Merrick doctor wants pain pill case tossed

A Merrick doctor under indictment for allegedly writing illegal prescriptions for patients is asking a federal judge to dismiss the case against him and go after those he thinks are really at fault — the pharmaceutical companies who promoted the drugs while downplaying their risks.

Dr. Michael Belfiore, who lives in Westbury and practices in Merrick, was charged in 2014 with unlawfully prescribing oxycodone to an undercover Nassau County detective, and now faces further charges of illegally prescribing the drug to patients.

Belfiore wrote 5,000 prescriptions for 600,000 pain pills between January 2010 and March 2013, according to documents filed in U.S. District Court in Central Islip.

According to federal officials, 5,000 is “an extremely high number of oxycodone prescriptions and oxycodone pills issued by a sole family practitioner, especially in light of the defendant’s specialty area: general family medicine and dermatology.”

According to Belfiore and his attorney, Tom Liotti, the doctor bears little responsibility for providing the drug to his patients because federal guidelines and warnings about the danger of addiction did not exist until recently, and the medical community believed for years that opioids could be used to manage pain without significant fear of addiction.

“With all due respect to the government, its overly simplistic ‘knee-jerk’ presentment to the grand jury totally ignored these compelling factors and wrongfully placed the blame on Dr. Belfiore instead of where it belongs — on ‘Big Pharma,’” Liotti wrote in a recent motion. “The government should indict ‘Big Pharma’ and should consent to the voluntary dismissal of the charges against Dr. Belfiore, or the court should do so.”

In an interview, Liotti said that he is serious about going after the pharmaceutical companies. He may join an ongoing Suffolk County case as a plaintiff against Purdue Pharma, the company that created the powerful opioid medication OxyContin, for deceptive marketing.

Suffolk’s attorneys assert that the 11 companies and four doctors named in their suit launched a “coordinated, sophisticated and highly deceptive marketing campaign” to convince doctors and patients that the reward of using opioids outweighed the addictive medications’ risks.

Purdue paid a $600 million settlement in 2007 when three executives pleaded guilty in federal court to “misbranding” the medication, according to a New York Times report.

According to Liotti, federal lawsuits against Purdue and other industry giants over the addictiveness of the drugs and their alleged connection to growing rates of heroin abuse are often settled out of court, amounting to a “cash cow” for the government, and no “higher-ups” in the companies are held accountable.

Liotti plans to introduce documents from the Suffolk case as evidence, if Belfiore’s goes to trial, and also floated the idea of filing his own action against Purdue, among other companies also named in the Suffolk suit.

Liotti also intends to subpoena federal officials, including Sylvia Burwell, secretary of the Department of Health and Human Services, and Dr. Vivek Murthy, the U.S. surgeon general, to testify, should the case proceed to trial.

If the federal officials named in a recent filing, including Murthy, do testify, Liotti said, he intends to have them explain, under oath, “the history of the opioid epidemic and the government’s role in it.”

The federal Drug Enforcement Administration opened an investigation in 2013 into Belfiore’s practice after receiving many complaints by pharmacists, law enforcement officers and confidential sources, court documents state. The DEA then sent an undercover detective to the office claiming to suffer from back and shoulder pain.

According to documents, the officer was “examined by Belfiore for approximately 30 seconds.” After a brief discussion, Belfiore allegedly wrote the officer a prescription for 90 30-milligram oxycodone pills.

After the detective made statements to Belfiore that prosecutors claim should have raised any doctor’s eyebrows, including that he liked the way the pills made him feel, Belfiore allegedly still provided prescriptions to him on five occasions. The officer paid $275 in cash for each visit. At no point, documents state, did the officer provide “any documentation of his injury.”

Belfiore, however, argues that he was “induced, cajoled and persuaded” to break the law by the detective.

Belfiore adds that he discharged at least 50 patients because he believed they were abusing their medication, something that, along with other information he claims would have exonerated him, was kept from the grand jury.

In the filing, Belfiore and Liotti also refer to guidelines for patients taking opioids that Belfiore created independently before federal guidelines were available, as well as an agreement called “Long-term Controlled Substances Therapy for Chronic Pain” that he asked all his patients to sign.

Liotti claims that Belfiore always acted “with legitimate medical purpose,” and on the best knowledge available to him, with the federal government offering no guidance or warning about the addictive drugs.

“Dr. Belfiore, like many other doctors and their patients, is a victim of an opioid epidemic created by [Big Pharma companies] which encouraged the aggressive prescribing of opioids for chronic pain,” Liotti said. “While the government cannot indict itself, it has clearly misfired in this prosecution of Dr. Belfiore, a learned and caring physician who works tirelessly for his patients.”

The U.S. Attorney’s office declined to comment on Belfiore’s case, which is tentatively scheduled to go to trial in March.

The companies and individuals named in the Suffolk County suit, including Purdue, Janssen and Johnson & Johnson, will ask a judge to dismiss it, according to court documents. A conference with the judge is scheduled for Jan. 11.