The Pain Relief Network

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News releases are available at http://www.usdoj.gov/usao/ks/press/Dec07/Dec20a.html

Contact: Jim Cross
PHONE: 316-269-6481
FAX:      316-269-6420

Dec. 20, 2007

HAYSVILLE, KAN., DOCTOR CHARGED IN DEADLY PRESCRIPTION DRUG OVERDOSES

Federal indictment says physician Stephen Schneider continued unlawfully prescribing pain medications as 56 patients died from accidental overdoses

WICHITA, KAN. – A Haysville, Kan., physician was charged today with illegally distributing prescription drugs to his patients, directly causing the deaths of at least four of them.

Stephen J. Schneider, 54, and his wife, Linda K. Schneider, 49, both of Haysville were arrested Wednesday evening. On Thursday, a federal grand jury in Topeka returned a 34-count indictment. They will make an initial appearance at 1:30 p.m. Friday in federal court in Wichita.The charges include:
– One count of conspiracy
– Five counts of unlawful distribution of controlled substances resulting in serious bodily injury and death
– Eleven counts of health care fraud
– Thirteen counts of illegal monetary transactions
– Four counts of money laundering.
“Dr. Schneider is charged with unlawfully prescribing large quantities of potentially dangerous narcotic medications,” said U.S. Attorney. “At least four of his patients died from accidental overdoses that investigators believe were directly caused by medications he prescribed. In the past 5 years, a total of 56 patients he treated died from accidental prescription drug overdoses.”
A 65-page indictment describes Schneider Medical Clinic, 7030 S. Broadway in Haysville, as a “pill mill” open 7 days a week. Schneider and his assistants unlawfully wrote prescriptions for Fentanyl, Methadone, Morphine, Oxycodone and other narcotic medications. Scheduling patients 10 minutes apart, the clinic billed more than $4 million to health benefit programs. Linda Schneider, the manager of the clinic’s business operations, often urged the clinic’s staff to work faster, the indictment says.
From 2002 to 2007, at least 56 of Schneider’s patients died of accidental drug overdoses, the indictment says, but Schneider and his assistants did nothing to alter their practices. They ignored red flags indicating that patients were abusing, diverting or becoming addicted to the medications, the indictment says. And they continued prescribing pain killers, muscle relaxers and other medications outside the course of usual medical practice and not for legitimate medical purpose.
Four patients died as a direct result of Schneider’s actions, the indictment says, including:
– Patricia G., 49, who died June 20, 2005, from an accidental overdose of Hydrocodone, Oxycodone and Benzodiazepines.
– Eric T., who died April 22, 2006, from an accidental overdose of Hydrodocone, Oxycodone, Methadone and Soma.
– Robin G., who died May 15, 2007, from Fentanyl intoxication.
– Katherine S., 46, who died Nov. 25, 2003, from an accidental overdose.

During a different time period for which comparable information is available – 2003 through 2006 – 51 of Schneider’s patients died of accidental drug overdoses while the greatest number of comparable deaths associated with any other doctor was 9 – and that doctor was treating AIDS patients.

THE DEATH OF PATRICIA G

In the case of Patricia G., the indictment says she began going to Schneider’s clinic in April 2003 after she was injured in a car accident. She complained of pain in her knees. Over a period of months, she received a variety of medications even though she reported increasing pain and exhibited signs of depression and drug addiction. She received prescriptions for controlled drugs including Hydrocodone (Lortab), Oxycodone and Benzodiazepines (Xanax) from the Schneider clinic.

On June 16, 2005, she was admitted to Via Christi Medical Center for a suspected overdose of prescription drugs. Via Christi notified the Schneider clinic of the incident the next day.
On June 18, 2005, Patricia G. returned to the Schneider clinic and received prescriptions for Lortab, Oxycontin, Oxycodone and Xanax. Two days later, on June 20, 2005, she died of an accidental overdose of prescription medications including Hydrocodone (Lortab), Oxycodone and Benzodiazepines.

