Dr. Lloyd Stanley Naramore, now 71, formerly of Urgent Care in Cincinnati, Ohio, pleaded guilty in Kentucky in 2009 to charges that from 2005 to 2007 he issued prescriptions primarily for methadone amounting to approximately 50,000 pills to more than 100 patients from Pike and Floyd counties without a legitimate medical purpose.
Now let’s put these numbers into perspective. Methadone is a medication that is usually prescribed in 10 mg tablets. Dosages can run up to 100mg/day, or 10 tablets per day. If the average patient just used 60 mg/day, the total number of tablets necessary to treat 100 patients for 2 ½ years is 550,000. So Dr. Naramore was convicted over 1/5th that number? Even if some of those patients used the 40 mg tablets at 2/day, that still makes 50,000 pills in 2 ½ years not an unexpected number. Methadone is a very good medication for pain when it is prescribed correctly. Also, at the time of these charges, methadone was the only long-acting pain medicine within economic reach of the uninsured population which probably made up a lot of the Eastern Kentucky patient base. Methadone is not an expensive medicine for people to make money as a street drug. Generally drug pushers at that time went after OxyContin.
Dr. Naramore acknowledged that he was aware that the patients were likely distributing the pills he issued in Eastern Kentucky. However, without real evidence of the doctor’s knowledge of patients being street pushers, in my opinion the work being done at this clinic was legitimate and they were simply targeted by the government simply because they treated pain and were easy marks. You can’t put any reliance on the admissions of the doctors at the time of the plea. Just like me, you have to agree to whatever the US Attorney says, or the plea isn’t accepted and you go to trial. Dr. Naramore didn’t want to go to trial, so he agreed. He also was aware that 60 of the patients had also been charged, and would probably be used against him in court in exchange for lighter sentences.
In 2010, Dr. Naramore was sentenced to 48 months in prison, probably a lighter sentence that if he had gone to trial. He was released from prison on 1/20/12
Assistant U.S. Attorney Roger West justified the government use of the CSA against a doctor by claiming “Mr. Naramore helped promote drug trafficking in Eastern Kentucky,” Then he projected that this action would be used to target more doctors when he said “I think that his sentence today shows that not only will users and distributors of prescription pills be punished but key sources of supply such as doctors will also be held accountable.”
Once the courts opened the door for criminalization of doctors for doing their job, all kinds of opportunity all over the country was made available for prosecutorial malfeasance.
To demonstrate how widespread the money goes in doing this, the investigation was conducted by DEA’s Drug Diversion Unit in Cincinnati, the Ohio Board of Pharmacy, Kentucky State Police, and the FBI. All those people’s salaries are supported for years based on just one investigation of one doctor.