Tweet Led to Dr. Kline Losing His DEA License

By Pat Anson, PNN Editor

A complaint from a woman in upstate New York launched the investigation that recently led to a North Carolina doctor losing his DEA license. Julie Roy doesn’t know Dr. Thomas Kline or any of his patients, but claimed he was dangerous and that “someone can die” because Kline believes opioids are rarely addictive.

Kline surrendered his DEA license to investigators with the North Carolina Medical Board last month.  He is still able to practice medicine but can no longer prescribe opioids and other controlled substances, leaving his 34 patients in medical limbo. All of them suffer from chronic pain and rare diseases that other doctors are increasingly unwilling to treat because they fear coming under scrutiny for opioid prescribing

“I do feel bad for the patients that were affected,” Roy told North Carolina Health News, which first reported on her role in the Kline investigation.

Roy became upset with Kline because he has been an outspoken advocate for pain patients online. Roy’s 26-year old son died from a heroin overdose and she took offense when Kline posted a Tweet last year stating that “opiates work fine without addiction potential” in 99.5% of people.    

She tweeted the North Carolina Medical Board on May 15, saying “this is a doctor that you allow to have an active license. He would love to prescribe every person on earth an opioid.”

NORTH CAROLINA HEALTH NEWS

That same day, Roy made a formal complaint with the medical board against Kline, making a series of unsubstantiated claims about the doctor.

“He is giving out information regarding opioids that is not correct and could cause harm,” she wrote. “I am very concerned as pain patients believe what he says. He says opioids are only addictive to someone who is genetically prone plus a ton of other misinformation.”

Roy even claimed that Kline might be “suffering from substance use disorder himself.”

“The man should not have an active license with his pro opioid perception. The information he puts out alone could cause harm. I would like you to verify (t)hat he is not writing opioid prescription,” Roy wrote.  

Kline Caught Off Guard

Kline responded in writing to Roy’s complaint in July, telling the medical board the information he shared about opioids was accurate and backed up by research. He also denied taking opioids or having a substance use disorder.

“Ms. Roy has lost a son to opiate addiction. Losing a child is the worst of all tragedies. This tragedy could have been avoided with the new knowledge I am presenting in my published research and public talks urging for early identification and treatment of opiate addiction to stop deaths in people like Ms. Roy’s son,” Kline said.

Because none of his patients were harmed by his prescribing and no other complaints were filed against him, Kline thought that would be the end of the matter – even when the medical board asked to review the records of nine of his patients.

Kline was caught off guard when investigators made a surprise visit to his office in Raleigh on February 17 and told him to surrender his DEA license. He did so voluntarily, not realizing at the time that it was unlikely he’d ever get the license back.  

No formal charges have been made against Kline and the medical board won’t comment on the status of the investigation — which could drag on for several more months.

Kline says he’s been able to find new doctors for a handful of his patients, but others are suffering due to untreated pain or running low on their prescriptions.

Ironically, Roy was once a pain patient herself and was on long-term opioid therapy after a failed back surgery. She told NC Health News that her pain medication stopped working, so she switched to buprenorphine (Suboxone), another opioid that’s usually prescribed to treat addiction.

Fighting Medical Injustice in North Carolina

By Michael Harmon, Guest Columnist

I’m writing on behalf of my wife Lynda, a 30-year victim of fibromyalgia. Lynda was hit by a drunk driver in 1985 and despite years of neurological testing and procedures, we were unable to stop this dreaded disease from spreading throughout her body.

By 1993, she was confined to a chair and faced 24/7 pain. Regrettably, the only plausible outcome in her mind was possible suicide, a place many with chronic pain find themselves.

Then we found a doctor willing to prescribe methadone. The medication worked and Lynda was given back a small semblance of life. It was still a very limited lifestyle, but she could occasionally shop, go to dinners, drive and take care of her house. 

Two other doctors carried on this fight for the next 20 years, with the same prescription and same dosage. They were years that my daughter and I counted as bonus years, given the dark periods of the early 1990’s.

Then the CDC got involved with its 2016 guideline establishing voluntary, not mandatory, amounts allowed for opioid prescriptions. The guideline led to forced tapering of patients, and penal sanctions and revocation of medical licenses for doctors found to be non-compliant with the new “standard of care.”

LYNDA HARMON

In 2018, Lynda’s pain doctor started the tapering protocol, and immediately we saw her tailspin into a dark depression. She knew what was coming! Her methadone dosage was cut to about 15-20% of her normal prescription levels of the past 25 years.

