It took Dale Messenger a long time to find treatment for his constant leg spasms.
He broke his neck in 1992. Today he can walk, but he still deals with spinal pain and his leg jumps so much that it keeps him up at night.
It wasn’t until Messenger was introduced to Dr. Merideth Norris, he said, that he found a treatment that worked for him – oxycontin, which he began after trying several non-opioid drugs first.
Messenger said Norris kept up with random urine tests and constantly checked in to make sure he was only using the medication as intended. When he built up a tolerance – Norris told him it was a risk – she helped wean him off it.
“She was just so careful and so compassionate,” Messenger said.
Morris was indicted on 10 counts of illegal distribution of opioids and other substances late last month. A federal complaint lists three unnamed patients who received prescriptions “that were not issued for a legitimate medical purpose.” She is the first person arrested by a newly formed task force through the FBI and the Department of Justice to target the illegal prescribing of opioids by medical professionals.
Attorney Timothy Zerillo, who is representing Norris, said in an email Friday that Norris denies the charges against her “and remains completely committed to helping her patients in any way she can.” He said she and her attorneys cannot comment on the case because of U.S. District Court rules.
The U.S. Department of Justice, which is prosecuting this case, could not be reached for comment Friday.
Norris was released on a $10,000 bond, but she had to surrender her passport and is barred from prescribing any controlled substances. She’s scheduled for trial in January 2023. This leaves approximately 400 patients seeking treatment for chronic pain and substance use disorder, according to Maine Medical Association communications director Dan Morin.
“Our concern wasn’t necessarily the legal process that was going on, it was completely on the disruption of care that’s being dealt to this population,” Morin said.
He said a majority of these patients have been transferred to other doctors. But many are still hanging in limbo because the state doesn’t have access to their medical records due to federal and state privacy laws, and doctors are hesitant to take patients whose medical history they don’t understand. Many primary care practitioners are also overwhelmed by workforce issues, and can’t accept new patients even if they’re willing, Morin said.
A GoFundMe had raised nearly $2,300 as of Friday to support Norris. The page says federal investigators have left Norris’ patients “abruptly without treatment, or options.” Others wrote on Facebook, saying they were shocked by the charge and worried about her vulnerable patients.
“There are many of us who know Merideth personally, some of us current or former patients, but many of us simply from the communities she has lived and worked in, that see right through the smoke and mirrors and firmly stand in saying there is no truth to this,” the organizer wrote.
A FEAR OF PRESCRIBING
Shifting prescription guidelines have made it challenging for patients who are struggling with opioid use disorder and seeking medication-assisted treatment, as well as those using opioids to address long-term, chronic pain.
Earlier this month, the U.S. Centers for Disease Control and Prevention released new rules, rolling back some of the group’s more hardline recommendations from 2016 that were meant to combat abuse of prescription opioids and addiction.
The changes remove a three-day limit on opioid prescriptions for acute pain, they don’t discourage doctors from increasing dosages, and they advise against any abrupt halts to opioid treatment unless a patient is in life-threatening danger.
Maine was one of several states who took the CDC’s advice in 2016 a step further, passing laws that remain in effect today to limit how many opioids a person can be prescribed, and for what reasons. Since then, Maine has seen a decline in prescriptions, but also a steady increase in fatal and non-fatal overdoses that’s largely attributed to a rise in illicit opioids like heroin and fentanyl.
There were more than 9,500 overdoses in Maine in 2021, a majority of which were opioid-related and more than 630 were fatal. That’s more than twice the 272 deaths reported in 2015.
The Maine Board of Osteopathic Licensure, which oversees physicians like Norris, addressed the new CDC guidance and conflicting state laws in its latest meeting Thursday while considering an investigation into another Maine doctor under scrutiny for opioid prescriptions.
This doctor, who board members did not name, inherited patients who were already receiving what another board member called “incredible high dosages.” The doctor met with these patients mostly over telehealth for a slew of issues – fibromyalgia, post-traumatic stress disorder, chronic pain, post-surgery pain, weight issues and anxiety.
Dr. Gust Stringos, a board member and family medicine doctor, acknowledged the CDC’s new guidelines “emphasize the harm of focusing on an arbitrary” dosage maximum.
“The quandary is, what do you do with all these patients who are already on high doses and have been for decades? Especially when their practitioner leaves,” he said. “What are the rest of us to do with that?”
Dr. John Gaddis, vice chair of the board, said Maine doctors are still struggling with patients who have been prescribed high doses for decades, resulting from old guidance that encouraged overprescribing.
“I think we’re dealing with a situation today where too many people, physicians and nurse practitioners, are fearful to prescribe narcotics when it’s appropriate,” said Gaddis, also a family medicine doctor. “These are very difficult patients and there’s not too many people who would take them on. … We do more harm if you cut them off, because they end up in the streets and they end up with fentanyl and they end up dead.”
The licensing board did recently investigate Norris, staff said during Thursday’s meeting, but dismissed her case. The board does not publicly disclose its investigations.
Chair Melissa Michaud told members Thursday they were opening a new investigation into Norris for record-keeping purposes. Michaud announced this without using Norris’ name, referencing only that she was a “licensee that the board recently dealt with who was arrested by a federal task force.”
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