Examining Doctors’ Roles in the Opioid Epidemic

Tom Petty and Michael Jackson have more in common than being internationally known recording artists; both of their lives tragically ended as a result of prescription drug overdoses. Petty was prescribed several prescription medications to deal with a hip injury, while Jackson was prescribed medication to combat insomnia. While Tom Petty’s doctor was neither charged nor investigated in connection with Petty’s death, it was a different story with Michael Jackson’s doctor, Dr. Conrad Murray. Dr. Murray was charged with and eventually convicted of involuntary manslaughter following Jackson’s death, and served two years in prison.

These two stories are not unique: prescription drugs, specifically prescription opioids, have been a problem in the United States since the mid-1990s. In fact, opioids have killed so many people, opioid use was declared a public health emergency by the Center for Disease Control and Prevention in 2017. In 2018, an average of 41 people in America died a day as a result of prescription opioids, totaling approximately 15,000 deaths. Doctors prescribing drugs to treat a patient’s pain or other chronic illnesses account for a significant percentage of these deaths.

What’s Being Done? 

People are searching for answers and ways to stop the epidemic. Some blame large pharmaceutical companies and have filed civil lawsuits against them. Others believe charging drug dealers with homicide if one of their customers overdoses is the answer. Another strategy that is gaining attention is charging doctors with homicide if they prescribe drugs that lead to a patient’s death.

In the past few years, states have charged doctors with varying degrees of homicide. The charges range from criminally negligent homicide to second-degree murder. Although the country is seeing more doctors charged than in years past, prosecutors use this method inconsistently. Only cases with extreme facts—cases in which doctors are blatantly overprescribing or where multiple patients die—are being prosecuted. For example, in early March 2021, a Long Island, New York doctor was arrested for the overdose deaths of five of his patients. This doctor saw his patients in Dunkin Donuts parking lots and continued to prescribe medication even after family members of the victims begged him to stop. Concerned family members alerted his practice to the police, and he was arrested. While it is clearly a good thing a doctor like this has been charged, there are plenty of doctors who are prescribing yet not being arrested. This is problematic because it is not really getting to the underlying issue: stopping the opioid crisis in America.

The Law Enforcement and Doctor Disconnect

 Doctors are a revered profession in the United States, and rightfully so—the majority of doctors are well-intentioned and want to help people. However, although doctors are viewed as the third-most trusted profession, people blame doctors for overprescribing opioids to their patients and getting them addicted. There is a disconnect in how the public perceives doctors’ roles in the opioid epidemic and what is actually being done.

Doctors who are prescribing opioids recklessly or negligently are often not discovered until it is too late and multiple people have overdosed and died. One law enforcement official described the problem as knowing something was wrong with the number of pills being prescribed, but not wanting to question how a doctor does his or her job. This law enforcement point of view is fair and unsurprising: doctors spent years in medical school and training, while police officers have not. Lay people, not just police officers, give reverence to doctors and may not want to step on doctors’ toes. Therefore, it makes sense that law enforcement may be hesitant to investigate doctors unless they have substantial evidence.

A Proposed Solution: Mandatory Investigation Statute

 The hesitancy to investigate and prosecute requires a change in perception in how society views doctors. However, a solution to hold doctors accountable that would in turn reduce the number of prescription overdoses would be for states to implement a statute the mandates law enforcement to affirmatively investigate if a person overdoses and dies from prescription drugs.  

The statute would provide that if a person’s autopsy revealed a person’s cause of death was a result of prescription medications, law enforcement would be required to contact and follow-up with the doctors who prescribed the medications. Law enforcement would then investigate the circumstances of the prescriptions including, but not limited to: the reasons for the prescription; current and previous medical records; and visits to other doctors. This mandatory investigation would only be triggered if the prescription medications were the contributing cause of death (also known as the “but-for” cause of death). In other words, the statute will be not be triggered any time prescription drugs are found in a person’s system at the time of their death. For example, if a person was found to have overdosed on heroin but also had a small amount of a prescription drug in his or her system, the statute would not be triggered

This would essentially require law enforcement to conduct more thorough investigations than they currently do. The goal of this statute is to change the mindset of responding police officers and detectives; doctors are indeed the suppliers of deadly drugs and need to be investigated in order to ferret out dangerous, criminal recklessness. The investigations will likely lead to a higher number of prosecutions of doctors which will in turn reduce the number of prescription opioid deaths in the country and save lives, which is the ultimate goal.