Under the push to rein in problem prescribers, an unprecedented number of doctors saw their practicing authority revoked, suspended or otherwise restricted for allegedly putting the public at risk by indiscriminately prescribing controlled dangerous substances (“CDS”) that can pave the way to addiction.

The crackdown on problem prescribers was part of the State’s multi-pronged strategy to combat the ongoing heroin and opioid addiction crisis plaguing New Jersey and the nation.

“When four out of five new heroin users are getting their start by abusing prescription drugs, you have to attack the problem at ground zero - in irresponsibly run doctors’ offices,” said Attorney General Porrino. “Physicians who grant easy access to the drugs that are turning New Jersey residents into addicts can be every bit as dangerous as street-corner dealers. Purging the medical community of over-prescribers is as important to our cause as busting heroin rings and locking up drug kingpins.”

The discipline measures sought by Attorney General Porrino were carried out by the State Board of Medical Examiners (“The Board”) within the Division of Consumer Affairs.

“As committed allies in New Jersey’s battle against opioid addiction, we will continue to take strong action against doctors and other practitioners who fuel the crisis by making pills available for abuse,” said Steve Lee, Director of the Division of Consumer Affairs. “We will not allow anyone, least of all members of the medical profession who have pledged to ‘do no harm,’ to work against us as we struggle to stem the deadly tide of addiction.”

The 2016 actions filed with the Board resulted in eight license revocations, five long-term suspensions, and one voluntary retirement that settled allegations against 14 doctors, including:

Dr. Mohamed Kawam Jabakji, known as “Dr. Kawam,” who practiced in Prospect Park. The Board of Medical Examiners revoked Kawam’s license in April after finding he prescribed pain killers, including Oxycodone, Percocet and Codeine, to at least six patients without proper medical justification. Kawam demonstrated gross negligence in failing to routinely screen his patients, even when they exhibited clear drug-seeking and doctor-shopping diversionary behavior, such as requests for early refills and inexplicable lapses of time between office visits, according to the State’s allegations.

Dr. Kenneth Lewandowski, who owned a pain management center in Red Bank. The Board of Medical Examiners revoked Lewandowski’s license in April after he was criminally convicted in a prescription drug distribution ring while suspended from practicing medicine. The Board suspended Lewandowski’s license in April 2014 after learning he had been arrested three times and charged with driving while intoxicated, over the course of less than two months. Five months later, Lewandowski was arrested as part of a joint investigation into a suspected prescription drug ring. He subsequently pleaded guilty to distributing or dispensing oxycodone and the unlawful practice of medicine by writing fraudulent prescriptions for opiates on prescription blanks he had created in another doctor’s name.

Temporary license suspensions and other cessations of practice and/or prescribing privileges were obtained for another 17 doctors, pending the outcome of allegations against them, including:

Dr. James Cowan, Jr., a psychiatrist who practiced from a home office in Ridgewood. The Board of Medical Examiners temporarily suspended Cowan’s license to practice medicine amid allegations he indiscriminately prescribed CDS to patients, failed to keep proper patient records, and aided and abetted the unlicensed practice of medicine by allowing his wife to use his pre-signed prescription blanks to dispense drugs like Adderall and Xanax to his patients. While confined to a hospital, and then a nursing home, the 72-year old Cowan allegedly pre-signed prescription blanks for his wife to dispense highly addicting drugs to his patients, many of whom exhibited signs of drug seeking behavior. Under a Consent Order with the Board, Cowan is barred from practicing medicine and also from writing prescriptions for CDS until the Board takes further action. Cowan is also required to surrender all prescription pads, and any CDS in his possession, except for those lawfully prescribed for his own use.

Vivienne Matalon, a family physician who maintains offices in Cherry Hill and Camden. The Board of Medical Examiners temporarily suspended Matalon’s license amid allegations she indiscriminately prescribed the oral spray painkiller Subsys to three patients, one of whom died. According the State’s allegations, Matalon jeopardized her patients’ welfare by ignoring the documented risks associated with Subsys and by flouting the rules for its use, which is restricted to treat breakthrough pain in certain cancer patients. Her conduct constitutes the use of fraud, deception, and misrepresentation; professional misconduct; gross negligence that endangered the life, health, safety, and welfare of the three patients; and indiscriminate prescribing of CDS, according to the State’s allegations. Under a Consent Order with the Board, Matalon is prohibited from practicing medicine or prescribing CDS pending a final resolution of the allegations against her, and pending further action by the Board.

Doctors were not the only professionals sanctioned for alleged CDS violations last year. Six other licensed professionals - a physician’s assistant, a chiropractor, a pharmacist, a pharmacy technician, social worker and a hearing aid dispenser – were also disciplined for alleged improper prescription, distribution, or diversion of narcotics. Additionally, the Division terminated a printing company’s authority to print prescription blanks for physicians after finding the company failed to follow security requirements and issued 25,000 blanks to unauthorized individuals.

The increased civil enforcement actions are part of the State’s ongoing efforts to fight the diversion and abuse of opioids that have paved the way to an addiction crisis driving up overdose deaths and ravaging communities across New Jersey. Among the initiatives undertaken by Attorney General Porrino and the Division of Consumer Affairs are:

• Five-Day Limit on Opioid Prescriptions – