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THE DAILY ASTORIAN • MONDAY, JANUARY 1, 2018
Armed with new data, officials target ‘drug-dealing’ doctors
By SADIE GURMAN
Associated Press
PITTSBURGH — The
pain clinic tucked into the cor-
ner of a low-slung suburban
strip mall was an open secret.
Patients would travel hun-
dreds of miles to see Dr.
Andrzej Zielke, eager for
what authorities described as a
steady flow of prescriptions for
the kinds of powerful painkill-
ers that ushered the nation into
its worst drug crisis in history.
At least one of Zielke’s
patients died of an overdose,
and prosecutors say others
became so dependent on oxy-
codone and other opioids they
would crowd his office, some-
times sleeping in the wait-
ing room. Some peddled their
pills near tumble-down store-
fronts and on blighted street
corners in addiction-plagued
parts of Allegheny County,
where deaths by drug overdose
reached record levels last year.
But Robert Cessar, a long-
time federal prosecutor, was
unaware of Zielke until Jus-
tice Department officials
handed him a binder of data
that, he said, confirmed what
pill-seekers from as far away
as Ohio and Virginia already
knew. The doctor who offered
ozone therapy and herbal pain
remedies was also prescrib-
ing highly addictive narcot-
ics to patients who didn’t need
them, according to an indict-
ment charging him with con-
spiracy and unlawfully distrib-
uting controlled substances.
Zielke denied he was over-
prescribing, telling AP he prac-
ticed alternative medicine and
many of his patients stopped
seeing him when he cut down
on pain pills.
His indictment in October
was the first by a nationwide
group of federal law enforce-
ment officials that, armed with
AP Photo/Keith Srakocic
Assistant U.S. Attorney Robert Cessar shows a map illustrating the rates of opioids pre-
scriptions by county during an interview in Pittsburgh. The Justice Department is giving
federal prosecutors in 12 regions ravaged by the opioid abuse epidemic a trove of data
officials say will help them stop over-prescribing doctors.
new access to a broader array
of prescription drug databases,
Medicaid and Medicare fig-
ures, coroners’ records and
other numbers compiled by the
Justice Department, aims to
stop fraudulent doctors faster
than before.
The department is provid-
ing a trove of data to the Opi-
oid Fraud and Abuse Detection
Unit, which draws together
authorities in 12 regions across
the country, that shows which
doctors are prescribing the
most, how far patients will
travel to see them and whether
any have died within 60 days
of receiving one of their pre-
scriptions,
among
other
information.
‘Shines a light’
Authorities have been
going after so-called “pill
mills” for years, but the new
approach brings additional fed-
eral resources to bear against
the escalating epidemic.
Where prosecutors would
spend months or longer build-
ing a case by relying on erratic
informants and only limited
data, the number-crunching by
analysts in Washington, D.C.,
provides information they say
lets them quickly zero in on a
region’s top opioid prescribers.
“This data shines a light
we’ve never had before,” Ces-
sar said. “We don’t need to
have confidential informants
on the street to start a case.
Now, we have someone behind
a computer screen who is help-
ing us. That has to put (doc-
tors) on notice that we have
new tools.”
And Rod Rosenstein, dep-
uty attorney general, told AP
the Justice Department will
consider going after any law-
breaker, even a pharmaceu-
tical company, as it seeks to
bring more cases and reduce
the number of unwarranted
prescriptions.
Attorney General Jeff
Sessions has been in lock-
step with President Don-
ald Trump about the need to
combat the drug abuse prob-
lem that claimed more than
64,000 lives in 2016, a prior-
ity that resonates with Trump’s
working-class supporters who
have seen the ravages of drug
abuse firsthand. The presi-
dent called it a public health
emergency, a declaration that
allows the government to redi-
rect resources in various ways
to fight opioid abuse.
But he directed no new
federal money to deal with a
scourge that kills nearly 100
people a day, and critics say
his efforts fall short of what is
needed. The Republican-con-
trolled Congress doesn’t seem
eager to put extra money
toward the problem.
While the effectiveness of
the Trump administration’s
broader strategy remains to be
seen, the Justice Department’s
data-driven effort is one small
area where federal prosecutors
say they can have an impact.
The data analysis provides
clues about who may be break-
ing the law that are then cor-
roborated with old-fashioned
detective work — tips from
informants or undercover
office visits, said Shawn A.
