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MISHAWAKA, Ind. — Dr. Todd Graham wasn’t yet halfway through his workday at South Bend Orthopaedics when a new patient came into his office here complaining of chronic pain.

Heeding the many warnings of health officials, he told her opioids weren’t the appropriate treatment.


But she was accompanied by her husband, who insisted on a prescription. Graham held his ground. The husband grew irate. The argument escalated to the point that Graham pulled out his phone and started recording audio until the couple left.

Two hours later, the husband would return, armed.

Graham didn’t know that the shouting in his office wasn’t the end of the confrontation. It was frightening, he told his colleagues. But the incident two weeks ago wasn’t out of the ordinary — physicians here and across the country have grown increasingly accustomed to disputes over opioids. So Graham didn’t call the police. He didn’t file a report. He just kept seeing patients.

Many of his peers say they would’ve done the same thing. Many of them have.


Now, they’re not so sure.

That’s what they whispered to one another at the funeral five days later — the funeral for Dr. Graham.

Graham, 56, had worked in the community for decades. He was known for wearing a suit to most every appointment. For pushing patients to push themselves — to get out of bed even when it hurt. He and his wife had raised three children in the area, two daughters and a son, who was finishing his last year of residency and planning to return to town to practice medicine.

Dr. Todd Graham
Dr. Todd Graham South Bend Orthopaedics via Facebook

“He was really tough, but in a good way,” said Dustin Stacy, who credited Graham with helping him get out of a wheelchair and back on his feet when he didn’t think he ever would.

And now Graham was gone. Two hours after their verbal scuffle in the orthopedics office, Michael Jarvis — who had wanted that prescription so badly — had come after him again, this time in the parking lot. Again, Jarvis shouted. He ordered two people at a nearby picnic table to leave.

Then he pulled out a semiautomatic weapon and shot the doctor who wouldn’t give his wife pain pills.

Days after the July 26 murder, STAT interviewed doctors, law enforcement officials, and local residents to piece together the full story — and to understand how the shouts in the office and the gunshots in the parking lot have reverberated through this small Midwestern town.

Those reverberations echoed loudly at Graham’s funeral, when hundreds of mourners packed into the pews at Pius X Catholic Church. Among them were many of the area’s doctors — including Graham’s colleagues — who asked one another if they’d keep prescribing opioids.

“That fear was palpable, and this was among a group of orthopedists, who give tons of medicine because the things they do are painful,” said Dr. Mark Thompson, a local surgeon.

Dr. Brandon Zabukovic, a family medicine provider who also sees patients in treatment for opioid addiction, put it this way: “A lot of us right now are a little raw.”

In a modest town, opioids take hold

Mishawaka is home to 46,000 people, AM General’s Hummer plant, and plenty of cornfields. The median household income in this town — just a hop, a skip, and a jump from the University of Notre Dame — is $33,986. It is, by most measures, a modest Midwestern town.

It long thrived on the business of the Ball-Band rubber company, which made leather sneakers that were laced up on the feet of kids walking to school. Thousands of people here in the Princess City lined the streets and perched on the roofs of gas stations when 5,000 sticks of dynamite were tucked inside the factory’s five buildings on a summer day in 2000. A 9-year-old cancer survivor pressed the button to blow the buildings up into a massive cloud of milky-white dust at 8 a.m.

The opioid crisis is a quiet undercurrent in the area. There isn’t a “Methadone Mile” in Mishawaka — if there were, it’d stretch through a good part of town. More often, the overdoses take place in homes, whether in cookie-cutter subdivisions or subsidized apartments.

Across St. Joseph County, which includes Mishawaka, there were 59 overdose deaths last year, and 58 the year before. That’s more than the number of homicides and fatal car crashes — combined — in this quiet corner of northwest Indiana.

And the fatality numbers don’t begin to capture the depth of the problem: Last year, there were 384 overdoses so severe the victims required medical treatment.

“That fear was palpable, and this was among a group of orthopedists, who give tons of medicine because the things they do are painful.”

Dr. Mark Thompson, local physician

“This isn’t going away,” said Ken Cotter, the county prosecutor.

After shooting Graham in the parking lot, Jarvis, who was 48 and battling his own issues with addiction, sped off in his red Dodge Neon. He raced down Dragoon Trail, a road that parents tell their newly licensed teens to stay away from because the curves and the cars both come quick.

