“The rights of every man are diminished when the rights of one man are threatened.” ― John F. Kennedy
Before the 2012 Drug and Alcohol Testing Industry Association (DATIA) annual conference, Dr. Robert Dupont delivered a speech entitled “Drug Testing and the Future of American Drug Policy.” He describes a “New Paradigm” for substance abuse treatment that enforces “zero tolerance for alcohol and drug use” that is enforced by monitoring with frequent random drug and alcohol tests in which positive tests are “met with swift, certain, but not draconian, consequences.” The paradigm is based on the current Physician Health Programs blueprint. Dupont states:
“…physician health programs , have set the standard for effective use of drug testing. These pioneering state programs provide services to health care professionals with substance use disorders. The programs are run by physicians, some of whom in recovery themselves. PHPs feature relatively brief but highly focused treatment followed by active lifelong participation in the 12-step fellowships of Alcoholics Anonymous and Narcotics Anonymous. The key to the success of the PHP system of care management is the enforcement of the standard of zero tolerance for any alcohol or other drug use by intensive long-term random testing for both alcohol and drugs with swift and certain consequences for even a single use of alcohol or any other drugs of abuse. PHPs use drug panels of 20 or more drugs. The PHPs commonly use EtG and EtS tests to detect recent alcohol use. Similar comprehensive programs have been developed for commercial pilots and attorneys. These innovative programs of care management produce unprecedented long-term, outcomes.”Physician Health Programs use a doctor’s medical license as “leverage” in what they call “contingency management.” What this means is that a doctor who is being monitored by a PHP must comply with any and all demands of the PHP under threat of being reported to the state Medical Board and loss of licensure. Dupont wants to extend the PHP model to other populations including kids.
The 2013 American Society of Addiction Medicine White Paper on Drug Testing describes the organizational structure of the “New Paradigm” which includes utilization of the medical profession as a urine collection agency for their drug and alcohol testing. When a doctor-patient relationship exists the testing is rendered “clinical” rather than “forensic.” Thus the consequences of a positive test can be deemed “treatment” rather than punishment. This bypasses the strict chain-of-custody and Medical Review Officer requirements designed to ensure accuracy and minimize false-positives. Forensic drug testing is tightly regulated because the results a positive test can be grave and far reaching. Erroneous results are unacceptable.
The ASAM paper describes mandated drug-testing for patients in a number of specialties including adolescent medicine, psychiatry, obstetrics, and geriatrics. Contingency management will involve “the potential for loss of current or desired employment, or threatened loss of or restrictions on a professional or commercial license, or legal and forensic necessity.”
“This White Paper encourages wider and “smarter” use of drug testing within the practice of medicine and, beyond that,broadly within American society. Smarter drug testing means increased use of random testing* rather than the more common scheduled testing,* and it means testing not only urine but also other matrices such as blood, oral fluid (saliva), hair, nails, sweat and breath when those matrices match the intended assessment process. In addition, smarter testing means testing based upon clinical indication for a broad and rotating panel of drugs rather than only testing for the traditional five-drug panel.”
As onerous, unwarranted and unjust as this future dystopia sounds it may very well come to fruition. Across the country doctors have been going to the media, law enforcement, and the ACLU complaining of ethical breaches, civil rights violations, abuse and criminal activity only to be turned a deaf ear. The Federation of State Physician Health Programs has been able to construct this scaffold with no meaningful opposition and below the public radar. They have done this by removing accountability at all levels. By preventing access to information and erecting a system without oversight no consequences exist to deter misconduct and abuse. The same tactics and strategies will be used as they expand this to other populations.
American Society of Addiction Medicine, The Federation of State Physician Health Programs, and Like-Minded Docs
“With one arm around the shoulder of religion and the other around the shoulder of medicine, we’d resolve their differences. Having learned to live so happily, we’d show everybody else how. Why, we thought, our Society of Alcoholics Anonymous might prove to be the spearhead of a new spiritual advance! We might transform the world”.–Twelve Steps and Twelve Traditions 1953 A.A. World ServicesThe American Society of Addiction Medicine exists to trump the 12-step chronic relapsing brain disease model of addiction as defined by A.A. The authoritarian view necessitates the authority maintain authority so everything is engineered around that goal.
