The Kaua‘i doctor charged with distributing a controlled substance outside of professional medical practice is negotiating with the Alabama U.S. Attorney’s Office but hasn’t pleaded guilty, he said yesterday. Claiming he is a well-intentioned physician being mischaracterized by the government,
The Kaua‘i doctor charged with distributing a controlled substance outside of professional medical practice is negotiating with the Alabama U.S. Attorney’s Office but hasn’t pleaded guilty, he said yesterday.
Claiming he is a well-intentioned physician being mischaracterized by the government, Dr. Harold Spear III, of Hanapepe, admitted he consulted with patients suffering from pain across state lines over the phone but said he “believes history and time and understanding is a good 80 percent of medicine,” noting over-the-phone medicating is “almost as effective as a face-to-face visit.”
U.S. Alabama Attorney Alice Martin said in a prepared statement that from January 2004 to December 2005, Spear was writing Hydrocodone prescriptions for customers he never met.
“The pharmacists knew this, solicited the business, and put their profits above patient safety,” she said. Though narcotics prescription laws vary according to state, in Alabama, physicians are not permitted to prescribe narcotics based solely on answers to questions without having met the patient in person.
Martin announced last week her plans to garner guilty pleas from Spear and other doctors and pharmacists stemming from their relationship to an “illegal Internet pharmacy.”
Spear, who was the subject of a federal investigation in which undercover authorities sought pain medication from him over the phone and across state lines, is accused of prescribing narcotics without conducting physical exams or establishing a legitimate doctor-patient relationship with patients.
According to the Feb. 29 U.S. District Court criminal complaint, Spear was working with William and Mary Pharmacy, of Alabama, which ran the Web site athomescripts.com.
Spear said in an interview yesterday that he had chosen to work with “compounding” pharmacists who share in his philosophy of “not poisoning people with chronic acetaminophen intake,” adding, “My philosophy was congruent to theirs in this respect.”
Spear explained that in simple terms, compounding means doctors can alter the ratios of components in medicine by using raw ingredients.
“I treated my pain management patients with medications I felt were less harmful than those available from physicians available in their local areas,” he said.
“I found these patients by word of mouth and referred from the pharmacy and took care of them through telemedical relationships.”
Martin’s office claims the IRS helped trace “numerous personal and real properties” and that Spear was paid $482,027 by a third-party to write Hydrocodone prescriptions, for which he faces up to five years in prison and a fine of $250,000.
FDA Special Agent Garrett Chin claims in a June 4, 2007 affidavit that two special agents called Spear in his Hanapepe Clinic from San Clemente, Calif., claiming to have lower back pain from an automobile accident.
One of the agents, the complaint continues, told Spear she had been taking one to three Vicodin a day with Tylenol.
The complaint continues that Spear then prescribed the agent 120 tablets of Hydrocodone with Guaifenesin, telling her Hydrocodone alone might be too strong.
According to Martin, for a controlled substance prescription to be legal, it must be issued for a legitimate medical purpose by a physician acting in the usual course of his professional practice.
According to the Drug Enforcement Agency’s Office of Diversion Control, prescriptions for controlled substances must be issued for a legitimate medical purpose by an individual practitioner acting in the usual course of his professional practice.
Prescriptions can also be issued within a legitimate doctor/patient relationship, which includes a patient having a medical complaint, a medical history having been taken, a physical examination having been performed and a logical connection between the medical complaint, medical history, physical examination and the drug prescribed.
Spear said he is still trying to get medical records back for his patients, and though he is no longer permitted to prescribe narcotics, he is acting as “custodian of what records were left.”
Spear also said several of his former patients are suffering because their charts are still in the custody of the federal government, accusing authorities of violating the Health Insurance Portability and Accountability Act, which protects residents to medical privacy rights.
Spear says he admits his approach to prescribing medication has always been “outside the box,” noting the real issue he’s been fighting in pain management is moving away from anti-inflammatories such as acetominophen, which he claims is “contrary to healing,” and offering those pain sufferers the convenience of phone visits.
“If there are laws now that reflect something other than my philosophy, I can accept that. If that means accepting a guilty plea, we’ll see,” he said.
• Amanda C. Gregg, assistant editor/staff writer, can be reached at 245-3681 (ext. 252) or agregg@kauaipubco.com.