As police were swarming the murder scene in the parking lot, Jarvis called a friend and said he might not be around that much longer. Then he drove to his friend’s home and killed himself.

In the days since, Cotter’s phone in the prosecutor’s office has not stopped ringing. In the first few days after the murder, he fielded roughly 20 calls from doctors concerned about the safety of their patients, their staffs, and themselves.

Those calls are forcing him to rethink his own approach to the opioid crisis.

The historic stretch of downtown Mishawaka, Ind. Kristen Norman for STAT

A clash over how to help

Cotter is a hard-hitting prosecutor when he needs to be. He chugs Diet Mountain Dew in the morning as he gets to work on the county’s criminal cases. But he’s also softened his office’s stance on addiction since being elected in 2014. He expanded the purview of the county’s drug court to allow individuals who commit crimes driven by drug use — not just drug crimes — to seek treatment instead of jail time.

“If you’re someone who is just profiting off another person’s addiction and misery, I have zero problems getting you in prison for as long as I can,” Cotter said. But the majority of individuals in the area who are arrested for selling opioids are themselves struggling with addiction, Cotter said.

“They’re pinching off a little for themselves and selling it to support their habit. Those people I’m trying to get to treatment,” he said.

But until recently, Cotter hasn’t supported the full range of treatment.

He has long been opposed to the use of buprenorphine, a medication-assisted treatment to help individuals who are addicted to opioids wean off the drugs. It helps reduce cravings. But it is, in itself, an addictive substance. And Cotter saw it as simply swapping one opioid for another.

That changed after Graham’s death.

“I began talking to doctors who I respect very much, and they’ve shown me to reconsider that there might be a place for that,” Cotter said.

But Cotter and some area doctors still don’t see eye to eye on other ways to tackle the crisis. At a press conference after Graham’s murder, Zabukovic, the family medicine physician, said he’d like the town to discuss hosting a needle exchange. It’s an idea that many in this conservative community wouldn’t support — including Cotter, who stepped to the center of the stage to interrupt.

“I’m against drug safe zones. I’m not a fan of needle exchanges. I think all we’re doing is allowing people to die in a very nice place,” he explained in an interview.

Local newspaper clippings about Graham’s murder. Kristen Norman for STAT

They all do agree on one thing: There aren’t nearly enough resources to deal with the crisis. The closest medical detox is in Plymouth, Ind., 35 miles away. The nearest inpatient addiction center is in East Chicago, Ind., more than 80 miles west. Every homeless shelter in town is “dry,” meaning individuals who are still using drugs can’t come in and try to wean off opioids.

“Right now the best place for somebody to dry out is in jail. It’s not the best place, by far, but it’s the best place we have,” said Cotter.

Doctors, law enforcement officials, and mental health providers have tried to find ways to address the crisis. But up until now, those efforts have been largely been separate.

“[Doctors] have done a lot of good work, but they’ve been working in a silo. We’ve done a lot of good work, but we’ve been working in a silo,” said Cotter.

Now, Cotter and the rest of the law enforcement community are trying to figure out how to best support doctors who are afraid they can’t win either way — overprescribe opioids and they risk fueling the fire; refuse to prescribe and they risk losing a patient in need of help, or putting their staff and themselves in danger.

“The last thing we want doctors to worry about while prescribing is safety,” Cotter said. But doctors in the area say that’s something they’ve had to worry about for years.

“I have had knives pulled on me over narcotic prescriptions,” said Zabukovic. Six years ago, his practice stopped prescribing long-term opioids to anyone but cancer patients. Everyone else is referred to the pain specialist. Some patients left the practice over the decision, but it calmed things down in the clinic.

“Since then, it’s just how we do things, so there’s not a lot of argument,” said Zabukovic.

Some of the community’s doctors, for their part, said they want to focus on educating their peers about the proper way to prescribe opioids. They also want to double down on efforts to get their peers to use the state’s prescription drug monitoring program, dubbed INSPECT, which lets physicians look up a patient’s history of opioid prescriptions. Just 47 percent of Indiana’s health care providers were licensed to use the program in 2015.

