Tearse 1!

David Tearse

Mr. Cole

ENC 2135

20 March, 2017

A Doctors Obligation to Act Professionally

The word drug has several different connotations. Depending on who you ask, a drug can

help treat a severely ill cancer patient or it can be something that takes the life of a loved one.

Drugs or medications are compounds created through extraction of medicinal plants or organic

synthesis and are intended to aid in the healing or well being of specific ailments. These

chemical substances come in different forms and are made from different compounds depending

on their intended affect on the patient. Drugs that have stronger effects are restricted by

prescriptions and held behind the counter at pharmacies due to their tendency to be abused more.

Prescription pain medication like Morphine, Oxycontin, Oxycodone, Vicodin and many more are

dangerous if used in the wrong way or unintended amount. By law, these drugs are held by

pharmacies and administered via prescription that are given to the patient by the doctor. It is the

job of the doctor to act professionally and use their best judgement to assign the correct drug

with the appropriate prescription, in order to help the patient heal as quickly and effectively as

possible. Controversy comes when patients become addicted to these prescription medications

and attempt to deceive doctors in order to receive more pills. It is the job of the doctor as a

professional and as a moral human being to use their best assessment of whether the patient is

being honest or not, and what is best for their health. It is both illegal and potentially deadly

when the system is abused by doctors and patients so that the patient receives a false prescription
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and abuses the drugs they recieve. Ultimately it is the moral obligation of the doctor to intervene

and protect addict patients from further injuring themselves.

National Overdose DeathsNumber of Deaths from Prescription Opioid Pain Relievers./

asam.org

Opioid addiction usually stems from a patient being prescribed an opiate for an injury or

other sources of chronic pain. Once a patients body becomes accustomed to the effects of the

drug, the body begins to crave the drug and the patient will experience symptoms of withdrawal.

Opioids, like Oxycodone, block pain receptors in the brain and the more of the drug that is taken,

the more tolerant to the drug the patient becomes. Addicted patients suffer changes in their brain

chemistry. Marc D. Lewis reviews the chemistry behind addiction in an essay and review of

addiction and explains that the neuromodulators that interact with dopamine shift over time.

Lewis explains that because acetylcholine is the neuromodulator responsible for normal
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alertness and attention, the character of behavior now shifts from exploration, alertness, and

volition to single minded, desperate pursuit (153). These patients are unable to make rational

decisions which is why it is so important for the doctor to act professionally. When these patients

are no longer prescribed these painkillers but they still crave the desired effects that they felt

from them, they often turn to drug dealers for heroin.. Heroin is extremely addictive and

dangerous because of the way that it is taken and the mystery and inconsistency of the substance.

Unlike prescription opioids which are manufactured by large pharmaceutical companies and

administer by government regulated healthcare offices, heroin is manufactured, distributed, and

taken illegal on the streets. Dirty syringes and added chemicals are just two reasons that heroin

can be deadly and act as an ideal source to transmit disease.

Large pharmaceutical companies and pharmacies are businesses and they operate as one.

Their main concern in making more money and providing a product that will be purchased and

consumed by more people. A documentary by Steven Okazaki claims that In 2015

pharmaceutical companies revenues for opioid painkillers reached fifteen billion dollars while

every year prescription opioid abuse costs tax payers fifty five billion in healthcare, criminal

justice, and lost productivity. All large companies have their best interest in mind, and while

they want to create a product that will help patients, they are ultimately concerned with the

money they are making off the patients. In other words, these corporations are making billions of

dollars based on the idea that people are becoming dependent on their products. Pharmacies are

simply the middleman for the drugs which leaves the final link, the doctor and the patient. A

morally just doctor is not concerned about the money he is making, but what the patient needs in
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order to become healthier and no doctor who is doing what is right should be concerned about

being prosecuted.

Future plans for new prevention strategies of drug abuse are being developed by teams of

practitioners. US drug policy has not changed dramatically in the past thirty years and drug

addiction has risen which means there needs to be a change in how prescriptions are monitored.

A report done by the Center for Disease control reports that a possible strategy for future

prevention is the use of prescription data combined with insurance restrictions to prevent

doctor shopping and reduce inappropriate use of opioids (10). Non invasive strategies like

this one are ideal in order to protect the patient while not putting more work in the doctors hands.

Drug addicts are victims of a disease that they took part in developing, but must be viewed as

victims non the less. The main concern of an opioid addict is finding the next way or the next

time to get high again, and they will put themselves and people they love in jeopardizing

situations in order to get this high. It is the job of the doctor to do his or her best to help the

patient get healthy or provide options for the patient to pursue. An article written by Dhalla A

Ifran, Persaud Navindra and David N Juurlink from the British Medical Journal suggest that

drug companies should be prohibited from linking employee compensation with volume of

opioid prescriptions and coupons entitling new patients to a free prescription should not be

permitted for potentially addictive drugs (570) It is the moral obligation of the doctor to do his

or her best to properly diagnose and accurately prescribe medicine to the patient regardless of

fear of losing their job or pressure from the patient. Doctors go through years of school and hours

of practice in order to train for the possible situations they might have to go through. Another

strategy that comes with controversy is the debate on whether pharmaceuticals should be made
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legal under extreme restrictions. In an article from the Washington Post Newsweek Interactive

written by Ethan Nadelmann, he tells that the greatest downside to legalization may well be the

fact that the legal markets would fall into the hands of the powerful alcohol, tobacco, and

pharmaceutical companies (30). While these corporations will continue to monopolize the

industry and create harmful products, there will be much less violence and crime related to

prescription pills. Legalization may not come for a while or ever at all, but it is im

portant to review all possibilities that might make an improvement to the system.

(Prescription Drugs/ alltreatment.com)

Prescription medications are measured in specific amounts and come with instructions in order to

properly medicate the patient. Once the patient has their prescription from the pharmacy, there is

no control on the doctors part on what the patient does with the pills. When a doctor prescribes a

patient with a medication they do not need or an amount that is not suitable for them, that patient

is at a greater risk of overdosing or becoming addicted to the medication. According to Ronald T.

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Libby, author of Treating Doctors As Drug Dealers, federal and state prosecutors have

prosecuted licensed physicians for drug distribution, fraud, manslaughter, and even murder for

the death of people who misused or overdosed on pain killers (513). These doctors are treated as

drug dealers in the court and are subject to the same style of prosecution.

LA Times reporter Marisa Gerber reported on a case in 2016 of a physician who was arrested on

murder charges after being found guilty of prescribing non needed narcotics to three patients

who overdosed and died. Dr. Hsiu-Ying Lisa Tseng is reported as stating I terribly regret that

even after learning of the overdoses, I did not investigate my prescribing practices to see if they

played a role. Other doctors have reacted to this case and are becoming hyper vigilant with their

prescriptions in fear of becoming tied into a similar situation. The results of a study done in

California in 2001 that was reported by Ronald Libby found that 40 percent of primary care

physicians said that fear of investigation affected how they treated chronic pain (514). This

number is concerning considering that means that forty percent of these doctors patients are

being inadequately treated for their chronic pain.

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(Irfan Khan / Los Angeles Times)

The case of doctors being cautious of the prescriptions they give out in fear of being prosecuted

is a major issue because it involves the health of the patients. The small group of corrupt doctors

who are compromising their patients health by over prescribing are also jeopardizing the well

being of the patients of the doctors who are under prescribing in reaction to rising rates of

prosecution. Last year in San Diego, a doctor named Naga Raja Thota was convicted of

exchanging narcotics to two different women in exchange for sex acts. Thota agreed to write

prescriptions for potent prescription medications to patients who did not need them in exchange

for sexual favors In a news release summary from the US Department of Justice U. S. Attorney

Orlando B. Gutierrez explains that Thota agreed to treat her but documented that his treatment

was for pain even though this victim did not suffer from any medical condition that caused

chronic or ongoing pain. This real life scenario proves that not all doctors are morally just

humans and can still behave as criminals. Doctors are respected professionals who's power over

the health of their patients should not be taken for granted. Especially when dealing with drug

addicts, it is the doctors responsibility to act accordingly when adjusting to individual patients

needs.

