Doctor Gets 4 Years in Prison for Insys Opioid Kickbacks • Hacker News Board

Re: Doctor Gets 4 Years in Prison for Insys Opioid Kickbacks

#61

Post by onetimemanytime » Mon, Mar 12, 2018, 2:25 AM UTC

mikeash wrote: post #13

onetimemanytime wrote: post #9

Earlier quoted context omitted.

Not really comparable. The street dealer is not likely to get 40 years, although many may have gotten it (Assuming that a street dealer doesn't have 400 kilos of coke in his stash house. If he does, he's no street dealer) Also the doc loses his license and every single penny he has, between lawyers, years without being able to make a penny, and court fines. When you make a certain amount of money the trend is to live…

Are you implying that being bankrupted is worse than going to prison?

>>Are you implying that being bankrupted is worse than going to prison?

He's getting both. And he's losing everything: money, status, possibly family, ability to get another decent job... So he might rather do 10 years in jail but return to what it had before.

Re: Doctor Gets 4 Years in Prison for Insys Opioid Kickbacks

#62

Post by stordoff » Mon, Mar 12, 2018, 2:28 AM UTC

jjeaff wrote: post #33

j_jochem wrote: post #23

Earlier quoted context omitted.

I was thinking of dealers selling heroin in particular, since that feels like the appropriate thing to compare fentanyl-pushing MDs to, but in a broader sense, your point is if course correct.

Ironically, fentanyl is more dangerous than heroin and a large amount of heroin overdose have supposedly been because fentanyl was mixed in with the heroin unbeknownst to the user.

It's more dangerous in street drugs because it is potent at extremely low doses, so poorly mixed drugs can contain fatal doses very easily.

In a controlled setting, where the dose is precisely known, that is not an issue. I did some reading of fentanyl vs. morphine a while ago, and found that fentanyl is often preferred for acute pain due to faster onset, shorter duration (which may make controlling adverse reactions/overdoses easier), fewer side-effects and less histamine release. Specifically:

> When adverse event rates were counted across both the out-of-hospital and ED phases, morphine's and fentanyl's safety levels were extremely close, erasing even the suggestion of a trend toward safety in one drug or the other. Our data do not suggest that further work should be done to try to determine which drug is safer: The low absolute rates and small difference between the two drugs make it unlikely that this difference would become either clinically or statistically significant, even with a larger sample size.

I don't believe the notion that fentanyl is per se more dangerous, rather than being dangerous when misused/poorly handled, is supported.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2924527/

Re: Doctor Gets 4 Years in Prison for Insys Opioid Kickbacks

#63

Post by overcast » Mon, Mar 12, 2018, 2:31 AM UTC

dmoy wrote: post #55

ekianjo wrote: post #43

Earlier quoted context omitted.

any source for that claim?

Alan Reynolds' book "Income and Wealth". I mean doctors in particular, but other high income earners in professional areas as well.

Football players for one.

Re: Doctor Gets 4 Years in Prison for Insys Opioid Kickbacks

#64

Post by stordoff » Mon, Mar 12, 2018, 2:32 AM UTC

toomuchtodo wrote: post #50

skookumchuck wrote: post #46

Earlier quoted context omitted.

> they are responsible for the death of others Are they? Those others knowingly and voluntarily took those drugs.

Addiction is not voluntary.

Addiction is not voluntary, but addiction is a known, likely side-effect of many drugs. That first step is, to a large extent, voluntary (in most cases).

Re: Doctor Gets 4 Years in Prison for Insys Opioid Kickbacks

#65

Post by ransom1538 » Mon, Mar 12, 2018, 2:53 AM UTC

As a side project I sorted the doctors based on opioid prescribe count. It isn't hard to see who the pill shops are -- I am sure the DEA can do a sql command. IMHO they (DEA) prefers kicking down doors in poor areas.

https://www.opendoctor.io/opioid/highest/?hn=1

From article, John Couch and Xiulu Ruan are on top of the list.

Re: Doctor Gets 4 Years in Prison for Insys Opioid Kickbacks

#66

Post by adrr » Mon, Mar 12, 2018, 3:03 AM UTC

ransom1538 wrote: post #65

As a side project I sorted the doctors based on opioid prescribe count. It isn't hard to see who the pill shops are -- I am sure the DEA can do a sql command. IMHO they (DEA) prefers kicking down doors in poor areas. https://www.opendoctor.io/opioid/highest/?hn=1 From article, John Couch and Xiulu Ruan are on top of the list.