Thompson, the surgeon, said he wanted to raise the idea at the state Legislature of requiring doctors use INSPECT, following the lead of New York and other states with aggressive prescription monitoring programs.

But he knows — everyone here knows — that that there isn’t one easy solution.

“I don’t think there’s a way to find the smallpox vaccine for this epidemic,” said Thompson.

St. Joseph County Prosecutor Ken Cotter fielded calls from more than a dozen doctors fearful for their safety after the murder. Kristen Norman for STAT

Doctors caught in the middle

Jarvis’s wife, who was in to see Graham that morning for pain, was a new patient. First-time patients who are seeking painkillers present a tricky problem for doctors who say they often need considerable time to diagnose what’s wrong with the patient and figure out how best to help.

If a patient demands the quick fix of an opioid prescription instead, the situation can swiftly escalate. But doctors say they’re not sure what to do when that happens. They often don’t want to call the police on a patient. Yet they don’t want to give in and write an unnecessary prescription, either.

They are all too aware of the stakes. Health care workers face a disproportionate share of violence in the workplace: An average of 146 attacks for every 10,000 workers, compared to seven assaults per 10,000 workers across the entire U.S. labor force, according to Bureau of Labor Statistics data from 2015.

“If patients become belligerent, what is the plan in your office? Do you have a back-up of a social worker, a psychologist? Do you have a plan to help take care of these patients that are upset?” said Steven Stanos, the president of the American Academy of Pain Medicine.

“If patients become belligerent, what is the plan in your office? Do you have a back-up of a social worker, a psychologist? Do you have a plan to help take care of these patients that are upset?”

Steven Stanos, American Academy of Pain Medicine.

That’s a question the St. Joseph County community is coming together to try to answer now. It’s not just about whether doctors decide to call the police — it’s also what, if anything, the police can actually do to help.

Cotter said he’d tell doctors to contact the police any time they feel uncomfortable. But, he admitted, most police officers wouldn’t have known how to respond appropriately. He likened it to a fight in a bar over rival football teams.

“What can the police do? They say, ‘Knock it off, knuckleheads,’” he said. “People get mad at each other all the time, that’s human nature. When does it cross the line? You shouldn’t have to make that call as a medical provider.”

Cotter said even if the police did toss a report about a belligerent patient on his desk, he wouldn’t have paid much attention to it before Graham’s murder. He would’ve seen it as the patient just “letting off steam.”

He’s still not sure what he’d do with such a report now. But he knows he would pay close attention.

Casey Ross contributed reporting.

  • Honestly until there is medications that help pain the way opiates do, you can’t deny a patient a life.

    If there pain is lower they may be able to handle other medications that can help. But when you have chronic illness and are intractable pain suffers then you should treat them and be able to do so without fear if government prosecution.

    Doctors need protection to treat with opiates as they see fit, if you e never had pain education. Following the guidelines is Nessessary. But for the chronically ill, we are the ones being pushed to the street not knowing how to dose yourself for pain relief, this is why the overdoses are rising after the CDC Guidelines and witch hunts on disability cries started.

    It’s scary knowing your wife may go into cardiac arrest if not tread red for pain properly.

    Not sure how bad his wife was.

    But I know if I was not treated adequately for my pain it would push me to pain induced suicide. I’d get a compassionate suicide from a Doctor, then at least the scar won’t be so bad on the family…

    More rules on drug wars cause more problems. Allowing people to use but offer education and help, that’s what saves epidemics like this..

    Just look at statistics in other countries that have decriminalized drugs, nearly everyone stopped that did it(they took the rebellion out of it) and all crime decreased dramatically..

  • I’ve been on narcotics for 35 years. Never had an overdose. Never even came close to an overdose. The danger of opioids is blown way out of proportion. Narc means “sleep”. When you take a little too much, it means you get sleepy and take a nap. You sleep it off. If you’re taking opioids to get high, that might be something different. But get it through your big fat thick skulls… pain patients are NOT people looking to get high. If I ever did once get “high”, I’m certainly NOT still getting high after 35 years of use.