(Rehabs.com/Center For Disease Control and Prevention)

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There is something to be said on the difficulty to judge whether a patient is a drug addict

or not because it is the job of the doctor to give the patient the benefit of the doubt when they

claim that they are feeling pain, and prescribe them accordingly. This fine line between the truth

and deception are part of a doctors job to distinguish between. Needle exchange programs were

slowly implemented into areas with high rates of drug use in order to reduce the adverse effects

of using dirty needles. In a journal article written by Peter Reuter on why the US drug policy has

changed so little in the past thirty years, he explains that There is considerable empirical

backing for claims that needle exchange programs can bring about significant reductions in HIV

transmission (106). This is an example of a minor change that has not had a major effect on the

amount of drug use, but a positive, indirect effect. Often times although a patient may be in pain,

a prescription for Oxycodone might not be what they need to heal. Today there are several other

forms of treatment that are successful including weening the patient off of the drug. There are

successful cases of addicts healing after taking regular doses of the same drug they are addicted

to at lower and lower amounts while simultaneously implementing various forms of therapy.

Distractions can be a key component to treatment. If someone is addicted to an opioid it is most

likely that they have an addictive personality which means they are capable of becoming

addicted to something that is actually healthy. If an addict can supplement thoughts of getting

high with the action of running or doing yoga, the mental tie between the high and pleasure felt

will be broken and a new tie will be made between the positive feeling that the hobby brings.

Treatment options for addicts are limited to rehabilitation centers and institutions that

administer opioid agonists like methadone in small amounts. In a journal article from the

Milbank Quarterly written by Bradley D. Stein, he describes the issues regarding addiction
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treatment by saying Opioid treatment programs, the only licensed providers of methadone, are

located predominantly in urban areas and usually require patients to take methadone at a clinic,

which is difficult for many individuals (563). This unfortunate fact leaves addicts without many

options for receiving treatment and becoming clean again. The biggest threat for prescription

opioid addicts is their propensity to try heroin in search for a similar effect at a lower cost.

Heroin is a drug that hooks users on their first try, and is very hard to get clean from, and while

possessing, selling and taking the drug is illegal, hospitals and clinics provide clean needle

exchanges for addicts to practice safe drug use. With rising prices of prescription medication and

the increasing legality of marijuana, Mexican Cartels are continuing to produce and push these

potent, deadly narcotics further into the youth of the US. Opioid addicts are still people and have

the same rights as anyone else which means at the end of the day they can not be forced into a

treatment facially or administered medication against there will. Doctors are well aware of the

link between prescription opiates and heroin, and should take necessary precautions to check

whether their patients are addicted to street drugs or not.

https://www.youtube.com/watch?v=QxpGYyHOtvc

A common problem that is faced by addicts is their addiction is stronger than their will to

actually take the necessary steps to heal. A documentary titled Heroin: Cape Cod, USA

interviews several addicts in the Cape Cod area about their experiences with heroin and provides

a grim insight to the destructive world of heroin. The addicts interviewed in the movie all

became addicted to prescription medication or at least tried it before transitioning to heroin due
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to either an injury or curiosity of trying something new. They explain that they hate the fact that

they do drugs and wish that they did not want to or did not need to get high. Without a constant

dose of heroin they become sick and irritable, and describe the inappropriate or regrettable

actions they take to relapse. One girl tells how she would turn to prostitution in order to make

enough money to buy drugs while others admit to selling their belongings or stealing from their

family. The addicts tell of how they feel at piece when they experience the rush from heroin and

even describe it as similar to Christmas morning or the feeling when you just go down a roller

coaster. It is extremely hard for a heroin or prescription addict to come forward as such because

while they may be aware that what they are doing is affecting their health and well being in a

negative way, they are either ashamed or not willing to admit to their disease. One addict from

Okazakis documentary Heroin: Cape Cod, USA describes himself as felling like a kid and

explains that opiates dont stop the pain, they make you feel good so that the pain doesnt hurt.

