Pubdate: Sat, 24 Jun 2017
Source: Hartford Courant (CT)
Copyright: 2017 The Hartford Courant
Author: Cleve R. Wootson Jr.



On Nov. 21, 2012, Sheila Bartels walked out of the Sunshine Medical
Center in Oklahoma with a prescription for a "horrifyingly excessive"
cocktail of drugs capable of killing her several times over.

A short time later, she was at a pharmacy, receiving what drug addicts
call "the holy trinity" of prescription drugs: the powerful painkiller
Hydrocodone, the anti-anxiety medication Xanax and a muscle relaxant
known as Soma.

In total, pharmacists handed her 510 pills that day - all legal,
because she had a prescription with the signature of her doctor, Regan
Ganoung Nichols, scrawled at the bottom, according to a probable cause

Bartels' lifeless body was found later that day,court documents say. A
medical examiner concluded that she died of multiple drug toxicity,
another victim of the America's opioid epidemic.

But investigators say the 55-year-old Bartels was also a victim of
Nichols, a pain management doctor who investigators concluded "either
didn't know or didn't care what she was doing."

Nichols is charged with second-degree murder in the death of Bartels
and four other patients, some of whom died just days after receiving
large prescriptions from the doctor. She was arrested Friday and
released from Oklahoma County Jail on $50,000 bail.

She couldn't be reached for comment on Saturday. A number listed for
Sunshine Medical Center was disconnected. Jail officials didn't know
whether she had hired an attorney.

The doctor's arrest is part of a new and growing offensive in
America's battle against the abusive use of opioids, which kill an
average of 91 people a day, according to the Centers for Disease
Control and Prevention.

Law enforcement agents aren't just going after drug dealers and
Mexican cartels - they're also targeting pharmaceutical companies and
doctors, who they say are irresponsibly flooding the nation with
potent painkillers, and holding them responsible for overdose deaths.

"Nichols prescribed patients, who entrusted their well-being to her, a
horrifyingly excessive amount of opioid medications," Oklahoma
Attorney General Mike Hunter told the Associated Press on Friday as
his office announced the doctor's arrest. "Nichols' blatant disregard
for the lives of her patients is unconscionable."

Opioids killed more than 33,000 Americans in 2015, according to the
CDC. Since 1991, the number of opioid overdose deaths has quadrupled.
In 2014, according to the Agency for Healthcare Research and Quality,
1.3 million Americans were hospitalized for opioid-related issues.

And prescription opioids are a primary driver, and prosecutors
increasingly have gone to the source to stop abuse. In February 2016,
another doctor, Hsiu-Ying "Lisa" Tseng, was sentenced to 30 years to
life in prison after three of her patients fatally overdosed,
according to the Los Angeles Times.

Prosecutors said Tseng made millions from overprescribing opioids to
drug-addicted patients.

And lawyers for the Cherokee Nation in Oklahoma have sued the nation's
top six drug distributors, according to The Washington Post's Scott
Higham and Lenny Bernstein. The suit says the pharmaceutical companies
are profiting from the epidemic and "decimating communities across the
nation's 14 counties in the state."

Last month, seven counties in West Virginia, a state that has the
highest prescription drug overdose rate in the nation, filed suits
against many of the same corporations, according to Higham and Bernstein.

A lawsuit by the state of Missouri against pharmaceutical giants
strikes a similar tone.

Missouri Attorney General Josh Hawley said the companies have used
bogus science to mislead patients about just how addictive opioids
are, according to The Washington Post's Katie Mettler. As a result,
the companies have "profited from the suffering of

The lawsuits have different aims, although attorneys in the Missouri
case say they want state legislatures to more closely monitor
prescription drug use.

Oklahoma's attorney general has been trying to paint Nichols in the
same light.

Nichols prescribed more than 3 million doses of controlled dangerous
drugs from 2010 through 2014, according to court documents, including
"irrational" and dangerous combinations of drugs that led to five deaths.

On March 24, 2010, for example, Debra Messner received a prescription
for 450 pills - the same cocktail of Hydrocodone, Xanax and Soma and
died six days later of acute drug toxicity, according to court
documents. A doctor contracted by the Drug Enforcement Administration
to review her case file found that there was "no need for the quantity
or combination" of those drugs.

Lynette Nelson was evaluated by Nichols once, a few days before
Christmas in 2008. Still, over the next four years, Nelson was
prescribed so many potent drugs from Nichols's clinic that
investigators were baffled that she didn't die sooner.

She was found dead on March 1, 2012, five days after getting her final
prescription of Xanax filled.

In the probable cause affidavit, the doctor contracted by the DEA to
examine the dead patients' files concluded that because of Nichols's
"lack of the use of the basic fundamental safeguards, patients suffer
and very well may end up paying the ultimate price as all ten of these
patients did."

Missouri lawsuit: Big pharma caused opioid crisis with 'campaign of
fraud and deception'
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