Friday, January 14, 2022

My little white lie, or How federal and state agencies stopped pharmacies from dispensing ivermectin and hydroxychloroquine, ushering in government-imposed medical care

In early December, I had a very high risk patient for whom I had already prescribed ivermectin pre-COVID, but I had suggested getting him hydroxychloroquine (HCQ) when he got COVID, because he was at such high risk of an adverse outcome.  

I had also prescribed supplements and vitamins.  When the patient called me with COVID, I wanted to get him HCQ as quickly as possible, as it only works at the beginning of the illness.

In early 2020 any pharmacist would dispense the drug without asking for a diagnosis, but by late March 2020 controls were quietly placed on the drug in most US states.  In Maine, you had to attest that a patient had "active COVID" to get it dispensed, per our emergency rules, which were never voted on by a legislature.

However, in late August 2021, a concerted effort was made by state and federal agencies to stop patients accessing both ivermectin and hydroxychloroqine. CDC sent out an urgent warning about potential overdoses, citing only one person who used an animal product and one who got it on the internet.  There was no evidence presented that anyone had suffered as a result of taking the drug when they got it by prescription. Doctors in several states suddenly lost their licenses for prescribing ivermectin, and these stories made the national news.  It became obvious to me then that a campaign was afoot to terrorize prescribers, so they would stop issuing prescriptions.

I wrote about this on September 5, and then Dr. Justus Hope (a pseudonym for a real physician) wrote about ivermectin heresy in California's Desert Review. 

At the same time, the supply was suspiciously drying up.  Wholesalers or drug middlemen began saying they were unable to access ivermectin to supply pharmacies. I contacted the US' largest manufacturer of ivermectin, Edenbridge, and their head of sales said they were producing it in normal amounts. But it wasn't getting to the drugstores. She sugggested I try some of the smaller distributors to obtain some for my patients.

In late September, Maine's Pharmacy Board (an arm of state government) contacted all of Maine's pharmacists with a threatening letter, demanding they review all prescriptions and only dispense ivermectin for "legitimate" purposes. 

Only a few small compounding pharmacies, which had a larger choice of wholesalers, and knew what they could legally do, were still able to obtain sufficient quantitities and dispense the drug, but they too sometimes ran out. In December 2021 the FDA and FSMB colluded to try to stop the compounding pharmacies from supplying it:  in the linked letter, FDA made the false claim that "currently available data do not show that ivermectin is safe or effective for the prevention or treatment of COVID-19." 

Maine's pharmacists know how to read between the lines, and so nearly all of them stopped dispensing both ivermectin and hydroxychloroquine.  They suspected if they didn't, they could be inspected and potentially closed down or lose their license.  The harrassment of me by the Board no doubt clinches their suspicions.

By the way, these actions are unprecedented.  Both drugs remain licensed and doctors and other medical providers can legally prescribe them off label for any indication for which the patient and doctor feel they will be beneficial.  FDA has not restricted their licenses. The Board of Medicine in Maine has not restricted their use, and has not issued any instructions on them to my knowledge.  The Maine Governor and DHHS authorized hydroxychloroquine for the treatment of acute COVID, which is exactly what I used it for.  So there is no legal nor scientific basis for this medical terrorism. 

FDA did restrict the use of free, donated hydroxychloroquine which was put into the Strategic National Stockpile (and left to rot there) in March 2020, after Trump sang its praises.  But this restriction was never issued for ordinary hydroxychloroquine that Americans buy from pharmacies.  However, a huge number of other impediments were imposed on hydroxychloroquine to prevent patients obtaining the drug.  I wrote the seminal article about that in June 2020.

Back to my high risk patient.  He lived 2.5 hours away from a pharmacy that I knew was willing to dispense the drug.  The other drug stores were dispensing it for all other off-label and label diagnoses, but not for COVID.  It was late.  He and his wife were sick.  I knew I was taking a risk, but I felt I had to do the right thing.  So I called in the medicine to the local pharmacy of their choice, warning them that it might not fill the scripts:  hydroxychloroquine and azithromycin.

The pharmacist called me up, asking for the reason I had prescribed the drugs.  They are often used together for Lyme disease, so I said Lyme disease, and the pharmacist dispensed the drugs.  I then informed the patient what I had done, and I immediately informed the Board of Licensure in Medicine what I had done as well.

Since it should have been unnecessary for me to have to lie (the drugs are licensed without restriction; they were so safe that they were over-the-counter drugs in most of the world; Maine's Governor and DHHS say hydroxychloroquine can be used for acute COVID; and I was a licensed physician) I told the Medicine Board that the Boards of Medicine and Pharmacy had created a bad situation in which I was forced to lie to protect a patient.  I told them this was unacceptable and they needed to fix this.  Their threats to pharmacists appear to me to be against the law, interfering with the normal practice of medicine and pharmacy, restricting the use of drugs without citing any medical evidence to support this interference.

