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Contraindications: Dr. Jayam Krishna-Iyer

Contraindications: Dr. Jayam Krishna-Iyer

Those of us lucky enough to attend New York Medicaid Inspector General Jim Sheehan's talk Saturday at the Association of Health Care Journalists conference in Seattle heard him make reference to Dr. Jayam Krishna-Iyer. I was curious about the back story. Here it is:

Krishna-Iyer of Clearwater, Florida, had her DEA certificate, which allows her to prescribe controlled substances like painkillers and anti-psychotic medications, revoked in September 2006. The DEA gave the doctor three chances to do the right thing. It sent three undercover officers to her to request painkillers. In all three cases, the DEA said, the agents told her that they were not actually in pain and that they already had scored some painkillers from other sources, including their friends. Krishna-Iyer did not examine the patients but marked in her records that she did.

"Moreover, during each of the visits, Respondent made statements that indicated that she knew the patients were seeking the drugs to abuse them and not to treat a legitimate medical condition," wrote Michele M. Leonhart, DEA deputy administrator.

The story then takes a legal turn, and the DEA does a nice job of compiling the records for you. Krishna-Iyer appealed the decision. And the U.S. Court of Appeals for the Eleventh Judicial Circuit vacated the DEA's decision in September 2007.

"In considering Petitioner's experience in dispensing controlled substances under factor 2, the DEA identified only four visits by three undercover 'patients,' who were all attempting to make a case against her. The DEA failed to consider Petitioner's experience with twelve patients whose medical charts were seized by the DEA, or with thousands of other patients. In short, the DEA did not consider any of Petitioner's positive experience in dispensing controlled substances."

This would make for an interesting story. Because a doctor has done a good job treating the pain for most of her patients, does that negate the finding that she, according to the DEA, knowingly gave drugs to patients who were clearly just trying to get drugs any way they could? How often are the courts preventing the drug agency from shutting these diversion pipelines down? And are there particular judges who seem averse to stopping bad prescribing practices?

Because of the court's ruling, the DEA had to take another look at her case. After monitoring her practice, the agency found that, after being warned by the DEA about what she was doing, the doctor, perhaps not surprisingly, started to shape up. In December 2008, she was able to start prescribing drugs again but was required to provide monthly reports to the DEA.

"The reports shall list all controlled substances prescribed by the patient's name, the date, the name of the drug, its strength, the quantity prescribed, and the number of refills authorized," the DEA demanded. "The reports shall be due no later than the tenth day of the subsequent month and shall list all patients in alphabetical order. Failure to comply with the terms of this Order shall be grounds for the suspension or revocation of Respondent's registration."

Comments

WOW-This is shocking, I have now read two of these articles today as a result of a Google search. I have been a patient of Dr. Iyer for 11 years now and I flat out KNOW BETTER. I just know that she would NEVER write an RX for someone coming in saying, I just want to get buzzed on pain pills. Was this recorded,? Of course not. It was a DEA Vendetta. If it were not for Dr. Iyer and all of her health care professionalism over the years, I would probably be in a wheelchair right now. It scares me that an article like this can potentially ruin someone's life's work and excellent care and serving they have given to their community. She is very strict and serious about pain meds, how sad, what a slaughter.

I completely agree. I've been a patient for over 8 years and would be bedridden or simply not able to have any quality of life in my condition. She is against all those who seek it for recreation. She always asked questions and charts everything, she does NOT NEED to examine me every time because I see her every 30 days due to dea ruling that pain medicine ONLY CAN FILL 30 days w/us disabled and very in pain and sick patients must run to office,sit and wait , see dr, drive to pharmacy wait hr or more,and all on DAY we are due for meds. Dr. Iyer is kind, compassion and efficient. She is very fast and she thinks very fast because she is brilliant, therfor sometimes can cover more than most can in same time. SHe makes sure MY WHOLE SELF is being treated, she does injections w/ lidocain, nerve blocks, and more for pain. She also does ayurveda,traditional indian medicine, talks about yoga, meditation, healing, relaxing right, making sure I am excercising, making sure I do right things for type of pain and illnesses I have, she is amazing! I am 38 and have been dealing w/chronic pain and illness since I was 15 yrs old. It took me over 15 years to find her, theres is not anyone even LIKE her.She has saved my life. And I've been to every Pain dr in florida, none want you when you are young, look fine and have odd, incurable diseases they can't blame on spine injury and car accident and do some chiropractic and a few pain meds. They don't want a YOUNG CHRONIC pain patient, they popped me around like a ping pong ball, all treated me as if I was doing something wrong. I never drank or did drugs recreationally but I have had to pay the price for those who have. Dr. Iyer is the ONLY dr who understood and took over and saved me.
There are two sides to every story and then the truth. Its the news and papers that made her out to be some evil person drug dealer when here she is an angel and a blessing. Why would she have so many patients , clearly pain patients if it was a pill mil. And its NOT just about pain medicine. I take a number of meds, only 2 are considered pain medicines. she manages ALL my other symptoms and care. Its just the bad people have ruined it for the TRUE honest people in need. Its such a shame. Its needed, its medicine. Just as heart meds to heart patient, insulin to diabetic.Its now illegal for primary, gyn, rheumatologist and many other specialist to prescribe pain medicine, hence pain management doctors, they are trained and the ONLY ones legally allowed to prescribe it.
Imagine your worst back pain, now imagine getting hit by a car, now have the flu no, have mono on top of that, now sprain your wrist and break your leg and have 4 herniated discs and be told you CAN NOT HAVE the very medicine invented to HELP the body deal with pain. Chronic pain is an illness in itself as the nerves are constantly over firing pain signals to tell brain theres something wrong, but because its chronic and not say, a hand on fire,the brain already knows and it goes back and forth, pain meds and other meds are neeed to calm these nerve signals down, like LYRICA and NORTRIPTYLINE...which works on neorotransmitters in brain. Lyrica works directly on nerves. All these meds are given as well....but the pain is still debilitating and pain relief is simply needed in an ongoing basis for some of us unfortunate to have to battle it daily. It has taken our lives, our plans, our jobs, our future, our past times, our friends, our family. It has taken nearly everything from us, can we at least have some relief so we can LIVE in our own skin?

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