    However, my idiot doctors decided I needed to be taken off all narcotics, cold turkey, about the same time as this shooting. I tried to go to methadone clinics to deal with my doctor forced withdrawal but surprise, surprise. Methadone clinics will not accept withdrawling pain patients under any circumstances. I, too, was ready to murder the idiots who forced this kind of pain on me. Their ideas are half-baked and poorly thought out. I’ve come to resent doctors who hold the monopoly over opioid access. I’m an adult. I’m in pain. Why should doctors have anything to do with my opioid access? I pay doctors for consultation. That’s it. My opioid consumption is none of any doctors business, although he thinks it IS his business. I’ve come to resent all doctors. I see them as arrogant know-it-alls. Pharmacists too. They’re concern does not seem to be the patient at all. They’re concern is somewhere else and I resent that. If their concern is elsewhere, none of these people should be made narco-gatekeepers.

    Portugal made all drugs legal and consumption, deaths, crime, addiction… all went down. Maybe doctors need to get off their high horse and allow adults to make decisions for themselves. You think so, idiots?

    • Portugal did NOT make all drugs “legal.” Portugal de-criminalized the possession and use of drugs. This means that people caught with drugs do not go to jail; they are provided with treatment options.
      The other part of your argument is also a little flawed. Doctors are under immense pressure right now to limit the prescriptions of opioid painkillers they write. This is due to the enormous number of overdoses, along with outrageous diversion and addiction rates. I agree that simply cutting someone who has been on painkillers off, without the option of gradually tapering or being referred to a pain clinic, is inappropriate. But look at it from their angle: doctors spend inordinate amounts of time and money becoming doctors. The decision to write these prescriptions can affect whether they are allowed to continue to practice – it can ruin their careers and their licenses can be suspended or revoked. This has to be a collaboration between doctor and patient, and not all of this one-sided decision making. Patients should not decide whether they want painkillers or not, and doctors should not abandon their patients when they have been on these drugs for a long time. It is a very tricky situation.

  • There isn’t ever a reason to injure or kill anyone unless in self defense or in the defense of someone else life. I fear this issue will become another political one where the patients along with doctors get used.

    We’ve seen how destructive social engineering is and politicians using issues to further their agenda or for votes and even money. I’m already scared to death that the opioid crackdown smells of money and politics.

    I know what it’s like to feel never ending severe chronic pain then have my pain treated under the close supervision of an excellent doctor which allowed me some quality of life.

    It is far from the good life but it’s a life being treated with the use of opiates, I had aches and pains in sports, military and 14 years at UPS but inoperable nerve damage, spinal damage, unsuccessful surgeries are on another level.

    I can only speak for myself but I didn’t know anything could put me in bed unable to do anything and when I was healthy you couldn’t have convinced me that was even possible.

    This opioid crackdown started in 2015 with some states putting laws in place that limit daily doses to 90MG no matter how bad your injuries and pain level are, it is a “guideline” in most states but enforced in such a way doctors fear jail or losing their license if not adhered to so you can see this will end up law in every state.

    I can understand caution for new patients and making sure the patient is severely injured on MRI/CAT/XRAY but for stable pain patients with years taking the proper dose to allow enough relief to get around and the patients taking their meds as directed and no problems why are we being cut back 66-70%?

    Why is it ok for bureaucrats to decide how much pain is acceptable for each individual’s pain/injuries? I have a dozen years of sports. Military, and 22 years of physical work, never took a Tylenol, didn’t drink, no drugs, and I get hurt and am 100% disabled, miserable, pain beyond anything I ever imagined then treated with opiates which allowed me to have some quality of life.

    A closed door meeting with the CDC/DEA and insurance companies has any fair minded person curious as to what this is really about. I know the stats that the self righteous talking heads on TV keep throwing around use heroin ODs and suicides, mixed meds, all being lumped in with pain patients .

    The insurance companies will save tens of millions under this crackdown (good they were in the closed door meeting) all we hear is how many lives will be saved but pain patient suicides are on the rise and will get worse.

    So doctors are being forced to violate the oath they took and now I am unable to do the simple things and can’t fathom the folks worse than me but I know they are out there but nobody is taking this issue seriously.

    It is brutal knowing that there is no relief coming and tomorrow will be the same or worse, it’s inhumane and I am more than offended that the talking heads on TV lump us in with heroin addicts or we are an acceptable loss for the greater good because it’s just wrong.