The American philosopher Eric Hoffer noted:
“The only way to predict the future is to have power to shape the future. Those in possession of absolute power can not only prophesy and make their prophecies come true, but they can also lie and make their lies come true.”
The PHP model is built on the very foundation Hoffer describes.
“Addiction Medicine” not a recognized medical specialty.
This begins with the ASAM itself. “Addiction Medicine” and ABAM “board certification” is not recognized by the American Board of Medical Specialties. The requirements for this self-certification are not commensurate with ABMS certifications and only requires a medical license and board certification in ANY specialty.
Dubious Drug Testing-Not FDA approved, Conflicts-of-Interest
Federal workplace drug testing is done in accordance with mandatory guidelines. This testing is regulated using FDA approved tests with established sensitivity, specificity, and cutoff levels. FDA approval requires rigorous research and proven validity. The FDA requires valid scientific evidence (with both clinical and analytical validation) The FSPHP has introduced non-FDA drug testing via a loophole that removes accountability. The EtG, EtS, and PEth tests were introduced as Laboratory Developed Tests (LDTs) with little evidence base. The LDT pathway was developed for “clinical” tests of low market potential that would not otherwise make it to market as the FDA approval process would be prohibitive. An LDT does not even require in vivo testing or proof that the test actually tests for what it s claimed to test. Without FDA oversight, however, the labs can claim anything they want with no accountability. After getting the labs to develop the tests the FSPHP then convinced the Medical Boards they were both necessary and accurate and began using them on doctors in PHP programs.
Changing Public Policy and Regulatory Authority to Increase Power and avoid Accountability
The 2011 FSMB Policy on Physician Impairment identifies, defines, and essentially legitimizes “potential impairment” and “relapse without use.”
A PHP Should be empowered to conduct an intervention based on clinical reasons suggestive of potential impairment. Unlike the Board which must build a case capable of withstanding legal challenge, a PHP can quickly intervene based on reasonable concern."
“Empowered” to conduct an “Intervention” for reasons “suggestive” of “potential” impairment means a doctor can be pulled out of practice for anything. It essentially gives them carte blanche authority. The disregard for physician rights, due process and validity is self-evident.
in 2011 The ASAM issued a Public Policy Statement on coordination between PHPs, regulatory agencies, and treatment providers recommending that only “PHP approved” treatment centers be used in the assessment and treatment of doctors. A recent audit of the North Carolina PHP found financial conflicts of interest and no documented criteria for selecting the out of state treatment centers they used. The common denominator the audit missed was that the 19 “PHP-approved” centers were all ASAM facilities whose medical directors can be seen on this list.
The FSMB House of Delegates adopted an updated Policy on Physician Impairment at their 2011 annual meeting distinguishing “impairment” and “illness” stating that Regulatory Agencies should recognize the PHP as their expert in all matters relating to licensed professionals with “potentially impairing illness.”
According to the FSPHP, physician illness and impairment exist on a continuum with illness typically predating impairment, often by many years.”
The policy extends PHP authority to cover physical illnesses affecting cognitive, motor, or perceptive skills, disruptive physician behavior, and “process addiction” (compulsive gambling, compulsive spending, video gaming, and “workaholism”). It also defines “relapse without use” as “behavior without chemical use that is suggestive of impending relapse.”
G. Douglas Talbott defines “relapse without use” as “emotional behavioral abnormalities” that often precede relapse or “in A A language –stinking thinking.” AA language has entered the Medical Profession and no one even blinked. It will get worse.
The ASAM has monopolized addiction treatment in the United States. It has imposed it on doctors through the FSPHP. The FSPHP political apparatus exerts a monopoly of force. It selects who will be monitored and dictates every aspect of what that entails. It is a, in fact, a rigged game.
The Need for Regulation, Oversight, and Accountability
Accountability is necessary to prevent corruption and requires both the provision of information and justification for actions. What was done and why? Accountability also necessitates consequences-the ability of outside actors to punish and sanction those who commit the misconduct. Without these constraints corruption is inevitable.
In 2012 Drs. John Knight and Wes Boyd recommended the medical community outside of PHPS provide oversight and demand accountability. As with the NC PHP audit, Ethical and Managerial Considerations Regarding State Physician Health Programs generated little interest from the medical community at large.
