Officials at the state medical licensing board confirmed this week that their agency last year began investigating allegations that a Vineyard physician was abusing the highly addictive prescription drug, OxyContin, and writing excessive prescriptions for the drug.
Under threat of a continuing investigation by the state board of registration in medicine, the physician, Thomas Lubin of Edgartown, officially retired from medical practice on May 22, 2002.
"The committee voted to close the complaint knowing that if Dr. Lubin decided not to retire, the investigation could be reopened," said board of registration spokeswoman Claudette Houle.
"Please let me know whether you are willing to permanently surrender your DEA certificate and restrict any future practice to conducting examinations and doing medical case reviews," an attorney for the state licensing board, James Barrett, wrote Dr. Lubin in April.
The agency, which licenses and regulates physicians in the state, ended the investigation in May and took no disciplinary action. Dr. Lubin, 52, denied all allegations, which were made by a former patient, according to documents obtained this week by the Gazette.
Dr. Lubin opened his general practice in 1996 at the Triangle in Edgartown and closed it last spring.
Information about the investigation into Dr. Lubin came to light in the aftermath of a drug bust two weeks ago in Newport, R.I., where three Vineyard residents were arrested in a sting operation by undercover detectives and then charged with conspiracy to buy and distribute OxyContin, a prescription painkiller made from oxycodone that replicates the effects of heroin.
The arrests of two men from Oak Bluffs and one from West Tisbury marked the first OxyContin bust connected to the Island, according to state police in Oak Bluffs, who believed the drugs were headed back to Martha's Vineyard.
When questioned about other OxyContin activity on the Island, state police Sgt. Jeffrey Stone acknowledged that police were probing complaints about an Island doctor's illegal involvement with the drug.
This week, Sergeant Stone confirmed that state police had received more than one complaint about Dr. Lubin, but they had referred the information to the federal Drug Enforcement Administration (DEA), where officials yesterday refused to comment about whether the doctor was the subject of any investigation.
But the state registration board's investigation began last November when a Vineyard resident wrote a letter to the state board's special investigator, Christopher Kiley. In the letter dated Nov. 30, 2001, the patient alleged that he went to Dr. Lubin in the summer of 1999 after knee surgery and was prescribed OxyContin.
"Prior to the summer of 1999, I had been a recovered alcoholic and drug addict for 15 years . . . Dr. Lubin was well aware of my drug and alcohol history," the patient wrote. "Almost immediately, I became addicted. Shortly after Dr. Lubin began prescribing the OxyContin, he told me that he hurt his back and asked me to give him a couple of pills for his own use. I did as he asked."
The letter detailed charges of escalating prescriptions: "Dr. Lubin would write prescriptions for OxyContin as often as weekly, usually for 120 40-mg tablets. . . . Dr. Lubin continued to require me to give him as many as 20 pills each time I filled a new prescription.
"I know he was doing this with other patients as well," he added.
The patient stated that his own addiction worsened to the point where he was taking between 500 and 600 milligrams of OxyContin a day. In an affidavit dated May 1, the patient also alleged that "Dr. Lubin showed me that by chewing the OxyContin tablets, I could obtain a better ‘high.'"
He stated that "Dr. Lubin frequently called me at home, on my cell phone, and would show up at various job sites to get pills from me."
Dr. Lubin responded to the initial charges in March, stating in a letter to the board that the complaint was false. He started his letter to the state agency by explaining that he was already planning to retire from medical practice because he had been diagnosed with hepatitis C.
The physician wrote that the patient who made the complaint suffered from depression and anxiety and came from a family with a history of mental illness and suicide. He also claimed, "It was the orthopedists who initiated his therapy with the narcotic OxyContin, not I."
Dr. Lubin also countered the allegations about excessive prescriptions and his own use of the drug. "He supposedly lost his prescriptions, or was too late in filling them, and I rewrote them," Dr. Lubin explained in his letter. "On several other occasions he came to me and told me he lost his medications, including one episode where his car was supposedly burglarized . . . As far as my writing prescriptions for him to provide for me, this is nonsense."
Yesterday, Dr. Lubin told the Gazette that the complaint was made maliciously. He also said that he believed that the state board of registration had acquitted him and not pressured him to turn in his medical license.
"I'm facing a liver transplant, and I decided I better retire. Before you can quit, you have to review any complaints for the last 10 years," he said in a telephone interview from Boston, where he is being treated for his hepatitis infection. "I was acquitted of all charges based on testimony from another patient."
But the chronology of the records obtained by the Gazette illustrate a building investigation that ended with the doctor's retirement.
Last January, the state investigator wrote Dr. Lubin and alerted him to the opening of a complaint against him: "The complaint alleges that you engaged in improper prescribing of controlled substances. Further, the complaint alleges that you took back portions of these prescriptions for your personal use."
In May, the board's complaint counsel, Mr. Barrett, wrote the Edgartown physician and asked whether he was willing to forfeit permanently his certificate from DEA allowing him to prescribe controlled substances.
While the investigation by the state board of registration into Dr. Lubin has been closed, it remains unclear whether federal drug enforcement officials will pursue any of the allegations.
But police and drug counselors on the Island remain concerned about the increasing abuse of OxyContin on the Island.
"It's a very powerful opiate, and it's easy to get into trouble with it," said Dr. Jane Dreeben, director of substance abuse counseling at the Island Counseling Center, an agency of Martha's Vineyard Community Services.
"We are still seeing more reports of heroin than OxyContin use, but use of OxyContin is clearly growing," she said.
Heroin is less expensive than OxyContin, but the morphine-like effects don't last as long as those achieved from OxyContin, said Sergeant Stone. A bag of heroin costs $25 to $40 compared to about $75 for one OxyContin pill, he said.
Meanwhile, Sergeant Stone said the arrests made in Rhode Island in September could lead to more arrests on the Vineyard. According to Newport police, Adam Robinson, 21, of West Tisbury, was released this week from jail on $5,000 bail.
Robert Kaye, 56, and Jason Bowes, 25, both of Oak Bluffs, remain in a Rhode Island jail, being held without bail. Mr. Bowes also goes by the name of Jason Blodgett.
Sgt. Russell Carlone of the Newport police narcotics division said he expects all three to enter a plea within the next week.