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Patients need to be warned of the dangers, Tuft said. "But if I take too much, more than prescribed, that’s my fault, not the doctor’s."
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Proposed patient protections
A Food and Drug Administration advisory committee has recommended reclassifying opioids that contain hydrocodone from Schedule III to stricter Schedule II restrictions.
Instead of getting a prescription for up to five refills over six months, Schedule II drugs are limited to a 90-day supply in certain cases. And they require up to monthly visits to a health care provider, instead of every six months or once a year.
Hydrocodone is an ingredient in painkillers including Vicodin and Lortab, meant to treat moderate to moderately severe pain. They’re used for acute, trauma-related and post-surgical pain, including dental procedures, and frequently for chronic pain.
The FDA has also called for public comment on the science of using opioids for chronic, non-cancer pain, noting that their safety and effectiveness as pain relievers has been called into question.
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Prescription overdoses on the rise
Nationally, drug overdose deaths increased for the 11th consecutive year in 2010, according to data released this month by the Centers for Disease Control and Prevention.
More than half of the deaths involved pharmaceuticals. And prescription painkillers were the leading culprit, implicated in three out of four prescription drug overdose deaths.
Utah already has one of the country’s highest drug overdose rates, and the deaths may be creeping back up after large drop.
The number of deaths had declined 28 percent from 2007 to 2010, down to 236 deaths, during a statewide campaign to educate doctors and the public about proper use of pain pills. But the number of deaths rose again in 2011, by 10.
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The rise of Lifetree. » Webster started Lifetree pain clinic in South Salt Lake in the 1990s. For nearly two decades he and a crew of nurses and other mid-level providers treated thousands of high-risk patients for chronic pain.
He remains licensed and has not been disciplined by the state’s Division of Occupational and Professional Licensing.
But he no longer treats patients, having sold the clinic in 2010 to focus on industry-funded research — months after a visit from the DEA.
"They came in and asked for records. I don’t know if it was a raid. From what I understand it’s relatively routine for the DEA to request records from time to time," said Webster.
The DEA visited Webster again last fall, inspecting the Lifetree Clinical Research facility he co-founded in 2003 in the same building as the clinic. Lifetree, which merged with CRI Worldwide in 2010, is hired by drug makers to test new therapies on patients, including drugs for pain.
The Senate committee asked manufacturers about their payments to Webster during a probe that began last year of financial relationships between the companies and groups that advocate opioid use, such as the academy Webster helps lead.
"The Senate never contacted me," Webster said. "They’re not investigating me. They’re investigating the influence the industry may have over the prescribing of opioids."
In 2012, Cephalon, which makes drugs for central nervous system disorders, pain and cancer, paid Webster $1.7 million for "clinical research." Merck reports $611,000 in sponsored research payments to Webster in 2012.
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Webster said the money funded research. "None of it went to me. I oversee the clinical research but I’m salaried by Lifetree."
Drug makers pay him smaller amounts for consulting and lecturing, he said, adding, "Most lectures I’ve been involved in have been educational, not advocating for any pharmaceutical product."
He admits, however, having no control over which of his trials gets published. "We’ve published negative trials, but I think all of them should be published, not just the findings, but the raw data. We need to be more transparent," he said.
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‘Bottom line, she was addicted.’ » The DEA and U.S. Attorney’s Office in Salt Lake City would not comment on their active investigation of Webster. But Roy Bosley said he was interviewed last month by local and federal authorities.
"They indicated there was an ongoing investigation and said they would get back to me and would I be willing to testify. I said I would." He added: "I just hope to stop someone from experiencing what I went through."
Bosley sued Webster and two of his advanced practice nurses for malpractice in April 2011, settling for an undisclosed amount. "I’m trying hard to move on, not away from my wife and her memory, but to reestablish my life," he said.
Carol, Bosley’s wife, was thrown through a car’s windshield in an accident in 1992, injuring her back. Despite multiple surgeries, she lived with constant pain, for which she was prescribed narcotics, he said.
In January 2008 she enrolled in Webster’s clinic. Over the course of two years, she was prescribed increasing amounts of muscle relaxers, sedatives, antidepressants and painkillers, including oxycodone, Fentanyl and Percocet, court documents said.
Before the accident, Bosley said, his wife was a skilled trauma nurse and attentive mother. On the pain pills she was forgetful, delirious, incapacitated.
"She would take a pill and forget and take it again. I can’t tell you how many times we’d end up in the ER," said Bosley. "I started taking photos of her while she was unconscious, which may sound brutal. But when you’re desperate and looking at the love of your life who denies acting this way, you have to do something. She was in denial, but bottom line, she was addicted."
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