Interesting Article

[Tuckamore]

This is a story sent to me by an RN from KY. Eastern KY is a very poor area. This is a sad story that will once again reflect on those of us that require pain management.  

BEGIN "CORNETTSVILLE, Ky. – A patient who made threats after being denied narcotics at a rural Kentucky clinic returned and shot his doctor to death, police said.

John Combs, 46, is charged with murder in Tuesday's slaying of Dr. Dennis Sandlin, said Kentucky State Police Trooper Tony Watts. Combs had been a patient of Sandlin's earlier in the day, returned with a gun and fired at the 57-year-old doctor, Watts said.

Watts said police don't yet have a motive. A Perry County sheriff's deputy said Combs had asked for narcotics but was required to give a urine sample, which he refused to do."

"From that point, he got real angry, he just went crazy, and he made a threat he was going to come back and blow up the building," said Sam Mullins, who responded when the clinic called about the threat.............END

The article went on to say.............
BEGIN "Lt. Gov. Daniel Mongiardo, also a physician in Perry County, knew Sandlin.

He said if the killing had to do with the doctor refusing to give the patient prescription pills then "this drug problem is tearing the fabric of our communities, of our society, and I'm angry."

"Now it's impacting a place where you expect to be safe, and that's a doctor's office," he said.

About two months ago, officials in eastern Kentucky arrested hundreds of people accused of selling illegal prescription drugs, a problem in the area." END

This story is from Yahoo News by the Associated Press. There is more to this story. I can't seem to get the link to provide it for you all. So I thought I would share at least part of the article.  

Tuck

[Tuckamore]

What great comments. We all see it a bit different and yet the same. Molly you are right, why did he refuse to submit his urine for a drug screen....unless he's had a previous drug screen that came back wrong and he didn't trust it would be right this time?? Or was he hiding something?? So many unanswered questions.

No matter what the reason(s), killing the physician was not the remedy. As so well put by  Otis, "...all the public at large will see is the connection being drawn in the article between drug users and him trying to "score"...."

Otis he may not have been an addict, even you have those thoughts. He may have been sick and tired of being treated like a drug addict, a criminal, seeking drugs because he indeed has severe, uncontrolled, irretractable pain. And he simply "lost it."  So many possibilities!!

But as well all agree, a horrific tragedy.

[Mollyrae]

Concerned621:

I guess we all have our thoughts. The bottom line with this guy and his clinic was that he refused a urine sample. Now I know that if for some odd reason that i would be asked to do so in my clinic, I wouldn't hesitate. I use my meds as prescribed and have never used street drugs. So in my mind, this guy had something to hide.
If you were asked to give a urine sample and it was protocol like in every Pain Clinic...you would agree to do so, right?  Was he hiding the fact that he had illicit drugs in his system?  So I hope that you see my point.

Be well,
Molly

[OtisDaMan]

I agree that there are a number of points of view (interpretations) of what went on behind the scenes in this story. Unfortunately, even if John Coombs had been the pinnacle of moral purity and social mores who suffered a mental breakdown due to lack of adequate pain control etc, all the public at large will see is the connection being drawn in the article between drug users and him trying to "score". This idea of "connection" is a standard story writing strategy in the journalist's toolkit; always worth asking yourself if a news article has led you to draw a hasty conclusion because of this technique. Anyway, it seems to me that a person intent on picking up drugs from a doctor's practice would just go to another doctor once rejected by their usual doc - not return and shoot them! It doesn't sound like he was a doctor shopper, more like someone with a MEDICAL CONDITION CALLED ADDICTION, and he should have been consulted by his doctor to deal with that. While noone is likely to know the whole story here - and it is a sad one no matter what the issue was - I keep wondering why chronic pain patients who develop addiction to their medication have their long standing patient/doctor relationship terminated abruptly, with the patient being treated like a criminal instead of like someone in the early stages of addiction who needs professional attention and help.

In my sleepy town I regularly see people at the clinic whose presentation would challenge the most objective of doctors, yet they may be in as much pain as they say. On the other hand at the pain clinic I attend in a capital city (more than 1 million people), most people are fairly well presented and look normal so to speak. I have trouble enough getting adequate pain at both places even with complete doc history and a signing over of rights for all my doctors to communicate and transfer my files among each other. Next time I'm at the pain clinic waiting room, I might ask around and see who actually feels their pain management is adequate.

