I was a family doctor in Clarksburg, West Virginia, and I just wanted to help everybody. I would give them what they wanted, thinking I was helping them. I had some semblance of, They need this medicine. But they'd lose their medicine. It would fall down the sink. Or they'd lose their purse in Ohio, and then they didn't have their medicine, so it was another prescription. Word got out: I'm a nice guy, I take care of everybody. Soon, everybody seemed like they were on a controlled substance.
I started my residency in Clarksburg in 1979. In 1982, I and a couple other guys established a full service family practice. We were trying to take care of patients in the office, in the hospital. We delivered babies. A bunch of the older general practitioners retired, and they sent their patients to us. All three of us got really busy. It was a gonzo practice.
Practicing medicine was very difficult, the stresses of life were very hard. I had sample pain pills I could take, Lorcet and Vicodin samples. I’d dabbled with some Valium as a teenager, I’d taken some pain pills I had access to early in practice if I had a headache. But it really got fired up in the 90s. It progressed along to where I would write prescriptions for patients they would fill and bring back to me. Finally I didn’t have enough patients I could trust to do that with, so I’d just write prescriptions fraudulently and fill them for myself.
I had no idea if I would get caught. It didn't matter. I had to have hydrocodone. It was more important than oxygen. I was taking 40 pills a day—25,000 milligrams of acetaminophen every day. A toxic dose.
Between my own impairment, and the pressures of trying to take care of patients, my whole medical practice got really sloppy. I was over-prescribing to patients. The stuff was really dangerous, and we were reckless with it. I was reckless with it. What starts as 60 hydrocodone a month turns into 180. I didn’t have a lot of boundaries, and I didn’t know how to say no to people.
American medicine—as a whole—overprescribed, and that got us into this pickle. In the late 1990s the idea of the “fifth vital sign” came out, and we equated pain with pulse, blood pressure, temperature and respiration. All the professional organizations of doctors and hospitals taught us to believe we could and should control pain, so that patients could be pain-free. I take responsibility: I got addicted to the stuff, and I didn’t have any judgment. But the stage was set.
And the drug companies did promote to us the idea that the sustained-release opioids like Oxycontin were not addictive. It’s not the steady state that’s a problem, it’s the highs and lows, doctor. That had very little basis. What did we know? They were trusted colleagues.
I knew nothing about recovery. I knew nothing about addiction. We weren't trained in that. Didn't know anything about the brain science. I knew alcohol was dangerous. I knew that AA was a good program. I knew that NA was for drug addicts. I knew to send people to them, but it wasn't for me. It was for somebody else.
I was struggling. My marriage was failing. My children got estranged. I was working all the time. I knew I was struggling with addiction. Late one night I was caring for a patient in the intensive care unit. I met a nurse who was very peaceful and serene. I shared with her a little bit about my struggles. She said she’d pray for me. Over the course of getting to know Donetta, she shared the good news of Jesus Christ with me. In the spring of 2003, I gave my life to Christ. That fall, with God’s help, and with a whole bunch of people praying for me, I got clean. I’d tried to detox myself before, didn’t have much luck with that. Being dopesick is awful. This time it was easy. Donetta and I got married in January 2004.
Then, bang. The feds came in and raided my office.
What a mess I had made. And then they talked about incarceration, and felony, which were words I was not familiar with. Maybe I was a sloppy prescriber, maybe I was addicted, but I thought, surely there’s a way to work this out without losing my license and going to prison. When they say “United States of America versus Louis Ortenzio,” wow, it sounds like they’re coming at you with tanks. And essentially they are.
In March 2006 I pleaded guilty to prescription fraud and health care fraud. A lot of people wrote letters to the judge. I got home confinement for six months, and five years of probation, and restitution for the fraud. I’m still paying $200,000, $100 a month.
My medical license was revoked. I went to work cutting grass at a golf course. I sold office supplies. I delivered pizza for two and a half years. I really loved pizza delivery. I made pizza deliveries where I used to make house calls as a doctor. You go up to the door, you've got hot food in your bag, and the kids are screaming, "It's the pizza guy!" They're so excited. You give them the food, they give you money and a tip, and you drive away.
I had to face the fact that I overprescribed to people, and some had overdosed, and some had died. I had to make peace with folks. People told me, “Once we knew, doctor, that you were as addicted as our family members, we don’t hold you responsible. We hold you responsible, but we forgive you. We understand it’s easy to get caught up in this.”
I didn’t want to go to AA or NA where I had to say, “I’m Lou, I’m an addict.” I was no longer an addict. I didn’t know what I was. Jesus had delivered me from my substance abuse issues. He hadn’t delivered me from my underlying issues which fueled my addiction.
I met the director of the Clarksburg Mission and signed on to be the director of ministry at our homeless shelter. If my mission residents were going to Celebrate Recovery, I would check it out. In working the steps, I realized I had all these problems with people pleasing, being a nervous, anxious kind of guy. I got involved in Celebrate Recovery, and lo and behold I got a lot of freedom in that. This week we’re training 35 peer recovery coaches. I get to go to the federal prison in Morgantown—I'm a federal felon going to the federal prison, doing Celebrate Recovery there.
I've been clean 14 years, 11 months. God has a great plan to upcycle me, to give me more important work than I ever had as a family physician.
Lou Ortenzio, 65, is executive director of the Clarksburg Mission in Clarksburg, West Virginia.