Because addiction is currently defined as a disease, addicts must be “treated” (which in the United States is more often coercive than voluntary), and “cured” (which is defined as remaining abstinent). When the disease concept is not strictly reserve for medical conditions but is expanded to any and all drug and alcohol use.
And this is how the ASAM “New Paradigm” will encroach upon others. This is why the ACLU needs to get involved. This is not just about doctors but about the future of society.
The ASAM white paper contains the following quote minimizing the critical role of the MRO in drug testing. They feel clinical testing is good enough. And unless you want mandated random drug and alcohol testing at your physician visits using non-FDA approved testing with swift and certain consequences you will need to speak up. This occurred in the medical profession rapidly and with little notice. And that is how it will occur in other venues.
Unlike forensic drug testing where the test results must be able to meet rules of evidence in administrative, civil or criminal proceedings, clinical drug testing* is part of a patient examination performed by a clinician with whom the patient is in a therapeutic relationship. The testing is used for the purposes of diagnosis, treatment, and the promotion of long-term recovery. Clinical drug test results must meet the established standards of medical practice and benefit the therapeutic relationship, rather than meeting the formal legal requirements of forensic testing. Drug testing in medicine employs the same sound procedures, safeguards, and systems of information management that are used for all other health-related laboratory tests, tests on which life-and death medical decisions are commonly made.State Physician Health Programs have no meaningful oversight or accountability. Across the country doctors are reporting ethical and civil rights abuses and even criminal activity to law enforcement, the ACLU and the media. With the exception of North Carolina their complaints were patently ignored. Feeling hopeless, helpless, defeated and entrapped many are killing themselves. Institutional justice is a protective factor for preventing suicides. None exists here. The North Carolina PHP audit revealed conflicts-of-interest and no oversight by the state medical society or board. The audit also found that abuse could occur undetected because of this lack of accountability.
There seems to be a willful ignorance or apathy regarding PHPs. Perhaps most take the side of the PHPs complacent that these are just helping sick doctors and protecting the public the complaints are nothing more than “bellyaching.” In reality the misconduct and abuse perpetrated by the PHPs is commensurate with the behavior of Dr. Farid Fata, the Detroit Oncologist who intentionally misdiagnosed patients with cancer so he could make money off unnecessary chemotherapy treatment. Dr. Fata’s egregious betrayal of trust and unconscionable acts generated a flurry of comments. His vile acts resulted in an appropriate response.
The exact same misconduct is being perpetrated by PHPs but being overlooked, justified or otherwise ignored. Dr. Fata intentionally misdiagnosed patients with cancer who did not have cancer so he could give them chemotherapy to make money. PHPs are intentionally misdiagnosing substance abuse and behavioral disorders in physicians who do not have them in order to give them unneeded treatment and force them into monitoring contracts to both make money and gain control.
It undermines the very integrity of the profession. It is particularly vile when the betrayal of trust involves doing the opposite of what was entrusted. Abuse of positions of power, trust and influence in the field of medicine need to be both prevented, recognized and addressed. Oversight, regulation and accountability are essential if this is going to be accomplished. There are no exceptions. Policies and procedures must be enforced in a consistent manner.
The medical boards, medical societies, and departments of health have given the state PHPs carte blanche control and absolute power. They will not even investigate misconduct or even crimes.
And the PHPs have convinced law enforcement that this is a parochial matter. Doctors reporting crimes are often turned back over to the PHP.
This refusal to investigate or even acknowledge valid and factual complaints of professional misconduct has not only prevented the exposure of wrongdoing and corruption but deepened it. How does wrongdoing and corruption serve the best interests of the public or promote public health? It doesn’t. How could a culture that protects the perpetrators of unethical and indefensible misconduct yet turns a deaf ear to their victims possibly contribute to the common good? It can’t. And giving an oppressive, illegitimate and irrational tyranny absolute power and granting them unrestrained managerial prerogative over doctors is fallacy.
“Every time we turn our heads the other way when we see the law flouted, when we tolerate what we know to be wrong, when we close our eyes and ears to the corrupt because we are too busy or too frightened, when we fail to speak up and speak out, we strike a blow against freedom and decency and justice.”
