LOUISVILLE — The doctor at a Lexington pain clinic that was raided by the Drug Enforcement Administration had little formal training in pain management or primary care, yet he was paid $7,500 a week to write prescriptions for powerful narcotic painkillers, according to the Kentucky Board of Medical Licensure.
Documents detailing the medical board's allegations were provided to the Herald-Leader on Thursday, after the medical board voted in Louisville to suspend the license of Dr. Najam Azmat, who was prescribing drugs at Lexington Algiatry, a pain clinic on Alexandria Drive. The DEA raided the clinic Wednesday.
The board ordered an emergency suspension of Azmat's license effective immediately. According to the board's order, "Azmat organized his practice at the Lexington Algiatry Clinic to maximize fraud and abuse, and it appears to be intentional."
Board president Preston Nunnelley told the Herald-Leader that the board "acted on an investigation that's been going on for some time."
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Azmat deferred comments to his attorney when reached by phone later in the day.
Fox DeMoisey, a Louisville attorney representing Azmat, said he could not respond to the accusations because he had not been given copies of the medical board's allegations or the DEA's search warrant.
"He intends to defend the matter vigorously," DeMoisey said.
The DEA and the medical board's investigations are separate, though the agencies have interacted with each other, board members said. The board began its investigation of Lexington Algiatry in November, collecting and analyzing 21 patient records. The investigation stemmed from grievances about suspected inappropriate prescriptions written by Azmat.
"It's been part of a team approach with law enforcement," Nunnelley said.
DeMoisey said he was troubled that investigators did not allow Azmat to speak with his attorney during the DEA raid, which lasted more than six hours Wednesday.
"He tried to cooperate to the best that he could," DeMoisey said Thursday. "I find it certainly coincidental that the raid was yesterday and his case was before the medical board today."
Pain management doctors struggle to sort through legitimate patients and people who are trying to manipulate the system, he said. If another doctor later takes issue with a prescription, it often leads to board complaints, he said.
"One of the problems you have with pain management is ... there are no black and white lines," DeMoisey said.
Documents released by the board provided a glimpse into how Lexington Algiatry worked.
In an interview with a board investigator, Azmat said he was an employee of Warren Gold of Tampa, Fla., who owns Lexington Algiatry, according to the documents. Azmat was paid $7,500 a week.
Gold provided him with an apartment in Lexington, and Azmat traveled between Lexington and Georgia, where his family lives, organizing his work schedule around his flight schedule, the documents said.
When asked about his training, Azmat told the investigator he takes continuing medical education in pain management and "had worked one day in Atlanta, Ga., with a pain management doctor. He said he also keeps updated on the Internet," the report said.
Documents outlined several findings that troubled board members. All 21 patients whose records were seized by the board had visited out-of-state pill mills previously. The documents said that Lexington Algiatry charged $250 for an appointment and that Azmat "placed all patients on the same high dose opioid medications," although most did not have a diagnosis that warranted such a prescription.
Azmat ignored reports of patients' drug abuse and prison terms, and once prescribed medication to Gold, his employer, the documents said.
A DEA spokesman confirmed there was a federal investigation, but he declined further comment.
Lexington Algiatry was closed Thursday.
Pharmacist Katherine L. Chase, who owns Corner Pharmacy across the street from the pain clinic, said she was happy to see action taken.
Chase said she had seen "a flood" of despondent customers trying to fill prescriptions from Azmat. She denied most of the customers, she said, except for a few who fit certain criteria.
Most of the prescriptions were for the narcotic painkiller Oxycodone, Chase said, which the documents corroborated. Azmat paired it with other, non-narcotic medications, she said.
Chase said Azmat usually prescribed 15-milligram or 30-milligram tablets. He typically prescribed 84 to 112 pills at a time, but never more than 120, "which evidently is some sort of marker that raises a red flag" with investigators, she said.
Some customers appeared to be having withdrawal symptoms, she said, adding that many seemed desperate and had been turned down by other pharmacists.
Most of the people who came to Corner Pharmacy with prescriptions written by Azmat were from areas such as Olive Hill, Mount Sterling and Ashland, Chase said.
"I'm happy the situation may be resolved," she said. "I just hope the people who are actually causing the problem are the ones who get in the most trouble, and not some of these individuals who are desperately seeking this for one reason or another."
Those with legitimate pain are the ones who suffer most when the board and law enforcement crack down on pain doctors, said DeMoisey, Azmat's attorney, who has served as counsel to the medical board.
"When you ... suspend a physician ... you leave patients in limbo," he said. "There is nothing Dr. Azmat can do. If he has been suspended, he cannot practice. It is a very troublesome and awkward circumstance."