THE DEATH OF ERIC T

In the case of Eric T, the patient suffered a serious back injury in a car accident in 1994. He first visited Schneider’s clinic on March 14, 2003. Without obtaining a sufficient medical history, performing a sufficient physical exam or performing a neurological exam, Dr. Schneider diagnosed Eric T. with degenerative disk disease of the lower spine. He prescribed Hydrocodone (Lortab) and Soma (a muscle relaxant).

For the next three years, Schneider prescribed escalating dosages of controlled drugs. Schneider continued the prescriptions although Eric T’s condition showed no improvement and there were signs Eric T was becoming addicted and abusing the drugs.

On April 19, 2006, Dr. Schneider wrote Eric T prescriptions for Hydrocodone (Lortab), Oxycodone/APAP (Percocet), Methadone and Carisprodol. Three days later, April 22, 2006, Eric T. died of an accidental overdose of Hydrocodone, Oxycodone, Methadone and Carisoprodol. He was 46 years old.

DEATH OF ROBIN G

Robin G. suffered from migraine headaches when she first visited Schneider’s clinic on July 13, 2004. She reported having headaches two or three times a month. With only a minimal physical examination and little information on medical history, Dr. Schneider prescribed Fentanyl (Actiq) and Morphine (Avinza).

For almost three years Schneider’s clinic prescribed increasing doses of Actiq, Avinza and Valium to Robin G. On May 11, 2007, she received prescriptions for Fentanyl, Valium and Lidocaine

Four days later, May 15, 2007, Robin G died of Fentanyl intoxication. She was 50 years old

Another patient, Katherine S., 46, died Nov. 25, 2003, which is cited in Count 5 of the indictment and in page 1 of attachment 1.

HEALTH CARE FRAUD

According to the indictment, Schneider’s clinic received more than $4.24 million in payments from health care benefit programs including Medicaid; Medicaid’s HMO, First Guard; Medicare; Blue Cross/Blue Shield of Kansas; and Preferred Health Systems.

Schneider submitted false and fraudulent claims to health care benefit programs, the indictment says, including:
– Claims for a provider seeing patients on days when the provider was not present at the clinic.
– Claims for prescribing medications that were not provided for legitimate medical purposes.
– Claims that were “upcoded” to make it appear a physician had seen a patient when in fact an assistant saw the patient.
– Claims for laboratory services that the clinic did not provide.

ILLEGAL MONETARY TRANSACTIONS, MONEY LAUNDERING

Seventeen counts of the indictment focus on the proceeds of the alleged crimes. In transactions involving $50,000 to $130,000, the Schneiders are alleged to have moved money among accounts at Valley State Bank, the Credit Union of America, Intrust Bank, Bancomer Bank in Acapulco, Mexico; Union Bank of California; and various individuals including themselves, Sara Levin de Gonzalez and Lee Atterbury.

The indictment also seeks the forfeiture of all proceeds from the crimes. Real and personal property listed in the forfeiture count includes 7030 S. Broadway, 224 W. 79th South in Haysville, Kan.; bank accounts at Valley State Bank, Bank of America, the Credit Union of America and Bancomer Bank of Acapulco, Mexico; a 2004 Hummer H2, a 1978 Ford Mustang, a 2002 Nissan Frontier, a 1971 Ford Mustang, a 1995 GMC Jimmy, and two boats.

If convicted, the Schneiders face the following penalties:
– Conspiracy: A maximum penalty of 5 years in federal prison and a fine up to $250,000.
– Illegal distribution of controlled substances: If death or serious bodily injury occur, not less than 20 years and not more than life.
– Health care fraud: If death or serious bodily injury results, a maximum penalty of 20 years and a fine up to $250,000.
– Unlawful monetary transactions: A maximum of 10 years in federal prison and a fine up to $250,000.
– Money laundering: A maximum penalty of 20 years in federal prison and a fine up to $250,000.

The following agencies worked on the investigation:
––Heath and Human Services
– Kansas Bureau of Investigation
– Drug Enforcement Administration
–Kansas Attorney General’s Medicaid Fraud and Abuse Division
– Federal Bureau of Investigation
– U.S. Postal Inspection Service
– Social Security Administration

Assistant U.S. Attorney Tanya Treadway and Assistant U.S. Attorney Alan Metzger are prosecuting.