― Robert F. Kennedy
Disrupted Physician 
The “unprecedented long term outcome” for my son was death. Karen Miday
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So you think the government is trying to impose universal random drug testing followed by swift sanctions and lifetime AA attendance? I would call that psychotic paranoid if I wasn’t already familiar with the policy proposals by his buddies Keith Humphreys, Angela Hawken and Thomas McClellan. http://drugpolicyinstitute.psychiatry.ufl.edu/our-fellows/
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Precisely, and that is why it is so hard for the average person to get his head around this. It sounds like conspiracy theory paranoid ideation gibberish. But as you know it is true. I have heard from physicians in six states who have gone to the ACLU only to be turned away. Two were told that doctors “are not a priority.” What the ACLU needs to know is that the infrastructure ( junk-science tests, “treatment” vs. sanction, the rigged “approved” assessment and treatment centers, etc.) is all set up and was the result of “public policy” and rules and regulations being passed with no meaningful opposition. The “PHP-blueprint” is just a couple of public policy steps away from them. And if you look at the history of public policy the ASAM and FSPHP have put forth it has been with 100% success. The ASAM White Paper on Drug Testing as absurd as it is will be inevitable if people do not step up to the plate. The simple fact that they do not think it impacts them is the problem. Well it’s not that far away.
But the “swift sanctions” you mention will be limited to the “Professional Health Programs” –not the universal random drug testing done by the medical profession. This will be called “diagnosis” and “treatment.” A drug or alcohol test done by a physician on a patient in an already established physician-patient relationship renders it a “clinical” test and benefits the agenda twofold. 1. It bypasses “forensic” protocol so strict chain-of-custody and MRO review are not needed, and 2. It enables them to call both the testing and the consequences of a positive test medical assessment and “treatment” rather than “punishment” or “sanction.”
Of course the positive test will lead to an “assessment” at an “approved” assessment center which will undoubtedly be one of the NAADAC ( http://www.naadac.org/ ) facilities where a diagnosis of “Substance Use Disorder” under the new lowered bar that was robber baroned into the DSM-V will inevitably be given. This will then lead to lifelong fellowship in AA, NA or some 12-step program and increased random zero-tolerance drug and alcohol testing using non-FDA approved biomarkers, hair and nail testing the ASAM introduced as Laboratory Developed Tests to avoid FDA oversight and regulation (LDTs are essentially introduced under the “honor” system and the only oversight is by the College of American Pathologists and this is essentially useless–you don’t even have to prove the validity of the test to get it approved as an LDT-meaning you don’t even have to prove that the test is actually testing what you say it is testing let alone sensitivity, specificity, cutoff levels, etc.) Greg Skipper–modern day witch-pricker.
Coercion, abuse and torture hidden under a veil of “disease” and “treatment.” And, of course, it will all be set up as seen here–a rigged game.
http://disruptedphysician.com/2014/03/16/three-shells-and-a-pea-asam-fsphp-and-lmd/
Interesting link to the Drug Policy Institute by the way. Almost all of the names are red flags but I have been hearing a lot about one of the senior fellows on the list. Another Like-Minded Doc no less.
http://www.likemindeddocs.com/members.html
In 2000 when he approached the CT Medical Board with getting his license back two board members were opposed due to his long term history of manipulating the system. If you look him up in the Connecticut Licensing website all the sordid details can be seen: https://www.elicense.ct.gov/Lookup/LicenseLookup.aspx
These include the following statements: “The twice weekly random, observed urine screens imposed upon petitioner by the 1992 and 1994 Consent Agreements were insufficient to detect his then on-going substance abuse. Petitioner WAS QUITE ADEPT AT MANIPULATING The SYSTEM TO AVOID DETECTION.” (my emphasis).
Click to access connecticut_medical_examining_board_2000_minutes.pdf
But he got it back under the 12-step salvation card, became “board certified” in “addiction medicine,” and where is said petitioner now? Be it Bath Salts, George Zimmerman or Casey Anthony we can always look to Florida to lead the way!
Said petitioner is now running the entire Health Professionals Program in Florida–nurses, doctors, and any licensed medical practitioner is in the hands of said petitioner. Brilliant! Let’s not just give him his license back but how about we put him in a leadership position with no transparency, regulation or accountability and put all the medical professionals careers and lives in his hands. Put him in a position of complete power and control like Josef Mengele at the gates of Auschwitz. Put health professionals lives and livelihoods in his hands alone.