It still hurts, but youre happy that it hurts. Doctors work in an office and have a full schedule of

patients who they see, and it is not their job to follow up with or regularly check on their patients

outside of the office to make sure they are alright, nor is it possible. Ultimately, it is the job of the

addict to reach a point where they know they need help, and reach out to a friend, family

member, or healthcare professional for help.

There are several component that are involved in providing healthcare to patients.

Doctors have to work with patients in order to effectively diagnose and treat the patients ailment.

When the patient is able to honestly communicate their symptoms the doctor can properly assess

the patients problem and provide effective options for treatment. However, when patients

mislead the doctor regarding their symptoms with the motive to get access to prescribed
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medications, the doctor is put into a compromising situation. A doctor is obligated to take the

word of the patient when they claim to be in pain and to prescribe the necessary medications, but

it is also the job of the doctor to recognize when the patient is actually addicted to these

medications and using them inappropriately. The amount of prescription pain killers and the

strength at which they are administered should be more closely regulated and scaled back in

order to decrease the amount of young patients who become addicted to them. Being in pain can

cause excruciating agony and discomfort for the patient, but being underrated for pain is more

desirable than becoming dependent on opioids in order to feel normal. Opioids temporarily block

the pain that is being felt, but do not directly work to stop infection or cure disease. Once the

ailment is cured and the patient no longer feels pain from the original injury, they may now be

addicted to the medicine that was intended to help cure them. A doctor should only be prosecuted

if they are knowingly prescribing opioids to patients who are either addicted, or have illegal

intentions with them. The decision to become a doctor is a very serious one as doctors are

responsible for the well being of however many patients they see, and abusing this power can

cause severe effects to the lives of the patients.

Rhetorical Rationale

My paper is focused on determining the doctors responsibility to their patients by guiding

them and treating them in order to help heal them back to health. Through my research I have
found that there are several cases of corruption by doctors throughout recent years that have
resulted in doctors getting criminally charged for their actions. In my paper, I review these cases
and their effects on other doctors who are licensed to prescribe chronic pain medications. There
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are several variations on cases of doctors who knowingly prescribe potent painkilling
medications to patients who do not need them and have been convicted. Prescription addiction is
a relevant topic because it is so common in society and there are many harms that are tied to the
addiction of prescription pills. Heroin is the most common end result for prescription medication
addicts, and a very common killer. I was interested in this topic because it effects teenagers who
are around my age as well as their families. The heartbreaking reality that kids are dying because
they are becoming addicted to something that was intended to help cure them seems like a
concept that should have been abolished a long time ago. This controversial reality is very
interesting to me and I enjoyed reading opinions that well respected professionals have on the
issue. My paper took me a while because I had to chose which aspects of the relationship
between doctor and patient to include. There is so much information with respect to prescription
pain killers and their effect on the patients who take them. My paper is organized into different
sections related to the path experienced by patients who become addicts. I found it very difficult
to cite the extra interactive sources because I could not find the creator of some images or who to
credit the creation of the images to.

My interactive digital sources provide a valuable aspect to my paper that provides visuals to my
argument. The graphs I included depict extreme spikes in drug use and drastic statistics regarding
opioid use. The video of the trailer for the HBO documentary about heroin addiction is very
visually disturbing and invokes an emotional response from the views. These extreme images
show the reader in a visual way the severity of the issue that I discuss in my research paper. The
fact included in the images that I included contain facts regarding narcotic use and the staggering
numbers associated with the deaths and overdose rates of addiction victims. I included the
picture of the doctor named Lisa Tseng who was convicted of murder to show my audience that
not all murderers look like they are capable of what they do. Tseng is a small remorseful looking
woman who unknowingly claimed the lives of three individuals by prescribing them medications
that they overdosed on. This project was a challenge as it came with no strict guidelines on the
topic. My biggest challenge was figuring out what I wanted to research and how to narrow down
my argument in order to write a clear and concise paper.

