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.