    This is going to be a huge failure and it crosses all lines but I don’t see anyone in power showing interest us, I do have a hunch that if someone in congress or the talking heads on TV were disabled in permanent extreme pain they would get enough opiate medication to manage their pain.

    It’s bad enough making in a month what I used to take home a week, can’t afford to get teeth fixed which mine were excellent but now my diet is soft foods, as if anyone would want to live like this then we have to hear about the opioid epidemic but the heroin addicts will still get high, people will sell their meds but we must pay for it?

    There will always be abuses by a small number of doctors and patients but these medications are tools and it is pain patients being painted with a wide brush today, it can be something you need tomorrow. I don’t know what would cause someone to hurt or kill a doctor but this isn’t the action of a pain patient.

    I know we have big issues to deal with as a country but to the millions of us disabled and did nothing wrong yet we’re in brutal pain this is a huge deal with no end in sight.

    • I missed the human element of this tragedy which is about a doctor that had a family but was put in an impossible position then murdered. I would be pretty mad if that was a loved one.

      I’m sure his patients are tore up too as I would be if someone did that to my doctor. I know as a patient of several years you get to know your doctor and they are part of your life in many cases.

      Please no repeats of this behavior it isn’t the doctors fault and doesn’t do pain patients any favors, my original post while accurate missed the mark but I have a lot of time on my hands while stuck in bed with a computer.

  • Utterly vile comment, either shameful trolling or genuinely despicable belief system. The prescription being sought was for the murderers wife so you are wholly incorrect in your statement. Homicide is not the solution for these situations

  • THEY’RE ALL EASY ANSWERS WHEN YOU HAVE IGNORANCE AND CORRUPTION IN CHARGE!!!! Get rid of the ignorant, greedy, evil, and corrupt people!

    Give the pain patients their medication so they don’t become desperate & provide a place for addicts with the money you use to jail them to get well. Problem solved!

  • Im shocked that the reporter who wrote this article was not able to find a way to blame or slam Trump for this doctor’s murder. That’s the usual way that business is done on this website.

    • This article represents how sick our society is, especially with the lying about the number of deaths attributed to opioids (CDC website “opioid related deaths polydrug use, more than one CNS depressant kills…why not blame it on the alcohol mixed with opioids instead of calling it an opioid death? Suicides are also thrown in many from uncontrolled pain!) The CDC has admitted this mistake, but the media continues to lie. They have an agenda.
      100 Million people are in chronic pain…where is the REAL epidemic? Why aren’t 100 Mill people represented in the media? Why aren’t they keeping track of people who are lined up to commit suicide if their lifeline to pain meds is cut? Why don’t people realize the level of corruption in the government (who controls the media), the FDA, the DEA, Big Pharma & government stock in it in Washington & the FDA?
      HOW can people be so sick & stupid to reject the most archaic harm reduction actions, when it’s NEVER had a negative effect when employed? WHY do they ignore the statistics on PORTUGAL! THE NETHERLANDS, SWITZERLAND & the Czech Republic who have had SUCCESS? Enormous REDUCTION (not increase) in addicts, blood born diseases, crime, etc?
      The answer HAS to be 1) they don’t care “why give them a comfortable place to die” the ignorant DA said. 2) They WANT people to die! And/or 3) They are just INCREDIBLY IGNORANT.
      The truth about pain management is it’s been so tightly controlled for so long, there are NO pill mills quickly shut down if one opens. A pain patient signs a contract that PREVENTS ANY DIVERSION!!!! PERIOD.
      The government has no business telling Drs how to practice medicine! They have NO training in pain or addiction. Shows the spread of corruption. They’ve limited the amount of pain pills that can be produced.
      Yet this ridiculous media says pain pills are everywhere, they’re coming from thin air? Like our money?
      The Dr said ” Opiates aren’t useful for chronic pain” WHY? The government told him that, studies have consistently proved opioids are effective for chronic pain. Why is the government saying they aren’t?
      The reporting immediately calls both him & his wife addicts with absolutely no proof!
      Addiction & pain are not the same, they require vastly different responses by Drs, only 2% of pain patients become addicted, & they are easily identified as having alcoholism, etc PRIOR to entering pain management.
      So whether the man who snapped was an addict, or frustrated that no one would help his wife is immaterial. Either way,