Works Cited

"CDC Grand Rounds: Prescription Drug Overdoses a U.S. Epidemic." Morbidity and Mortality
Weekly Report, vol. 61, no. 1, 2012, pp. 10-13. JSTOR

This source is a part of a series called Morbidity and Morality Weekly Report from the Center for
Disease Control and Prevention. The CDC is a very credible source as it is a leading National
Public Health Institute that is government run. The CDC has a very large budget for research and
prevention strategies.
The article covers statistics regarding the rates of opioid addiction and overdose over the past
decade, as well as strategies for the future. The article reviews the different populations that are
at a greater risk of addiction and overdose, and graphs that display the statistics. There are
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insights for possible approaches to the drug epidemic in the future and practices for healthcare
professionals.
The article is written in a very straight forward tone. The facts are laid out under the two sub
headings Prevention Strategies and The National Response. The information provided is
straight forward and well organized as expected from a source like the CDC. Strategies for
preventing future increases in opioid overdoses and the role society plays in these rates.

Dhalla, Irfan A., Navindra Persaud, and David N. Juurlink. "The Prescription Opioid Crisis."
BMJ: British Medical Journal, vol. 343, no. 7823, 2011, pp. 569-571.

Written by Irfan A Dhalla, Vice President of Evidence Development and Standards at Health
Quality Ontario, Navindra Persaud, staff physician at St. Michaels Hospital, Toronto, and David
N Juurlink of Schulich Heart Research, Sunnybrook Research Institute. The article was
published by the British Medical Journal and provides solid information regarding statistics of
opioid use between 1999 and 2007.

All three authors collaborate to offer solutions or reductions in the mortality and morbidity of
opioid overdoses. The article mentions how this epidemic stretches across the globe and is
mostly prevalent among younger people, specifically men. The article reviews the evolution of
this international crisis and its relationship to the increase of prescribed opiates.

The article covers how prescription opioid addiction causes more deaths annually than any other
substance addiction and that there is pertinent evidence that more public access to opioids leads
to more deaths from opioid overdose. There are recommendations made in the article for a
centralized database of opioid patients which would potentially reduce the abuse found in the
present system.

Gerber, Marisa. "Doctor Convicted of Murder for Patients' Drug Overdoses Gets 30 Years to Life
in Prison.", Feb 5, 2016, http://www.latimes.com/local/lanow/la-me-ln-doctor-murder-overdose-
drugs-sentencing-20160205-story.html.

This article was written by Marisa Gerber who covers Los Angeles Countys criminal court
cases. Gerber has written a number of articles and has established herself as a respected reporter
for the LA Times. The article covers a case of a woman who was convicted for murder after
prescribing three of her patients opioids who later overdosed on them.

The Physician named Dr. Hsiu-Ying Tseng claimed to not have been properly educated on the
effects of painkillers and proper procedures for pain management. Her patients died after mixing
xanax and oxycodone that she had prescribed them with alcohol. This source shows the
controversy of several cases lately where a doctor is tried for murder from prescribing a pill.
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It may seem extreme to consider a doctor a murderer for something they prescribe but at the
same time it is the job of all doctors to know what substances they are dealing with and their
effects on the patients. The painkillers these doctors are prescribing are much more potent then
they realize in certain situations and these doctors need to be held accountable for their actions.

Lewis, Marc D. "Dopamine and the Neural "Now": Essay and Review of "Addiction: A Disorder
of Choice"." Perspectives on Psychological Science, vol. 6, no. 2, 2011, pp. 150-155.

Marc D. Lewis from the Behavioral Science Institute of Radboud University, Nijmegen,
Netherlands provides a review and response to a journal titled Addiction: A Disorder of Choice
by Gene M. Heymen, Ph. D, of Harvard University. Lewis uses Heymens argument as a tool to
help amplify his own, and provide comparative structure to his argument.

The article focuses on how individual choices and behavioral responses work together to bring
someone to become an addict even if this was not their intention. The presence of possible
rewards and the subconscious factors regarding human nature for immediate reward, and the
disregard of future consequences when someone is experiencing a state of altered brain
chemicals.