It is very hard to get one’s head around the decisions made here.
And the comments below are worth reviewing. In all probability the majority are true but in this sick system these comments are considered the gibberish of impaired and disruptive physicians. Delegitimize the opponent. Political abuse of psychiatry. Label the accused as deviant to disregard the claims of the accused.
How about we just apply Occam’s razor or a little bit of common sense? The veil of 12-step holiness is merely a smokescreen. Most of these guys probably thought why the Hell didn’t I think of this sooner?
http://www.vitals.com/doctors/Dr_Scott_Teitelbaum/reviews
https://www.ratemds.com/doctor-ratings/2557477/Dr-SCOTT%2BA.-TEITELBAUM-Gainesville-FL.html
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Those comments about Teitelbaum are hilarious I mean tragic. Well they can’t be good for business. A couple things I would say: I threw out my ACLU card years ago and CA decisively rejected drug testing for physicians. Don’t worry the tide is turning against them, and on many fronts. I think that are probably bewildered and confused by what’s going on. Their capacity for self-deception is boundless. I actually think it will be quite amusing to watch them implode. Keep uncovering the truth. It won’t be ignored.
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Tip of the iceberg! The aforementioned list includes multiple Felons and even a handful of double felons. Replacing a dying cancer patients IV narcotics with saline or selling the date rape drug to DEA agents are abhorrent acts that most physicians would never be a part of ( impaired, inebriated or on Ether it is just not something we would do under any circumstances) but they are all represented here. So too are pedophiles. Do the homework. It’s a sick system and regulatory medicine is not going to admit they have even bamboozled. So it’s up to us to show the world they have been!
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[…] Accountability is a rule not an exception. Hopefully this article will succeed in framing certain questions for the medical profession; questions that we all need to think about now before the door closes for good. […]
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[…] Accountability is without exception. Hopefully this article will succeed in framing certain questions for the medical profession; questions that we all need to think about now before the door closes for good. […]
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[…] on Drug Testing comes to fruition. Before we know it the Drug and Alcohol Testing Industries “New Paradigm” as described here by Robert Dupont will be upon us and, as it did with doctors, it will be ushered […]
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[…] on Drug Testing comes to fruition. Before we know it the Drug and Alcohol Testing Industries “New Paradigm” as described here by Robert Dupont will be ushered in. From the ASAM white […]
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Reblogged this on Chaotic Pharmacology and commented:
“The rights of every man are diminished when the rights of one man are threatened.” -—. John F. Kennedy.
Related post (Nov 29, 2014): Physician suicide http://disruptedphysician.com/2014/11/29/physician-suicide-4/
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[…] mentality and mechanics are well documented and reveal where they came from, how they evolved and what they have planned. It is a complicated web and hard to explain but once the pieces of the puzzle are fit […]
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[…] are expanding to other fields. Just ask the airline pilots. They eventually want to expand to students and children. Just take a look at the ASAM White Paper on Drug Testing or Dupont’s Keynote Speech […]
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[…] apathy of the masses and willful ignorance of organized medicine needs to end now! If not the ASAM White Paper on Drug Testing will come to pass and we will be faced with a future Police State run by unqualified, […]
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[…] The ASAM White paper states drug testing is “vastly underutilized” throughout healthcare and describes the use of drug testing “within the pr… […]
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[…] of all substances (including alcohol) and lifelong spirituality involving 12-step recovery And by using the healthcare system as a loophole and calling this testing “clinical” rat…he ASAM will have successfully introduced widespread testing of a variety of Laboratory Developed […]
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[…] If a doctor collects these tests on a patient the test is rendered “clinical” rather than “forensic” and by calling it “clinical” rather than “forensic” drug- testing they can then call the consequences of a positive test “treatment” rather than “punishment” and it is via this loophole they plan to introduce the junk-science tests they are currently using on other groups. And to prevent this from happening more people need to be talking about this. […]
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[…] But if a doctor collects a test on a “patient” the test is rendered “clinical” rather than “forensic” and by calling it “clinical” rather than “forensic” drug- testing they can then call the consequences of a positive test “treatment” rather than “punishment” and it is via this loophole they plan to introduce the junk-science tests they are currently using on other groups. And to prevent this from happening more people need to be talking about this. […]