Brokos, a supervisory special
agent in the FBI’s Pittsburgh
division. Investigators can also
get a sense for where displaced
patients will turn next.
Authorities acknowledge
there are legitimate reasons for
some doctors to prescribe large
quantities of opioids, and high
prescribing alone doesn’t nec-
essarily trigger extra scrutiny.
What raises red flags for inves-
tigators are the dentists, psy-
chiatrists and gynecologists
who are prescribing at surpris-
ingly high rates.
The effort operates on the
long-held perception that drug
addiction often starts with pre-
scriptions from doctors and
leads to abuse of more dan-
gerous black market drugs like
fentanyl, which, for the first
time last year, contributed to
more overdose deaths than any
other legal or illegal drug, sur-
passing pain pills and heroin.
But that focus can cause
law-abiding physicians to
abandon disabled patients
who rely on prescriptions, for
fear of being shut down, said
University of Alabama addic-
tion researcher Stefan Kertesz.
Those patients will turn to
harder street drugs or even kill
themselves, he said.
“The professional risk for
physicians is so high that the
natural tendency is to get out
of the business of prescription
opioids at all,” he said.
Another addiction expert,
Dr. Andrew Kolodny, founder
of Physicians for Responsi-
ble Opioid Prescribing, said
prosecutors’ emphasis on
“drug-dealing doctors” is
appropriate but inadequate on
its own.
“It’s just not really going to
have that much of an impact
on an epidemic,” he said. The
bigger change will come from
a stronger push for preven-
tion and treatment, he said.
And, he added, “They should
go after the bigger fish … the
legal narcotics distributors and
wholesalers who have literally
been getting away with mass
manslaughter.”
$250 a visit
Investigators said Zielke
charged $250 a visit and made
patients pay in cash. But Zielke
said prosecutors unfairly tar-
geted him. Instead of more
prosecutions, he said, the gov-
ernment “should promote
more alternative therapies,”
he said. “And they should find
out why so many people have
pain.”
A second indictment by
the anti-fraud unit involved a
cardiologist in Elko, Nevada,
accused of routinely pro-
viding patients fentanyl and
other painkillers they did not
need. Justice officials hope to
expand the data-driven work
nationwide.
Will it work? As Soo Song,
who watched addiction warp
communities while serving as
acting U.S. attorney in western
Pennyslvania, put it: “The best
measure of success will be if
fewer people die.”
Keeth: Memorial
set for Saturday
at Camp Rilea
Continued from Page 1A
Pacific National Monument,
told The Oregonian ear-
lier this year there are likely
fewer than 2,000 Pearl Har-
bor survivors left.
Keeth joined the Army
at 16 and was stationed at
Schofield Barracks in Hono-
lulu. He was on kitchen duty
at the time of the attack on
Dec. 7, 1941.
“He went out to dump
potato peelings, and he
heard unexpected sounds of
planes,” Barnett said. “Then
he looked up, and saw the
rising sun on the planes.”
Her father didn’t talk
about the attack much, she
said, besides that he watched
several of his friends die.
Keeth served in the Pacific
during World War II, includ-
ing battles at Guadalcanal
and in the Solomon Islands.
In a 1944 interview with the
the Yakima Herald, Keeth
described surviving nearby
shell explosions, a 19-day
siege and being shot at and
missed from 3 yards away.
“He could have touched
me with his rifle,” Keeth told
the newspaper of his run-in
with the Japanese soldier. “I
don’t know how he happened
to miss.”
After the war, Keeth mar-
ried Ruby, and the couple
had four children and nine
grandchildren. Most of the
family still resides in Yakima
Valley, Barnett said. Keeth
attended Perry Trade School
and learned to be a mechanic
who specialized in bodies
and fenders.
“Dad was so handy,”
Barnett said, describing her
father taking apart a surplus
house at Fort Vancouver,
Washington, and reassem-
bling it as the family home
in Wapato. “He self-taught
himself to do everything.”
Keeth strung together
jobs picking fruit, baking
and working at local auto-
motive shops before spend-
ing 30 years as the shop fore-
man servicing vehicles on
the federal Wapato Irriga-
tion Project in the Yakima
Valley. After retiring, Keeth
volunteered at local parks
and drove buses part time for
the school district and fruit
farmers.
Ruby Keeth cared for her
husband until falling and
breaking her hip, after which
he moved to Hammond.