By early 2019 she was once again in a chair, rocking in pain, 24/7. And yes, suicide was once again on the table. But hey, the government was happy, the politicians were happy, and her doctor wasn’t going to lose her livelihood!

Befriending Dr. Thomas Kline

I met Dr Thomas Kline in February of 2019 after reading an article he wrote that chronicles in detail over 30 pain patients who took their lives as a result of being tapered. I befriended this “true healer” and wanted to help him bring awareness of this injustice any way I could.

After 6 months of talking and working on these issues, Dr. Kline asked me one day if he could help Lynda. I knew he was not taking patients and I never asked him to help Lynda, I just wanted to help him bring light to this terrible problem.

Dr. Kline met Lynda in August and after lengthy interviews, examinations and medical testing, Lynda switched her pain care to Dr. Kline. We were delighted!  

DR. THOMAS KLINE

The protocol of methadone was slowly and professionally raised each month, and by January 2020 Lynda’s mood lifted. Thoughts of suicide disappeared, and movement of her extremities became easier and free of pain. You could tell her life was being returned to her.

Then came the news of last Monday, February 17 that Dr. Kline was under investigation by the North Carolina Medical Board.

He was told to surrender his DEA license, which means he can no longer prescribe opioid medication. All 34 of his patients were left in limbo, basically thrown to the wolves.

Who could do such a thing? Is this truly a medical board of doctors who made an oath to alleviate pain and suffering? Tell me, what are these 34 patients supposed to do? No doctor will take their case, for fear of losing their own livelihood.  

Lynda has only a few days left of her last prescription, as she was due to pick up her monthly meds last Tuesday, the day after receiving the news of Dr. Kline’s suspension. This type of oversight is inhumane and should have no place in a modern society. I would argue that we treat our pets better than this!  

Now don’t get me wrong, I am fully supportive of the President’s effort to fight the opioid crisis on the streets of America, on our borders, internationally and in hospitals. I agree wholeheartedly to the jailing of doctors that write scripts to bogus patients who profit from the sale of the drugs on the street. This is abhorrent.  

But the people we are talking about, people like my wife, have been on these medical protocols for chronic pain for 10, 20 and 30 years plus! They are functioning citizens of our society. These people have mortgages, car payments, and children in college. How are they going to work without the medicines needed to overcome their daily pain?   

Some are military veterans who were busted up and blown up, defending our freedom. One veteran commenting on the tapering of his pain meds was recently quoted as saying, “Once again my country has asked me to lay down my life!” 

Lynda and I consulted with three doctors last week, doctors of the highest repute, and each of them had no answer to this horrible matter. How can this be?  

Perhaps Dr. Kline’s DEA license will be reinstated, maybe not. Life will go on for this kind man and perhaps he will begin to enjoy the retirement he had seen for himself and his family when he moved to Raleigh. For that I am happy. This truly is a doctor who cares, and cares enough to push the limits in order to help improve the human condition.  

But what about his 34 patients? What about other patients around the country who, like Lynda, are on the threshold of suicide?  What are they going to do? They no longer have a Dr. Kline in their lives or a government that cares. If they did care, they would not be investigating a great doctor like Dr. Kline. They'd be empowering him and others to get in the middle of this injustice and fix it! 

Michael and Lynda Harmon live in South Carolina.

Pain News Network invites other readers to share their stories with us. Send them to:  editor@PainNewsNetwork.org.

Pain Patients Left in Limbo by Dr. Kline Investigation

By Pat Anson, PNN Editor

They call themselves the “NC 34” – thirty-four patients left in limbo after the North Carolina Medical Board told their doctor this week to surrender his DEA license. Without that license, Dr. Thomas Kline can no longer prescribe opioid pain medication and other controlled substances.

Kline’s 34 patients, who all suffer from chronic and rare diseases, now face the imminent prospect of withdrawal and uncontrolled pain when they run out of opioid medication in the next few weeks or days.

“The board has no idea how irresponsible their actions were taking away Dr. Kline's DEA license, because the board has adversely affected the lives of 34 of Dr. Kline's chronic pain patients, all of whom are pain refugees and all of whom require opiate therapy on a daily basis in order to have some semblance of a quality of life,” says Leslie Bythewood, a Kline patient who lives with hypothyroidism and Chiari malformation of the brain, which causes severe migraines and cluster headaches.

“When our pain meds run out, we are going to go through not only withdrawal but our original pain is going to rise exponentially and make our lives miserable, insufferable and totally unlivable once again.”

As PNN has reported, the North Carolina Medical Board won’t say why it is investigating the 76-year old Kline, who until now had no record of any complaint or disciplinary action taken against him.

Kline has no idea why his practice has come under scrutiny. In recent years, he’s become an outspoken advocate for pain patients — maintaining that doctors should decide when and how to treat their patients with opioids, not state medical boards or the DEA.

Kline says he was pressured by state investigators into surrendering his DEA license when they made a surprise visit to his office in Raleigh on Monday – a decision he now regrets.

“I was never notified when these inspectors came out that it was voluntary. They called me on the phone and said they were coming by in two hours to get you to surrender your license,” Kline told PNN. “I’ve been telling doctors, ‘Never surrender your license.’  But I thought this was something different. And it threw me for a loop as to why this is coming from the medical board.”

‘I Have 7 Days of Meds Left’

Kline’s medical license remains active and he can still see patients, he just can’t write prescriptions for opioids or other controlled medications. Kline has urged all 34 patients to find new prescribers.  

“All of the patients have been searching and searching and searching and they can’t find anyone,” says Kline, who treats several out-of-state patients who travel hundreds of miles to see him because they can’t find a local provider willing to treat them.

Opioid hysteria, fear of prosecution and medical discrimination have made doctors and pharmacists reluctant to accept new pain patients, particularly those on high opioid doses.  

“Right now, prospects are slim of finding either a provider or a pharmacy.  I don't know what is going to happen,” said Jeff Geurin, a disabled Air Force veteran in Georgia who was injured in a parachute accident.

“I have severe chronic pain, the only relief from which has come from high-dose opiate medications.  After the VA discontinued all veterans off pain meds in 2015, and shortly thereafter the civilian doctors, I was out of options. I was planning my suicide in 2018, and two weeks before my planned exit, Dr. Kline rescued me.”

While under Kline’s care, Geurin says he’s been able to live a relatively normal life. He was thrilled recently to land a job as a 911 dispatcher.

“I have about 7 days of meds left, so I'm going to be hurting and withdrawing while starting a new job. I'm scared, I'm angry, and I'm sad for all the other patients of Dr. Kline who have been ripped from stability and pain control for no good reason,” Geurin wrote in an email. 

“This board is putting all our lives at risk by keeping him from prescribing to us.”

— Kristina Mitchell, Kline patient

“There's another patient that is already talking of suicide. And what are you supposed to say to him? No, don't do it? That would be like telling the people trapped in the North Tower on 9/11 not to jump, they have to stay in the tower and burn to death.”  

“I am almost ready to check myself out of this life, because I can't seem to find a single caring physician since Dr. Kline lost his DEA license, and I know for a fact that I simply cannot live with this constant, intense pain,” said Bythewood.

“I deserve the right to proper medical care. A diabetic isn’t denied insulin, but pain patients are being targeted because of an opioid epidemic,” said Colleen Davis-Harrison, a Kline patient who has multiple sclerosis and arachnoiditis, a chronic inflammation of spinal nerves. “I will support Dr. Kline and my fellow patients. I just hope no one gets hurt or does something stupid while others wait to see what’s in the cards for us.” 

“I do not have another doctor to write my prescriptions. I had already exhausted all of my options in my state when I went to Dr. Kline,” said Kristina Mitchell, a patient with Ehlers-Danlos syndrome (EDS) who lives in Virginia. “Without him I don't know what I will do. Withdrawal is not my concern, that won't last. The full force of my pain coming back is my greatest fear and I know I can't handle it. 

“I hope this gives you a general idea of what an amazing, good, caring and life-saving doctor Kline is. Without him, myself and 33 other people may not be here today. This board is putting all our lives at risk by keeping him from prescribing to us.” 

Duping of Healthcare Providers

Will Kline be able to get his DEA license back? One expert says that is unlikely. 

“I have never heard of any controlled substance registrant who surrendered or otherwise lost a controlled substance registration being able to get it back from the DEA,” said attorney Michael Barnes, who is managing partner at DCBA Law & Policy, a law firm that advises healthcare providers.

Barnes tells clients not to be intimidated by DEA or medical board investigators who claim that surrendering a license is only temporary.

“If you surrender that authority, it doesn’t matter if there used to be a piece of paper. Surrendering of the authority is saying ‘I’m giving up my right to prescribe.’ This is part of the duping of healthcare providers, where they think they are doing one thing. In reality they’re doing something that’s permanent,” Kline told PNN.  

The North Carolina Medical Board’s investigation of Kline apparently began a few months ago, when it asked him for the records of nine patients. A spokeswoman for the board told PNN that investigations of healthcare providers typically take six months to a year to complete. 

In the interim, Barnes says the board should be proactive and make sure the “NC 34” are getting the care that they need. 