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[…] If a doctor collects a test on a “patient” the test is rendered “clinical” rather than “forensic” and by calling it “clinical” rather than “forensic” drug- testing they can then call the consequences of a positive test “treatment” rather than “punishment. ” It is via this loophole they plan to introduce and unleash these junk-science tests they are currently using on other groups who have no say in the matter (probationers, parolees and private professional monitoring groups ) onto the general population at large. A boon for the Drug and Alcohol Testing Industry Association that the involved assessment and treatment centers but a bane to the rest of society. And to prevent this from happening more people need to be talking about this. […]
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[…] If a doctor collects a test on a “patient” the test is rendered “clinical” rather than “forensic” and by deeming this drug-testing “clinical” rather than “forensic” they can then call the consequences of a positive test “treatment” rather than “punishment. ” It is via this loophole they plan to introduce and unleash the panoply of junk-science tests currently being used on other groups who have no say in the matter (probationers, parolees, private professional monitoring groups, etc. ) onto the general population at large. A boon for the Drug and Alcohol Testing Industry Association and the assessment and treatment industry but a bane to the rest of society. And to prevent this from happening more people need to be talking about this. […]
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[…] http://disruptedphysician.com/2014/11/02/1111/ […]
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[…] this article will succeed in framing certain questions for the medical profession; questions that we all need to think about now before the door closes for good. […]
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[…] If a doctor collects a test on a “patient” the test is rendered “clinical” rather than “forensic” and by deeming this drug-testing “clinical” rather than “forensic” they can then call the consequences of a positive test “treatment” rather than “punishment. ” It is via this loophole they plan to introduce and unleash the panoply of junk-science tests currently being used on other groups who have no say in the matter (probationers, parolees, private professional monitoring groups, etc. ) onto the general population at large. A boon for the Drug and Alcohol Testing Industry Association and the assessment and treatment industry but a bane to the rest of society. And to prevent this from happening more people need to be talking about this. […]
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[…] http://disruptedphysician.com/2014/11/02/1111/ […]
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The full report is available from IOM.
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Reblogged this on tea time with miss b and commented:
This. I’m so depressed today. It’s like a losing battle.
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[…] of all substances (including alcohol) and lifelong spirituality involving 12-step recovery And by using the healthcare system as a loophole and calling this testing “clinical” rat…he ASAM will have successfully introduced widespread testing of a variety of Laboratory Developed […]
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[…] of all substances (including alcohol) and lifelong spirituality involving 12-step recovery And by using the healthcare system as a loophole and calling this testing “clinical” rat…he ASAM will have successfully introduced widespread testing of a variety of Laboratory Developed […]
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[…] on Drug Testing comes to fruition. Before we know it the Drug and Alcohol Testing Industries “New Paradigm” as described here by Robert Dupont will be ushered in as it did with doctors; not with a bang but a […]
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[…] Robert Dupont’s 2012 keynote speech before the Drug and Alcohol Testing Industry Association (DATIA) describes a “new paradigm” for addiction treatment he proposes be expanded to the workplace, the healthcare system, and schools. The ASAM White Paper on Drug Testing describes in great detail how they plan to introduce non-FDA approved laboratory developed tests (LDTs) into the healthcare system and require doctors to drug test all patients ranging from pediatrics to obstetrics to geriatrics. They wish to do away with the forensic protections currently used in workplace drug-testing (such as strict documented chain-of-custody and Medical Review Officer (MRO) evaluation) by using your doctor’s office as a drug and alcohol testing collection agency and I describe this in detail here: Utilizing the Medical Profession as a urine collection agency–The ASAM White Paper on Drug Tes… […]
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[…] The ASAM White paper states drug testing is “vastly underutilized” throughout healthcare and describes the use of drug testing “within the pr… […]
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[…] The ASAM White paper states drug testing is “vastly underutilized” throughout healthcare and describes the use of drug testing “within the pr… […]
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[…] on Drug Testing comes to fruition. Before we know it the Drug and Alcohol Testing Industries “New Paradigm” as described here by Robert Dupont will be ushered in. From the ASAM white […]
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