As in any criminal case, a person is presumed innocent until and unless proven guilty. The indictment filed merely contains allegations of criminal conduct.

Feb 15, 2007
By: Red no more
Dailykos.com

Jan 27, 2007
Author Unknown
TheAge.com

It is the “social glue” that helps bind mother to child, stranger to fellow concert-goer. Tom Horan explains why music makes us happy.

A class at a junior high school are giving their term assembly in front of their parents. At the end of their potted version of Romeo and Juliet, the music teacher plays the piano and the 30 children begin to sing Greensleeves. There has been some parental pride in the air during the play and the children have clearly enjoyed performing. But now a more profound sensation begins to swirl around the room. The simple refrain of the song ignites in singers and listeners a kind of elation. It is almost tangible. Something has elevated the assembly from an event informed by mild interest and a sense of duty to a moment of sublime happiness. Without a doubt, it is the music.

Every day we are sold the notion that consumer goods will give us pleasure. Technology in particular is marketed as the key to modern contentment. While the computer itself suffers from a rather prosaic image, its highly desirable cousin, the iPod, has gripped the public imagination. Although some of its appeal can be put down to its sleek design, what really makes people want an iPod is not the equipment itself but its payload: an almost limitless store of music, and the promise of all the joy that it will bring.

“The technology is just a vehicle,” says professor Paul Robertson, a British concert violinist and academic. “What it delivers is the most ancient system for satisfaction known to man – music. And we are increasingly able to understand the processes by which music makes us feel things.”

Happiness is a subject as old as life itself but, in an increasingly frenetic and seemingly more depressed world, experts have become preoccupied with unlocking the mysterious and intense power of music and how it makes us happy. In London late last year, a loose series of talks, organised by the philanthropic body the Wellcome Trust, tackled this very subject. In a sign of how far technology has come in this quest, science can now be used to observe what is going on in the brain while we are listening to music.

“What we find is that the old idea that music is a language is now no longer a poetic fiction but a neurological fact,” Robertson says.

Robertson, visiting professor of music and medicine at the Peninsula Medical School in Truro, Cornwall, has spent 30 years studying the link between what we hear and what we feel.

Recent developments in PET and MRI scanning – the technology used to detect strokes and tumours – have led to compelling new evidence about the overlap between the way the brain processes speech and the way it interprets music.

“Music has syntax and semantics,” says Robertson, who participated in the Wellcome talks. “It has organising principles that are deeply implicated with how we communicate meaning. And here we touch on the deep mysteries of music – why it is meaningful and what that meaning is constituted of.

“It comes down to Mendelssohn’s extraordinarily prescient comment that ‘music is too precise to express in words’. This level of precision makes music itself a map of our own internal, subjective experience. And what we are also discovering is that this internal experience is heavily connected to how we communicate with others.”

Robertson is not surprised at the great music boom of the past few years, which involves not just a surge in the number of people listening to music via MP3 players, but also voracious demand for tickets to festivals and concerts, and huge viewing figures for TV shows, such as X-Factor and the Idol series, which promote participation in singing and dancing. So does he think that what people are seeking through all this music is a route to happiness?

“It’s not just happiness, it’s identity,” he says. “We know that the auditory system of the brain is the first to fully function. At 16 weeks a foetus has a functioning auditory system. At 26 weeks you have a functioning brain system around it, which means that you are musically receptive long before anything else. So as soon as we are born, as dependent infants, we use music. It’s the musicality, the prosody, the vocalisations of mother and baby that create the emotional bond. They are both necessary to our survival and central to our development as individuals.

“We are born with the ability to vocalise our emotional needs, but that also requires in the mother a set of brain systems that relate the baby’s calls to specific emotions. These prosodic interplays, these improvisations of mother and baby, actually follow musical form. They are in fact curiously classical. And we find that music tends to reflect these archetypal forms, because that is what is pleasing to the human ear.”

The links between music and happiness work on many different levels. At the most fundamental is the recognition described by Robinson of the codes and patterns of sound that are innately familiar and therefore pleasing – not just to the listener, but to the person who composed them.

“We are only going to be able to recognise as beautiful and true those things that reflect our own neurophysiology. It’s the only yardstick of ourselves we have. At the same time it’s the reinforcement of those into continuous, harmonious forms that comes back as ‘beautiful and true’. So it’s a self-fulfilling model.”