Keeth was quickly embraced
by local veterans and other
volunteer organizations, who
outfitted Barnett’s house with
ramps for Keeth’s wheelchair
and a specialized shower. He
became especially popular at
Camp Rilea Armed Forces
Training Center, where he
once visited for a doctor’s
appointment and ended up
having lunch with an entire
troop.
“There were so many
people wanting to meet
him,” Barnett said. “Some
grown men, my age, would
walk away crying. He would
remind them of someone in
their family. They’d be so
touched by meeting dad.
“At the end, they all said,
‘Thank you Mr. Keeth for
joining us today.’ Camp Rilea
was just amazing to dad.”
A memorial for Keeth
will be held Saturday at
Camp Rilea.
The Daily Astorian
Local brewers and distillers will reap some of the savings in the Tax Cuts and Jobs Act recently passed by Congress.
Tax plan: ‘Long overdue for the spirit industry’
Continued from Page 1A
Most Oregon-based brew-
eries fall well under the thresh-
old of the tax cut. Fort George
Brewery, the largest in Clat-
sop County, sold fewer than
14,000 barrels in the state last
year, according to the Oregon
Liquor Control Commission.
Jack Harris, co-owner of Fort
George, said the tax cut for
craft brewers has been a long
time coming.
“That was good news that
it passed, but unfortunate that
it passed with so many other
controversial issues,” Harris
said.
Bob Pease, CEO of the
Brewers Association in Boul-
der, Colorado, represent-
ing small and independent
craft brewers, said he has
been working on cutting bar-
rel excise taxes for nearly a
decade.
“It’s significant, because
the current (excise tax) rate
has been in place since 1976,”
he said. “Our belief is that
breweries will take the sav-
ings and reinvest them in their
businesses.”
The association would have
liked the alcohol legislation to
be passed on its own but were
told that was unrealistic, Pease
said.
Lawrence Cary, co-owner
of Pilot House Distilling, said
the reduction in liquor taxes
will help with his company’s
expansion.
“It’s long overdue for the
spirit industry,” Cary said,
adding he’d like keep his opin-
ions on the overall tax plan
to himself. “With this, you
might see a little boom in our
production.”
Wyden, a co-chairman of
the Senate Bipartisan Small
Brewers Caucus, introduced
the Craft Beverage Modern-
ization and Tax Reform Act
in 2015 to reduce taxes and
compliance rules for brewers,
cideries, vintners and distillers.
The bill was a combination of
previously attempted legisla-
tion to help the industries and
had broad, bipartisan support.
The Los Angeles Times
reported that including pro-
visions of the bill in the tax
plan was part of an unsuc-
cessful effort by Republicans
to curry Wyden’s favor and
vote. Wyden spokesman Hank
Stern told Willamette Week
the effort was a non-starter.
Wyden and other Senate Dem-
ocrats opposed the tax plan.
“Senator Wyden was and is
proud to lead the fight against
a bill that showers corpora-
tions with goodies and raises
taxes on over half of the mid-
dle class,” Stern said.
Fryberger: Background includes jobs in nonprofits, database management
Continued from Page 1A
Oceanside, near Tillamook, but
for a while she thought Hood
River would become her next
home. Those plans changed
and, after some test visits, she
made the leap to Astoria.
She brought a tech job with
her, but she hoped to land a
local job, perhaps in data-
base management. The search
proved to be harder than she’d
expected. She landed at Coast
Community Radio as a vol-
unteer. When former mem-
bership specialist J.D. Wells
announced he would be leav-
ing the job for health reasons,
Joanne Rideout, the former
station manager who transi-
tioned to a news director role
in November, suddenly had an
opening on the station’s small
staff. Fryberger got the job.
“We take it quite seri-
ously when we hire someone,
because we are a small group
and work closely together,”
Rideout said. She consid-
ers Fryberger to be part of a
“wonderful renaissance” at
the station.
“(Fryberger) is smart,
wise, efficient and full of
new, great ideas,” Rideout
said. “In the short time she’s
been with us, she’s made
great strides in raising reve-
nue and strengthening con-
nections to our members. But,
best of all, she’s a delightful
co-worker — a great person
to spend time with. She’s a
terrific addition to our team.”
For Fryberger, whose
background includes diverse
jobs in nonprofits, database
management,
bookstores,
event production and tech, the
station is the community hub
she was looking for. And for-
get Hawaii, she says, Astoria
is her paradise.