Opioid patients say they're in limbo after practice closes
By BRITTA GREENE
Jan. 08, 2018
NEW LONDON, N.H. (AP) — Dr. Anna Konopka, a physician in New London, surrendered her medical license in October to settle allegations from the New Hampshire Board of Medicine. Months later, she's still fighting to reopen her doors.
As her battle plays out in the courts, many of her patients are struggling to find a new primary care doctor. Many of them are low income and reliant on pain medication day-to-day.
Belinda Clark is one. In the winters, she lives in an RV on her mother's property in Charlestown, tucked down a back road in the woods. In the summers, she lives in a seasonal campground across the border in Vermont.
This annual migration is how she survives on her disability income of $12,000 a year. Moving back-and-forth is particularly difficult, though, for Clark because she's not supposed to carry much more than eight pounds at once. As she says, "no more weight than a gallon of milk."
She was working as a nurse in 2004 when a patient fell on her — hard, she said. She was left with permanent damage to her spine.
When Konopka settled complaints with the New Hampshire Board of Medicine this past fall, Clark got little notice she'd be losing her physician. Her pain medication is prescribed in one-month increments, so to stay on her current regimen, she knew she'd have to scramble to find someone else to give her an appointment in short order.
About three weeks after her last appointment, Clark hadn't found another doctor. Her strategy instead was to stretch her pain pills, take a lower dose. "Hence, the reason why, right now, my back is doing this," she said, clenching her fist in and out, "and my shoulders are hurting, just from sitting."
Without a doctor, Clark faces not just the return of debilitating pain, but also withdrawal. The same is true for dozens of Konopka's patients.
Just across the Connecticut River, for example, lives Michael Kennett. Like Clark, Kennett has a bad back. He's had four different surgeries, he said, and has a lung condition that makes it hard for him to breathe.
He heard the news that Konopka was closing her doors from the doctor directly, not long before he saw her for the last time. "I cried," he said. "I knew, if I didn't do something, I wouldn't make it through this winter."
He said Konopka tried to refer him to another doctor, but couldn't find anyone willing to take him on. He went through withdrawal after his Percocet ran out — vomiting, chills and shakes, he said. About a month later, he still wasn't feeling well.
Sitting at his kitchen table, he poured coffee in a mug, then poured cream in another. Looking down, he shook his head at the mistake. "I'm telling you," he said, "it's been a long night."
With the opioid crisis, doctors across the country are under increasing pressure around their opioid prescribing practices. Some say that's leading to unintended consequences for some chronic pain patients, people like Clark and Kennett who struggle to find primary care physicians willing to keep them on medication they've relied on in some cases for decades.
Dr. Gerard Hevern is medical director at a pain management center in Manchester. He said he's been seeing more and more referrals from other doctors in recent years, doctors unwilling to take on patients with chronic pain.
Many of Konopka's former patients say a pain specialist is not what they're looking for. They're looking for a primary care doctor, someone who will treat all their symptoms and learn their medical history and treatment plan, like they say Konopka did.
Kennett said he understands the scale of the opioid problem, but feels, in all the attempts to find a solution, people like him have been forgotten. "Our deaths are considered acceptable losses," he said. "We're old, we're close to dying. I don't know who's keeping score, but I'm not ready yet."
Details of the Board of Medicine's specific allegations relating to Konopka's practice remain sealed. It's difficult to know what exactly resulted in the doctor losing her license, but it's also difficult to know whether it's left her patients in any way better off than before.
Information from: WEVO-FM, http://www.nhpr.org/