      Statements like the suboxone is “trading one opiate for another ” proves our government is IGNORANT & shouldn’t be involved in healthcare decisions including addiction, which is a disease as proven by MRI’s of addicts brains. Buperenophrine (suboxone, subutex) saves lives. It can’t make an addict high & has antidepressant properties in a high number of addicts, who are often self-medicating. It gives them time to work on underlying issues leading to addiction, at which time they can be easily weaned off. If they need to take it for the rest of their lives, isn’t that a better alternative to addiction, OD ing, crime, etc etc.
      This DA idiot says NO to helping addicts….because suboxone is $8 a pill for both name brand & generic, which is $4 to $8 a DAY & insurance would rather addicts be dead, dying in a UNCOMFORTABLE place, than pay that. (It’s $1 for suboxone in Australia, so the markup by Pharma is $7 a pill at least).

      Give this community to me & in a decade it will look like Mayberry! Not because I’m so smart & this is such a tough problem, but because it’s gov created (Purdue started the epidemic of pain pills by lying about Oxycontin & saying it wasn’t addictive AT ALL, resulting in our Drs handing it out like Candy (why are they educated by the drug company who is SELLING) the drug?!?!) Plead guilty, paid a fine of 3 mill per charge, also gave Oxy away $6 mill total, then made 2. 3 BILLION in 2007 alone) and the problems self created by greedy, unethical, totally corrupt and EVIL corporate & government.

      I’m a simple (former) psychologist and a chronic pain sufferer with the “most painful condition known to mankind” among other serious health issues, I have no insurance….but I have a brain.


      IGNORANCE KILLS, I think the government wants that. Ultimately, it’s about population control.

  • Class II medications cannot be e-scribed in the state of Indiana. However concealed carry is legal. When I lived and practiced there I would never be without a weapon.
    Let’s face the facts. The most important aspect in many people’s lives is to get high. The same people telling us not to prescribe addictive medications are the same who are advocating the legalization-and taxation- of marijuana. We are subject to the recommendations of the government hypocrites. Those desiring to abuse medication will obtain them. Sixty percent of those abusing pain medications don’t have a prescription. Patients would tell me Norco was for sale openly in the steel mills not far from Mishawaka. It was imported from Mexico. Not much was done about this as investigation would be time consuming. It is easier to work backwards from the Inspect program and target physicians who are trying to reduce the misery of those in chronic pain.

    • They’re working backwards. Think how this epidemic got started. (Purdue). Drs no longer care about relieving pain & misery, because the DEA & all government are breathing down their necks telling them how to do their jobs, why is the government practicing medicene?

      Addiction can be dealt with appropiately, but not by that DA

      That would clear the way for Drs to do their jobs. 100 mill in chronic pain, 60 Mill (overinflated by CDC, CDC apologized for the misinterpretation) 60 mill addicts….where is the epidemic?

      If the addicts life is so much more important than mine, then what is being done to help addicts?

  • Victoria
    AUGUST 10, 2017 AT 9:03 AM
    We can have better laws on guns, but those only work on the responsible citizen. On the streets guns are everywhere, they are stolen, they come in from other countries, if someone wants a gun, no matter what the laws are, they will easily get it with no problem. If not, he would have used a knife or ax.
    My comment.
    I copied this from the comments. You could replace guns with Opioids. On the streets , drugs are everywhere, they are stolen, they come in from other countries.If someone wants a drug, no matter what the laws are , they will easily get it with NO problem.
    Keeping pain medicine from chronic pain patents will not help the illegal drug problem and will not prevent the majority of the overdoses. It will and , IS making people suffer needlessly.

    • As one who was addicted at one time to Norco and got off of it I can understand your point. For a long period of time opiods were pushed by Pharma and Doctors. I’m not saying Dr. Graham did this. In fact he did the exact opposite in my treatment. He told me that my pain was chronic and that I needed to find another doctor to treat my pain. I did. Ten years later when my doctor stopped accepting my insurance I was forced to go to another doctor. I asked myself “Do you really want to be on this stuff for another 10 years?”. I tried over the counter remedies and they worked pretty well. It was tough to do but I am so glad I did. Dr Graham was consistent in his diagnoses from what I can tell. This whole thing is beyond tragic. In regard to gun laws. Bad people can get guns no matter what. I also agree with the other person who replied to my comment. It appears that this man was addicted to the pain meds himself. I feel I can safely assume that he was taking his wife’s script. I was simply giving and idea of how to “get the patient out of the office” in a violent situation. I do not think it would have helped in this one unless he was arrested. Perhaps lawmakers can toughen the criteria for detainment if a doctor is threatened. They do it with politicians. If there was a blow up at the office and Dr Graham would have been a Senator, Secret Service would have arrested him right there on the spot… The whole situation is so tragic.