Similarly basic is the body’s reaction to noise. It is one of the intriguing quirks of nature than we cannot shut our ears. Even in sleep, our brains must process sounds, relegate some to the background, examine others minutely for significance. But when we discern a rhythm, the effect on us is immediate and physical. It triggers the release of chemicals into the bloodstream that are directly linked to pleasure.

“Rhythms make us tap our feet and fingers, make us engage with them,” Robertson says. “And once we engage with those shared rhythmic structures, a whole interplay of hormones comes in – primarily the opioids, which are the brain’s self-reward system – that give us the ‘high’ rewards of pleasure and also decrease pain. Serotonin, for example, which also decreases aggression.”

But if the positive effects of music can be experienced internally, then what is the force that drives iPod users to break out of the sonic bubble in which they have immersed themselves and gather together at a stadium for a rock concert or for a karaoke night at the local pub?

Ian Cross, an accomplished guitarist and director of the Centre for Music and Science at the University of Cambridge, also believes “unambiguously” that sharing music can make us happy.

“Music is above all a communication system for the creation and maintenance of social relationships,” says Cross, who also attended the Wellcome talks. “A body of people listening to one piece of music is able to have both the same experience – that of the group – and each one a unique experience – that of the individual. But their shared affiliation with one rhythm acts as a kind of social glue.”

Robertson agrees. “Wellbeing – a healthy sense of oneself, and pleasure in oneself – comes when your internal identity is broadly congruent with that which you find outside,” he says. “I believe this is a profound model of healthiness, and so it’s not surprising that we would seek out shared experience that matches our own internal aesthetic.”

So can our increased consumption of music, both as individuals and groups, lead indefinitely to greater happiness? If hearing a march or a piece of uptempo dance music can stimulate opioid production, then can listening to one all the time produce a limitless amount of joy and mood elevation?

Ian Cross laughs politely at the suggestion. “There is no room in our heads for a limitless amount of happiness,” he says. “The way opioids work is no different to any other drug. The more you have them, the more you need to achieve the same effect.”

Indeed, there are already those who question the ubiquity of music in contemporary life. At a recent round-table discussion, influential figures in the pop world including singers Jarvis Cocker and Nick Cave wondered whether there was now too much music, whether by being such a constant part of our lives it had become devalued.

What effect, for example, does it have to listen to music for a living? I asked author and Telegraph opera critic Rupert Christiansen. “As I get older I need less music,” he says. “I used to listen to it all day, every day. But it’s something to do with the intensity of the experience. It’s as if one’s palate gets sated: you’re no longer a mainline addict, but you savour the taste all the more when it comes.”

Christiansen, however, takes issue with the idea of a direct link between music and happiness, seeing it more as a kind of emotional sauna. “Music is the most physically arousing of the arts – it makes your heart beat faster, opens up your pores, makes you sweat emotionally. That’s what it’s good at. I think it’s a myth that sad music makes you happy. It often makes me feel absolutely suicidal. But it exalts you – purges you of emotions. You find stiff-upper-lip people bursting into tears, or getting up and dancing. It makes it all come out.”

Looking back at the children’s assembly and Greensleeves, it is striking that although the music created a special moment, the occasion itself had a definite rarity value. We do not congregate formally in the way that man has for so many centuries through organised religion.

In a predominantly faithless world, music clearly fills some kind of spiritual gap in our lives. It seems to be the one element of religious celebration that we are not prepared to see die. Where so much of modern life induces a sense of introspection and isolation, music has a universality that stretches beyond the mere generation of happiness and makes us feel connected to the rest of the world.

“We are receptive to music all the way through life, right through to the end,” Paul Robertson says. “As we head towards decay and dementia, the last system to go is musical receptivity. You can still reach people and recover a powerful personal identity and recollection through music, even when you can no longer communicate with words.

“The nerve it touches is this: most of us feel a strong sense of identity around music. But we don’t have much of a grasp of why – what does it mean? And one thing we are all universally interested in is ourselves. So music is a way of understanding ourselves. And that’s pretty potent stuff.”

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