The journal closely ties certain drugs like opiates effect on the brain and how the chemical
altercation of brain functions keeps addicts trapped in environments or habits that either put them
at risk of becoming an addict or further fuel their lifestyle as an addict.

Libby, Ronald T. "Treating Doctors as Drug Dealers: The Drug Enforcement Administration's
War on Prescription Painkillers." The Independent Review, vol. 10, no. 4, 2006, pp. 511-545.

This article was published by The Independent Review which is a branch of the Independent
Institute, a non-profit, scholarly research and education organization that sponsors a variety of
studies relating to public economy.

The article starts by acknowledging the chain of events that leads to opioid addiction. It reviews
how untreated injury and pain of patients are treated with a number of different painkillers like
oxycontin which hook users into a desire and addiction to unneeded, illegal opiates. The article
also covers how the DEA and other agencies are reacting to the apparent manipulation of the
system by doctors and patients alike.

The article also discusses the transition of prescription drugs into the black market through
patients ability to get access to large quantities of prescription pain killers and their ability to
then mark the prices up and sell the pills on the street.
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Nadelmann, Ethan. "Drugs." Foreign Policy, no. 162, 2007, pp. 24-30.

Drugs was written by Ethan Nedelmann, founder and Executive director of he Drug Policy
Alliance which is a non-profit organization based out of New York City which is attempting to
end the War on Drugs. Nedelmenns passionate views regarding his disapproval of the War on
Drugs is prevalent throughout this article which was posted the Washington Post Newsweek
Interactive.

Nedelmann highlights the failures and flaws of the drug system and the reasons for the decisions
behind why drugs are labelled illegal or legal. There is an apparent statement of Nedelmanns
that the War on Drugs is a war that cannot be won and that the illegality of certain substances is
precisely what fuels the crime and devastation related to that substance. Nedelmann argues that
legalization of drugs might be the best answer and how it is not completely out of the question
for the future.

Parker, R. S., and Charles E. Pettijohn. "Ethical Considerations in the use of Direct-to-Consumer
Advertising and Pharmaceutical Promotions: The Impact on Pharmaceutical Sales and
Physicians." Journal of Business Ethics, vol. 48, no. 3, 2003, pp. 279-290. doi 10.1023/B:BUSI.
0000005783.58142.6e

Stephen Parker is a professor of marketing in the College of Business Administration at

Southwest Missouri State University and Charles E. Pettijohn who has the same title at the same
University. This article covers the influence of direct-to-consumer advertising and physician
promotions. The article also focuses on the ethics surrounding doctors tendencies to accept
promotional offers from pharmaceutical companies.

Arguments for and against direct to consumer advertisement are both made in separate sections
of this essay. The extent of this type of DTC advertisement as well as the effectiveness of DTC
advertisement are both reviewed in this essay as well. Both sides of the arguments for and
against promotional gifts are reviews as well.

Reuter, Peter. "Why has US Drug Policy Changed so Little Over 30 Years?" Crime and Justice,
vol. 42, no. 1, 2013, pp. 75-140.

This journal article was written by Peter Reuter who is a Professor in the School of Public Policy
and the Department of Criminology at the University of Maryland. Reuter also founded and
directed RAND's Drug Policy Research Center from 1989-1993. Reuter has clearly researched
this topic thoroughly and is invested in US drug policy and the way it functions.
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This article makes five major claims regarding drug policy that are organized into six different
sections. These sections are organized in order of relevance and complexity starting with
background information on US Drug policy and ending with offering speculations about reasons
for resistance to change.

This thorough essay fully reviews the history of Drug Policy and explains why it has not changed
significantly in the past thirty years. Reuter mentions reasons for why the policy has not changed
much and reviews the minor ways in which it has. Reuter classifies drugs into marijuana which
he addresses separately from all other drugs. The article reviews all possibilities for the future
including legalizations and the possible consequences of each major action.

Stein, Bradley D. "Where is Buprenorphine Dispensed to Treat Opioid use Disorders? the Role
of Private Offices, Opioid Treatment Programs, and Substance Abuse Treatment Facilities in
Urban and Rural Counties." The Milbank Quarterly, vol. 93, no. 3, 2015, pp. 561-583.