[Tuckamore]

Eastern KY is a poor area with high unemployment. I am told that there are many residents that are in poor health and pain due in part to hard physical labor, COP-D's and illness brought about for some by working in the coal mines. These are good ppl.

According to the articles I have read and the RN that I know well, this is also a part of our country that has had major problems with OxyContin abuse. Some residents that have true chronic pain sell their narcotics to put food on the table, a very sad situation. Obviously there are others just like in any part of our country that just are abusers and sellers.

Joshua you are correct. I too feel like we are losing the battle. I think that all we can do right now is to be responsible. Take our meds as they are prescribed and try to educate those around us. There are organizations that are also fighting for our rights and attempting to educate the public and the medical communities. It is my goal to become more involved with such organizations in the future.

I don't know the actual reason John Combs went off the deep end. I would imagine all of you have some part of it right. It's just very sad for all parties involved. If I have more updates on this story I will share it with you all.

[concerned621]

I think I see this article in another way.  We as chronic pain patients are treated so poorly and being in the amount of pain I am in and being treated  the way I am by my doctors office,  not all the time, an office I have been going to for over 10 years I've lost my temper and I've cried.  All because of how I was treated either by my doctor, the front office staff or one of the nurses.  The amount of stress and schedules they are under they just don't seem to care. For instance last week I asked that my pain medication prescriptions be mailed to me instead of me picking them up.  I haven't been feeling well at all so I thought it might be easier. I was out of my pain medication for 8 days all because I asked that they be mailed and nobody could tell me why.  They kept saying "we mailed them on the 1st."    I called the doctors office twice.  The first call I was calm and nice. The second call I was very irritated, I was not only in a lot of pain but you don't just stop taking these pain meds.  The receptionist who probably hears this all day and is exhausted and has her own problems really didn't care.  So perhaps this man was in so much pain and so tired of giving a urine sample because he was tired of being distrusted and he snapped.   Not something I would ever even consider doing and I am so sorry for the doctor, his family, his office and the man who did this. But I have been so angry and frustrated with my doctors office over their treatment of me, again not on a regular basis but it has happened more often than not.   For those of us who suffer with this real daily pain, being treated like we are those people on the street selling and abusing drugs is almost as hard as living daily with this pain.  So that is my take on what may of happened to this man.  My thoughts and prayers are with the doctors family.  Maybe there should be an initiative put forth for doctors offices to enter in to some sort of empathy training for chronic pain patients so that in the future we don't hear of awful stories like this.

[Mollyrae]

Hi Tuck:

I read an article just recently about the Kentucky area and it's rampid use of narcotics. Most of the patients who are seeking out Narcotics are not there for the pain and the few that require meds to get through life are being denied because of the illegal use.

In the article it stated that a 10mg Oxycontin sold on the streets in rural America generally go for $10.00 or $1.00 per milligram. In Kentucky, Georgia, Mississippi and Alabama...mostly the Kentucky hills, Oxycontin sells anywhere from $20.00 for a 10mg and up. To sum it up, their street prices are double what you'd pay anywhere else in the country.

The man described trying to score his pain meds most likely had issues with drugs since he did not want to give a urine sample. Any normal Chronic Pain Patient that's on the up & up and are not taking illicit drugs would not hesitate to give a urine sample.  This man knew he would be denied and therefore was so angry and possibly going through W/D that he shot the Doctor. That's my guess anyway.

It's very sad that America is in such a state of drug use. It is easier by far to get pain medication from a Doctor then it was 20 years ago. Doctor give it out more freely then they did in the past. These are statistics not fabrication.

Thanks Tuck for the article. It sure makes you aware of your surroundings these days.

Be well,
Molly

[JoshuaY46013]

I think this is horrible, and yes it will reflect on us with chronic pain.  I'm speechless, what can we do?  We're losing this battle, and what's next?  The outlawing of narctoics? Will that help?  There needs to be a better placed system, but what will that entail?