Interesting that John Couch and Xiulu Ruan are on top of the list. They were mentioned in the article.

Re: Doctor Gets 4 Years in Prison for Insys Opioid Kickbacks

#67

Post by omgPhysics » Mon, Mar 12, 2018, 3:19 AM UTC

"Rosenberg’s son was an Insys sales representative for a year and made “substantial commissions” from his father’s willingness to prescribe the drug, according to prosecutors. The son wasn’t charged in the case."

A not-so-bright outlook for actually holding Insys's CEO responsible. Why were charges not brought on middle level employees especially if the father-son relationship could be an easy access route to bribery.

EDIT: Even the court document does not list is full name, Rosenberg's son is simply referred to as Insys Rep A.R.

Re: Doctor Gets 4 Years in Prison for Insys Opioid Kickbacks

#68

Post by chime » Mon, Mar 12, 2018, 3:22 AM UTC

ransom1538 wrote: post #65

As a side project I sorted the doctors based on opioid prescribe count. It isn't hard to see who the pill shops are -- I am sure the DEA can do a sql command. IMHO they (DEA) prefers kicking down doors in poor areas. https://www.opendoctor.io/opioid/highest/?hn=1 From article, John Couch and Xiulu Ruan are on top of the list.

As bad as pill mills are, wouldn't 'Pain Management' clinics rate high in this query since they give out pills to manage legitimate pain?

I have multiple herniated cervical disks and am going in for surgery soon because the pain is debilitating and unbearable. Among other specialists, I saw a pain management doctor to understand my non-surgical options. Many people with my condition choose to not get implants or disk fusions and instead opt for steroids, epidurals, and opioids.

Legitimate doctors at pain management clinics will rank high on these lists if they have a lot of really sick patients who don't want neurosurgery.

Re: Doctor Gets 4 Years in Prison for Insys Opioid Kickbacks

#69

Post by loufe » Mon, Mar 12, 2018, 3:25 AM UTC

csallen wrote: post #34

koolba wrote: post #16

Earlier quoted context omitted.

It’s really not. Four years is hardly a deterrent. It’s barely a slap on the wrist considering the number of lives destroyed by that plague. What’s makes this particularly heinous is the trust we place as a society in medical providers. The vast majority of people will take whatever medicine a doctor prescribes. No questions asked. Abusing that position of power is sickening.

> Four years is hardly a deterrent. It’s barely a slap on the wrist considering the number of lives destroyed by that plague. This is the exact kind of emotional thinking that makes it so easy to jack up sentencing to an unreasonable degree. It's why we spent so many millennia of human history insensitive to the torture and abuse of our fellow man so long as he could be labeled a criminal. First, you're comparing a s…

I have to agree. It's not "a slap on the wrist" at all. A criminal record is a massive hurdle to overcome in finding work or keeping standing with any professional association. Not to mention the damage to reputation, personal relationships, finances, and family dependencies. Purely emotional thinking does not help the problem.

Re: Doctor Gets 4 Years in Prison for Insys Opioid Kickbacks

#70

Post by ransom1538 » Mon, Mar 12, 2018, 3:27 AM UTC

chime wrote: post #68

ransom1538 wrote: post #65

As a side project I sorted the doctors based on opioid prescribe count. It isn't hard to see who the pill shops are -- I am sure the DEA can do a sql command. IMHO they (DEA) prefers kicking down doors in poor areas. https://www.opendoctor.io/opioid/highest/?hn=1 From article, John Couch and Xiulu Ruan are on top of the list.

As bad as pill mills are, wouldn't 'Pain Management' clinics rate high in this query since they give out pills to manage legitimate pain? I have multiple herniated cervical disks and am going in for surgery soon because the pain is debilitating and unbearable. Among other specialists, I saw a pain management doctor to understand my non-surgical options. Many people with my condition choose to not get implants or disk…

Yes! 'Pain Management' would be a high subscriber. But being the top 5 in the US? Maybe, but that is pretty strange - definitely worth a DEA trip. 'Family Medicine' in the top 40? Hm....