This article has several respected authors who collaborated to create this resource. The article is
associated with the RAND Corporation, University of Pittsburgh School of Medicine, Penn State
College of Medicine, as well as Virginia Pittsburgh Healthcare system and Community substance
abuse centers. This article is a collaborative project from multiple sources.

This article provides staggering statistics on the rates of overdose for heroin and the money
involved in addiction in the United States as well as provide relationships to trends in the
regulations of the healthcare system. The article explains how certain acts

and altercations of rules among medical practices have contributed to the rising use of
prescription opiates.

There is a very present topic of the controversial administration of Buprenorphine in this article.
Buprenorphine is a partial opioid agonist which reduces the effects of withdrawal and is meant to
aid recovering addicts. The passing of a regulation which increased the amount of patients
physicians are able to prescribe buprenorphine is frequently mentioned in the article and the
results of this action are thoroughly discussed.

Okazaki, Steven. Heroin: Cape Cod, USA." produced by HBO. , Home Box Office, 2015, Films
On Demand.

Sansei Japanese American filmmaker Steven Okazaki shows the real life horrors behind drug
addiction in the 2015 HBO documentary titled Heroin: Cape Cod, USA. Okazaki is a well
renowned documentary filmmaker and has even won an Oscar for one of his short films.
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The documentary is set in Cape Cod, Massachusetts and follows the lives of six adolescent drug
addicts who have turned to Heroin as a last resort. The documentary is shot in a one sided
interview style where the questions asked by the interviewer are not heard, but only the answers
given by those who are being interviewed. The young men and women interviewed in the movie
give a bleak and honest view on their experiences with drugs, providing a visual primary source
of heroins effects.

The documentary covers all aspects of the addicts road to their present sickness, showing how
most of them started on painkillers and became addicted to them before transferring over to
street opioids like heroin. The documentary also provides several facts about statistics involving
drug use and overdoses that add an eerie and startling reality to the scenes of the film.

Doctor Arrested and Charged with Providing Prescriptions for Opioids and Other Scheduled
Pharmaceutical Drugs to Patients in Exchange for Sex Acts. Federal Information & News
Dispatch, Inc. Lanham, 2016.

This article was published by the US Department of Justice as a news summary last year. This
source is credible as it is from the US Attorneys Office as an official news report. The article
covers a corrupt doctor who prescribed opioids to several different girls in exchange for sex acts.
Physician Naga Raja Thota was convicted for prescribing unneeded narcotics to at least two
young women in exchange for sex.

The article that at least one of the woman that the doctor prescribed medications to began using
heroin. This article is a good example of how not all doctors are good doctors and just because a
person goes to medical school and becomes a doctor does not mean they will act in a
professional manner or morally correct way once given the opportunity.

It is scary to see a real life example of how a person can abuse their power in order to get
something they desire at the expense of others. This doctor may or may not have known the
actual affect he was having the health of these girls by prescribing them the narcotics or not but it
is his job to know which is the thesis of my paper.

Heroin: Cape Cod, USA (HBO Documentary Films) YouTube, uploaded by HBODocs, 9
December 2016, https://www.youtube.com/watch?v=QxpGYyHOtvc

National Overdose DeathsNumber of Deaths from Prescription Opioid Pain Relievers.

American Society of Addiction Medicine, http://www.asam.org/docs/default-source/advocacy/
opioid-addiction-disease-facts-figures.pdf

Ifran Khan Dr. Hsiu-Ying Lisa Tseng Los Angeles Times, http://www.latimes.com/local/
lanow/la-me-ln-doctor-murder-overdose-drugs-sentencing-20160205-story.html
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Legally Dead: Exploring the Epidemic of Prescription Drug Abuse, Center For Disease Control
http://www.rehabs.com/explore/prescription-drug-abuse-statistics/

Prescription Drugs Center for Disease Control, http://www.alltreatment.com/prescription-

drugs