“The board should ensure that each of those patients receive a referral to a qualified, certified pain treatment professional who is capable of meeting these patients’ unique medical needs,” Barnes said. “The medical board really has an obligation, not just to give a paper with some addresses on it, but to make certain that each of these individuals is accepted into a practice and actually receives medical care.”

“The medical board has made a big mistake and has taken one of the finest doctors I have ever known, the only doctor I have ever trusted,” says Jess Stewart, another Kline patient who lives with EDS. “He wasn’t a pill mill doctor and instead of being worried about him I would be more focused on the illicit fentanyl out on the streets. You see, it’s actions like this that are forcing people to the streets. 

“Do I need another doctor? Now I do, thanks to the board. But there was nothing wrong with the one I had.”

North Carolina Investigating Pain Patient Advocate

By Pat Anson, PNN Editor

Dr. Thomas Kline, a North Carolina physician who is an outspoken advocate for chronic pain patients, is under investigation by his state’s medical board, PNN has learned.

Kline voluntarily surrendered his DEA license to North Carolina Medical Board investigators on Monday, which temporarily prohibits him from prescribing opioid pain medication and other controlled substances to his patients.

The reason for the investigation has not been made public. Kline’s practice in Raleigh, NC specializes in treating patients with chronic and rare diseases, including some on relatively high doses of opioid medication. Kline has been a vocal critic of efforts to rein in opioid prescribing.

"Dr. Kline surrendered his DEA license voluntarily, at the request of the NC Medical Board. In connection with the surrender of his DEA license, Dr. Kline also provided medical records of his patients to NC Medical Board,” Kline’s office said in a statement. 

“Dr. Kline will cooperate with the Board in order to ensure the well-being of his patients. Dr. Kline cares deeply about his patients and their needs at this time. However, he can no longer provide them with opiate pain medication.” 

The state medical board would not comment on the investigation.

DR. THOMAS KLINE

“At this point there has been no public action taken, so I’m not able to confirm or deny what may have occurred with this licensee,” said Jean Brinkley, a spokeswoman for the North Carolina Medical Board. “Investigations are confidential under North Carolina law, so until there’s been an action that’s made public, we can’t discuss it.”

The medical board has no public record of any complaint or disciplinary action against Kline. “As of now, Dr. Kline has an active medical license with no specific restrictions from the board,” Brinkley told PNN.

Without his DEA license, Kline will be unable to prescribe opioids and other controlled substances until the state’s investigation is completed. A typical “quality of care” investigation by the board takes six months to a year to complete, according to Brinkley.

“The average number of days to close a case, from the date it was opened to the date it was closed, was 104 days in 2019. But I will say quality of care cases, because of the need to obtain an independent medical review, typically take longer than that,” she said.

In public hearings, news stories, social media and his own YouTube channel, Kline seeks to expose some of the myths surrounding opioid medication and the damage done to millions of patients who’ve been abruptly tapered off opioids because of fears about addiction.

“This has never been done before in the history of medicine, at least in this country, where people are forced to stop taking medicine that is effective, is working, without side effects, against their will,” Kline says in his YouTube series, Medical Myths Revealed.

“I’ve talked to people that have post traumatic stress about going to the doctor. They lie awake for 3 or 4 days before they go see the physician for fear of another reduction in their pain medicine. This is just awful.”

Many of Kline’s patients will face the same fate, If they are unable to find a new doctor willing to prescribe opioid medication.

Last year the Food and Drug Administration warned doctors not to abruptly discontinue or rapidly taper patients on opioid medication. The agency said it received reports of “serious harm in patients who are physically dependent on opioid pain medicines suddenly having these medicines discontinued or the dose rapidly decreased.” The harm includes withdrawal symptoms, uncontrolled pain, psychological distress and suicide.

In another video, Kline said he researched federal law and could not find a single reference to “overprescribing” opioids.

“Is prescribing high doses a criminal act? No. We’re doctors. We prescribe what is needed. There is no dosage limit for opiates. You can use 1,000 milligrams a day or 10 milligrams a day. It doesn’t matter as long as you’re not getting side effects,” he said.

The CDC’s controversial 2016 opioid guideline recommends no more than 90 MME (morphine milligram equivalent) a day. Although the guideline is voluntary and only intended for primary care physicians treating chronic pain, it has been implemented as law or policy in dozens of states, and by the North Carolina Medical Board.

Over 2,000 people died of opioid overdoses in North Carolina in 2018. As in other states, the vast majority of the deaths involved heroin or illicit fentanyl, not prescription opioids.