A Virginia Beach doctor had his license suspended last week by the Virginia Board of Medicine for prescribing high-powered narcotics to 18 patients without proper monitoring.
One of the patients died of an accidental overdose of methadone and an anti-anxiety narcotic two days after Dr. George Herbert Amberman III wrote prescriptions for the medications in February 2009, according to Board of Medicine records.
The man had recently been released from a psychiatric hospital, but a state investigator said the doctor failed to review hospital records before writing a prescription for methadone and diazepam. Amberman had been prescribing narcotics for him since 2006.
The man's girlfriend found him dead on Feb. 5, 2009.
In a phone interview Thursday, Amberman said he is going to appeal the suspension. The Board of Medicine records say a medical examiner determined the cause of death was methadone and diazepam toxicity, but Amberman said the man was taking the drugs with substances he shouldn't have.
Amberman said he and other pain management doctors have been unfairly targeted by the Board of Medicine.
"The story behind these sanctions is the Board of Medicine is demonizing doctors," he said. "It always seems to be pain management doctors; isn't that a curiosity? We are doctors with a conscience because we see patients who are uninsured."
Deaths from pain killer overdoses have soared over the past decade. The Centers for Disease Control and Prevention released a report last week that said drugs like OxyContin, Vicodin and methadone claimed 14,800 lives in 2008, almost four times the number in 1999.
The CDC called for more action, not just from state regulators, but from public insurers to monitor claims data to track prescription drug abuse.
Many states, including Virginia, have set up prescription monitoring programs, to help doctors track whether patients are receiving prescriptions from multiple doctors, along with how many doses.
Virginia's Prescription Monitoring Program began collecting data statewide in 2006, with prescription information about federally controlled drugs that have a high risk of abuse, such as morphine and OxyContin.
A state investigator from the Department of Health Professions, though, found that Amberman failed to get substance abuse histories on the cases cited in the investigation and also failed to monitor through urine tests and physical examinations.
In one case, a patient told an investigator that he lied to the doctor about back pain, because "he had heard from other patients that Dr. Amberman would easily prescribe narcotics."
Board of Medicine records also show Amberman provided prescriptions to patients outside of a physician-patient relationship. Amberman disputes that allegation.
In the case of the man who died, the investigator found that Amberman failed to note drug-seeking behavior. For instance, the man had asked for drugs to be prescribed earlier than he should have on several occasions, saying his medication had been confiscated during a trip to Australia, that the medication had been stolen from his vehicle, and that someone had flushed the medication while at a hotel.
Methadone is a synthetic drug that is less addictive than morphine or heroin and is used as a substitute for those drugs in addiction treatment programs. It also can be used for chronic pain management.
At a formal hearing in October, Amberman said he was not responsible for the man's death. According to Board of Medicine records, he said 90 percent of his pain management patients were self-pay, and that he changed his practice from family medicine to pain management because he was tired of insurance paperwork.
On Thursday, Amberman said doctors prescribe medications that can be dangerous if they are not taken properly. He said he should not be held responsible when patients don't follow instructions.
He said many uninsured patients who are in pain cannot afford doctors who want to perform costly procedures to relieve pain, and so they turn to doctors for pain medications: "There's a shortage of doctors like myself who will see pain patients who are the working poor."
Amberman also said the charts the Board of Medicine reviewed were several years old and that he has since been using the Prescription Monitoring Program and urine testing to better monitor his patients.
Amberman's license was suspended for a year, and he must appear before the Board of Medicine to prove his competency to practice medicine to have his license reinstated.
Amberman said he has informed his patients, but he expects they will have a hard time finding another pain management doctor. "My patients tell me without pain meds, they cannot work."
He said doctors that his patients turn to next will likely find themselves in the same battle he is having with the Board of Medicine.
"Something isn't right," he said. "To me, the issue is no one wants to see poor people. I'm not perfect, my patients aren't perfect. Now I do better, but the board didn't want to hear that."
Elizabeth Simpson, (757) 446-2635, elizabeth.simpson@pilotonline.com
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