Rev. Ronald V. Myers, Sr., M.D.
Family Practice
Wellness Clinic of Roland
205 East Ray Fine Blvd. P.O. Box 961
Roland, OK 74954
918-398-9434 918-398-0637 Fax
www.AmericanPainInstitute.org
12/10/06
Karen Tandy, Director
DEA
700 Army Navy Drive
Arlington, VA 22202
Dear Administrator Tandy:
I received a copy of the enclosed 10/27/06 letter to Senator Tom A. Coburn, M.D., from Eric J. Akers, Chief, of your Congressional Affairs Section, in response to my enclosed 9/22/06 letter to your office. I appreciate receiving a copy of the letter from Senator Coburn's office.
After reading and researching the information in the DEA's 10/26/06 letter, I can only conclude that your requirement of forcing me to pay $390.00 to maintain two seperate DEA registrations in both Mississippi and Oklahoma, when I do not manufacture, distribute or dispense controlled substances in my part time practice in Roland, Oklahoma is not required by the Controlled Substance Act (CSA).
In his letter, Mr. Akers states, on page 2, paragraph 2:
"The CSA defines the term "dispense," however, to mean "to deliver a controlled substance to an ultimate user of research subject by, or pursuant to the lawful order of, a practitioner, including the prescribing and administering of a controlled substance and the packaging, labeling or compounding necessary to prepare the substance for such delivery." Sec: 21 U.S.C. - 802(10). Accordingly, a physician who prescribes a controlled substance is, in fact, "dispensing" that controlled substance within the meaning of the CSA."
According the CSA, a practitioner who prescribes and administers and packages, labels or compounding necessary to prepare the substance for such delivery, is required to have a separate DEA registration. I do write prescriptions for controlled substances out of my part time practice in Roland, Oklahoma, but that prescribing is not followed by administering and packaging, labeling or compounding necessary to prepare the substance for such delivery to my patients.
The enclosed official definition of administering and dispensing a controlled substance by the Oklahoma Board of Pharmacy is as follows:
13. "Administer" means the direct application of a drug, whether by injection, inhalation, ingestion or any other means, to the body of a patient.
14. "Dispense" includes sell, distribute, leave with, give away, dispose of, deliver, or supply.
Another point raised in Mr. Aker's response has no merit or is based in fact, on page 2, paragraph 4:
"For example, an individual practitioner who is an agent or employee of a hospital or other institution may, when acting in the normal course of business or employment, administer, dispense or prescribe controlled substances under the registration of the hospital or other institution in lieu of being registered him or herself, provided certain conditions are met. See: 21 C.F.R. - 1301.22(c)."
In reality, a practitioner who works in a hospital emergency room, is not an employee of the hospital or institution, but an independent contractor with an emergency room company who has been contracted by the hospital to provide emergency room coverage. A simple phone call to any local pharmacies in the area of the hospital emergency room will clearly reveal that those pharmacies are filling those emergency room physicians controlled substances prescriptions with the practitioner's DEA registration number and not the hospital's or institution's DEA registration.
Mr. Akers also states on page 2, paragraph 4:
"With regard to the practice of locum tenens, whereby a registered practitioner substitutes for another practitioner on a temporary basis at that other practitioner's registered place of business, DEA expects to publish a notice in the Federal Register concerning this practice in the near future. None of these exemptions apply to Dr. Myers' situation."
My raising the point about locum tenens practitioner's not having the requirement of maintaining more than one DEA registration when having multiple state licenses wasn't to emphasis my exact situation in Roland, Oklahoma, but to demonstrate the discrimination of the DEA toward my part time practice of medicine in Oklahoma as an African-American physician, forced to have two separate DEA registrations, when other physicians in the state, with multiple licenses writing prescriptions for controlled substances, are not required to do the same.
Mr. Akers states on page 2, paragraph 5:
"Please be assured that the DEA is obligated to enforce the CSA and its implementing regulations in an even-handed manner. DEA has always applied the foregoing registration requirements to all practitioners in the United States. Whenever the DEA becomes aware of activity contrary to the law and regulation, we investigate and take necessary action."
This is simply not the truth. The DEA does discriminate in the enforcement of the CSA. The DEA is not even-handed, especially in regards to physicians who treat chronic pain patients. The requirement for me to maintain two separate DEA registrations in my part time practice in Roland, Oklahoma as an African-American physician, chronic pain treatment and civil rights advocate proves that point.
What really adds insult to injury is the fact that the DEA, as a arm of the federal govenment, forced me to pay an additional $390.00 for a second DEA registration that I should not be required to maintain. I believe a better policy would be not to charge a practitioner for a second DEA registration if that physician has multiple licenses in more than one state and only writes prescriptions and does not dispense controlled substances.
I request a time to personally meet with you concerning this matter and other issues concerning the treatment of physicians who treat chronic pain patients. As the Founder and President of the American Pain Institute (API) (www.AmericanPainInstitute.org), Founder and Chairman of the National Juneteenth Observance Foundation (NJOF) (www.Juneteenth.us) and the National Juneteenth Christian Leadership Council (NJCLC) (www.njcjc.com), disparities in the delivery of healthcare to the disenfranchised, poor, minority and chronic pain patient community has been the focus of my medical and civil rights advocacy career.
Frank McCune, M.D., M.B.A. is the Chairman of our National Juneteenth Medical Commission and a Board Member of the API. I would like for him to accompany me with any meeting you agree to schedule with me.
I still have not received a response from the enclosed 9/16/06 letter to Thomas J. Tonkin, Diversion Investigator, Tulsa Resident Office, DEA. I still would like to know the names and contact information for the DEA agents involved in my initial situation that
lead to my part time practice in Roland, Oklahoma being shut down for several weeks.
In any case, we hope that we can work constructively with the DEA as we have with members of congress, governors and other state law makers to address health disparities to affected populations in the country. As the first ordained and commissioned medical missionary to the Mississippi Delta, America's poorest geographic region, in the history of the black church in America, the poor and disenfranchised have a voice of health care advocacy (The Myers Foundation - www.MyersFoundation.net).
Sincerely,
Rev. Ronald V. Myers, Sr., M.D.
enclosures
cc: Senator Tom Coburn, M.D.
Senator James M. Inhofe
Congressman Dan Boren
Senator Mark Pryor
Senator Blanche Lincoln
Congressman John Boozman
Frank McCune, M.D., M.B.A.
top