to smoking marijuana and consuming oxycodone. [Tr. 21, 84]. The Respondent had explained that he had moved to North Carolina to care for an ailing brother, who had Stage IV lung cancer, and the stress of tending to his brother had caused the Respondent to relapse. [Tr. 21-22]. This was his first relapse since beginning the recovery process in 2002. [Tr. 22, 93].
*2 DI Whisenand has been a DEA diversion investigator for just over six years. [Tr. 15].
Dr. Fred W. Frick submitted an affidavit in this proceeding. [Resp. Exh. D]. Dr. Frick is board certified in internal medicine with an extensive record as an addictionologist. [ Id. ]. Since 2004, he has been the contract Medical Consultant and Director of the Indiana State Medical Association's Physicians Assistance Program. [ Id. ]. He explained that the PAP "is currently recognized as an acceptable monitoring and advocacy program by the Indiana Medical Licensing Board." [ Id. ]. Dr. Frick oversees the program, "which directs the monitoring and advocacy for chemically dependent physicians in the State of Indiana." [ Id. ]. Dr. Frick was familiar with the Respondent's history of drug use and addiction. [ Id. ].
Dr. Frick wrote that each of the Respondent's drug screens have been negative since November 23, 2009, except for the presence of Ultram, "which was prescribed for Dr. Dobyns by a treating physician." [ Id. ]. Lastly, Dr. Frick wrote that to the best of his knowledge, the Respondent "has been compliant with all other aspects of his Continuing Care Contract since November 23, 2009." [ Id. ].
C. Respondent's DEA Application
In his DEA application, the Respondent disclosed that his North Carolina medical license had been placed on indefinite suspension. [Tr. 18; Govt. Exh. 1]. No charges are pending before the North Carolina medical board. [Govt. Exh. 1]. The Respondent also disclosed that he had had a positive drug test in 2008. [ Id. ].
The Respondent also disclosed that he had applied to renew his medical license in Indiana, and that the Indiana Medical Board agreed to do so on a probationary basis. [ Id. ]. The Respondent agreed to participate in the Indiana State Medical Association's Physician Assistance Program (PAP). [ Id. ]. The Respondent also wrote that his participation in Indiana has continued to the date of his application without incident. [ Id. ].
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