By Doug Brunk, San Diego Bureau
When Dr. Michael W. Sullivan started taking hydrocodone to cope with the pressures of his 100-plus hours a week ob.gyn. residency in Cincinnati in 1996, he knew he was hooked.
“It was love at first sight,” he recalled. “That euphoria—there was absolutely nothing like it.”
By the time he joined an ob.gyn. practice in Wisconsin a few years later, he was hoarding hydrocodone samples brought in by drug representatives and popping 20–25 pills a day, mostly after work. “Now it's much more difficult to get those samples, but at that time, I could get thousands of them at a time,” he said. “It was very discreet, and it was cheap.”
As a married father with four children, his chief concerns became keeping supplied with hydrocodone—he started ordering from pharmacy supply houses because drug reps were cutting back on dispensing samples—and making sure his family didn't find out about his habit.
In 1999, Dr. Sullivan and his family moved to Omaha, Neb., where he joined a small practice. By this time, his hydrocodone use had escalated to 30–40 pills a day, and he was using at work.
He tried to quit by not refilling orders for the drug he placed with pharmacy supply houses. “My way of trying to con myself into quitting was thinking, 'I'll just get through this 1,000 and then I'll stop. This is my last bottle.' So I'd get to the end of that bottle and [tell myself], 'I'll just get one more.'”
Well aware that an order placed to a pharmacy supply house would take days to reach him, he started writing fictitious prescriptions at local pharmacies to get him over the hump until his shipment arrived. He'd pick up the prescriptions in person, but they'd be in someone else's name.
He did this 60–70 times and even devised a system on his Palm Pilot to track the fictitious names he used to make sure he did not go back to the same pharmacy more than once every 6 months.
His scheme backfired in October 2000 when a pharmacist said she would fill the prescription only if Dr. Sullivan brought in a photo ID of the person whose name appeared on the order.
“I left and I never came back,” Dr. Sullivan said. “The next day in my office I got a call from that pharmacist. She said, 'I think someone stole your prescription pad and is using your prescriptions. There was a guy in here who just didn't look quite right. I think he was falsifying prescriptions, and I saw him in here 6 months ago and he did the same thing.'”
The next day, a state trooper showed up at Dr. Sullivan's office and asked for a photo of him to match against the image on the drugstore security camera.
They had their man.
Within 2 weeks, Dr. Sullivan entered a month-long program at a drug treatment facility in Hazelton, Minn.
“The humility that I learned in those 30 days was the most remarkable thing. My definition of myself is not that I'm a physician—it's that I'm a person and I happen to practice medicine. And I'm an addict.” He called drug withdrawal “one of the most hellacious parts” of treatment. “Even though [I've been clean] for 5 years, that still burns in my mind. That was a torture to go through.”
A few months after his treatment, Dr. Sullivan made amends with the pharmacist who outed him “because I realized she saved my life,” he said. “The hardest part was telling my wife what was going on. In the mixture of being angry and scared, there was relief. Someone knew about it, and I was going to get help,” he said.
In January 2002, the Nebraska Health and Human Services System's state medical board sentenced Dr. Sullivan to a 9-month license suspension, 5 years of license probation, 100 hours of community service, monthly meetings with a licensee assistance program counselor, and five 12-step meetings a week.
“In my case, I go to Alcoholics Anonymous,” he said. “The people in the 12-step group are what keep me sober.”
He added that the prevalence of substance abuse among physicians is as high as that seen in the general population.
“There are at least 15% of us in medicine who are using [alcohol or drugs],” he said. “These physicians have to find someone in confidence to tell what is going on, someone who they positively trust [and] who will know how to help them. A lot of times, they'll be able to find that out through Narcotics Anonymous or Alcoholics Anonymous. There are health care professionals in all of those groups. Eventually, you have to lose the pride and ego and become humble.”