Someone pointed out that there is a legal term for setting up a situation like this:  inducement.  The state government agencies had created a situation (with no law behind them) in which I had no choice but to lie in order to carry out the obligations of my profession. So who is the real criminal?

Even the AMA Code of Ethics says duty to the patient is the doctor's primary responsibility.  But I am not sure the Board would understand an ethical code if it tripped over one.  I think it tripped over this one.

And so that was my lie, which I freely admitted to the Board, and it seems to be the linchpin on which I am to be hung. 

The bottom line is that federal and state agencies, colluding with "nonprofits" like the Federation of State Medical Boards, the AMA and the medical specialty boards, whose CEOs make enormous salaries* and solicit grants from these agencies, are trying to enforce One Size Fits All medicine imposed by government, and simultaneously stamp out any dissent.  If you want to keep lining up for worthless and probably dangerous boosters (according to Europe's FDA) whenever the government says so, and concur with the government telling you what licensed drugs you are allowed, then go ahead and hang me.

* Being the CEO of these organizations brings incredible rewards. Why? While public health positions generally pay much less than a practicing physician earns, the CEO of the FSMB, Humayun Chaudry DO, earns $777,225/year.  His last job was public health officer for Suffolk County, NY.  Richard Baron, CEO of the American Board of Internal Medicine, which also warned about misinformation, earned over $1.1 million in 2018. The CEOs of the American Board of Family Practice and of Pediatrics each earned over $900,000 in 2018.  They too warn about misinformation.


Anonymous said...

"If you set a trap for others, you will get caught in it yourself. If you roll a boulder down on others, it will crush you instead." Proverbs 26:27 NLT.

The medical and pharmacy boards have set traps for others. We shall see who gets hung.

Thank you, Dr. Nass, for advocating for your patients.

Tyro said...

the state created an irresolvable conflict of ethical vs legal obligations that would be regarded as 'inducement' in other contexts - i.e. they're motivating the act that they're penalizing, have eliminated alternative options, and based the violation on an otherwise conventional and riskless behavior.

Anonymous said...

The comedian Jerry Seinfeld referred to 'must-lie' situations.
We also could make a deeper ethical argument about a 'necessary lie'.

I am sure many have considered possible options for suing these Boards ... both medical and pharmaceutical. The money and power supporting their actions is formidable. The public has to start demanding change. They are harming people with these policies.

Anonymous said...

We’re with you all the way in your battle with the medical authorities, here in the new Soviet Union. Preventing doctors from accessing necessary medicines is criminal and requiring a psychological exam for publicly disagreeing with their opinions is outrageous.

lynnbrad said...

correction of quote: “The Arc of the Moral Universe is Long, But it Bends Toward Justice.” lynn b.

lynnbrad said...

Dr. Nass; as the injustice done by lying cowards at the medical board, (as well as the Portland Press Herald and Maine Public) continues to magnify, we remember a moral cohort of yours saying
“The Arc of the Moral Universe is Long, But it Bends Toward Justice.”
'Thank you for your intelligent, compassionate, ethical care of your patients and persevering service to humanity these many long years. This is the first place I daily check for the most important news of the day. We sorely need your enlightening word and know its dangers to the fraudulent and corrupt are why you are being scapegoated. Stay strong.

TRANSDEF said...

The only evidence of harm that could possibly be cited by the Board for these long-safe drugs is harm to the billions in profits that Pharma is eager to kill for.

Unknown said...

So appropriate that the sidebar shows a memorial to the author Franz Kafka, who wrote famously about a totally irrational bureaucratic Trial.

Anonymous said...

Thank you for your clear summary of what happened and why. In the history of all things compassionate, you are part of the story.Best wishes to you.

Anonymous said...

even if the patient didnt have lyme, the rational might be the same - hydroxy alkalinizes the cell to help antibiotic penetration, and helps imflammatory response.
I am horrified that you are being put through this!

americatemychildren said...

Dr.Nass, I hope you are acquainted with the case of Dr. Mel Bruchet of Canada who was imprisoned in a psychiatric ward for exposing the huge numbers of stillbirths in vaccinated mothers. While there he was forcibly medicated with Abilify which caused him to have 2 TIAs. He was released after more than a month only due to efforts by activists.

Unknown said...

Dr. Nass. Thank you for all you do. I'm sorry that this is now taking up your time -maybe that's the plan. Wishing you the very best of luck.

David Chandler said...

You might call this the My Lie massacre!

Jon D. Olsen said...

Good one David, Got it. Reality does not care what anyone believes; it just IS, but her daughter, Truth cares very much when beliefs insult her mother. Thank you Meryl and the commenters here for defending Reality, and supporting Truth. Injunctions, not injections! We assert the right NOT to Bare arms!

Anonymous said...

Bless your heart Dr. Nass, you've have stepped into the gaping cavernous jaw of Leviathan; perhaps with $50,000.00 you could throw a fleet of lawyers and sue their asses for their belligerent attack on the practice of medicine. Have you thought about 'go fund me?' Until a mass protest arises, your best hope of restoring your position is swift legal action to defend your liberty right to practice medicine.