    • That’s what’s happening 100 mill chronic pain patients & 60 mill addicts ( not just opiate addicts).

      WHERE IS THE EPIDEMIC HERE? Good people kill themselves every day due to untreated or undertreated pain. The SILENT epidemic, the media is controlled, this is a complicated situation, but only one side is told & they make the assumption he & his wife were addicts. Perhaps so.

      EASY EASY ANSWER give me control of that town, I guarantee it would look like Mayberry within 10 years.

      The problems are created by government & can be solved as they have in other Countries with regards to addiction. Government has no place in medicine,

  • I used to work at a bank. If we had a robbery we were instructed to give them the $ and get them out of the building asap. We live in a computer age and most scripts are electronic. Why couldn’t the DR. write the electronic script get them out of the building and then cancel and file a police report, then never see that patient again? Also have remote controlled audio and video controlled by the Dr that can be turned on from on his or her person in the event of difficulties. Just my thoughts.

    • The doctor could possibly do that with the script, but, as pointed out in the article, police can’t arrest someone for getting angry, justified or not. Even if Dr. Graham had called police after Jarvis left, that wouldn’t have stopped Jarvis from coming back later–if not that day, then, in 2 or 3–and shooting up the office.

      Remote controlled audio and video sounds too expensive for many clinics, and it probably wouldn’t have prevented violence in this case (since the doctor was recording with his cell). Perhaps it could be used for evidence, though.

      It will take lots of different efforts from many different parties–doctors, medical groups, other health care organizations, legislators, law enforcement, community groups, etc.–to make progress on this terrible issue.

    • Because, as was pointed out in the article, opioids cannot be e-scribed, but must. E written or printed out and handed to the patient. Canceling it after the fact is impossible unless you know for certain where the addict is going to bring that Rx to fill it.

    • How do you know the patient was an addict? (If he was, that’s the problem). Focusing on a end result is a horrible way to fix a problem, especially when you don’t even know what caused it.
      The Dr said “Opiates are not prescribed for pain”….no I’m not the lying media, he said “Opiates are not prescribed for chronic pain”,
      1) That’s the government, not Dr talking. He has to assess the patient to decide that & it is a time consuming process.
      2) The man was in considerable distress. It’s possible his wife needed the medication for pain, or he did, & fighting for pain control became too much when he realized the system he was fighting, he realized it was useless.
      3) If the Dr had written a low dose until he could fully assess the patient, both of them would still be alive.

      CONCLUSION: opioid phobia created by the media has made you dense, and the GOVERNMENT caused the death of 2 more people, whether he was an addict, pain patient, or he realized advocating for his wife was useless. The addiction problem is easily solved, as well as this murder/suicide. The comments of the DA prove it’s a self-created problem, caused by the GOVERNMENT. Why did the FDA allow Oxycontin to be marketed as totally non-addictive? Why are Drs educated by the Pharma co trying to SELL THEM SOMETHING? CONFLICT OF INTEREST MUCH? DRS handed out oxycontin like candy, a miracle painkiller that didn’t cause addiction or physical dependence. A epidemic was purposely created by Purdue & the FDA (which has stock in Purdue) & Purdue was found guilty of “mislabeling” & “giving out controlled substances without a prescription” ( If it caused NO physical dependence, why was it a controlled substance?) Purdue paid 3 Mill per charge & made 2.3 BILLION in 2007 ALONE. A LOT of people got rich off oxycontin, including Drs who had stock in it….they ARE the gatekeepers…
      So you have a Nation of addicts (though not NEARLY what the media reports CDC site & CDC apology for misinterpreting the data) and IDIOTS who know nothing about addiction or pain patients making laws with an agenda they sure as hell aren’t sharing with you…..and you wonder why one of these victims snapped & killed a Dr?

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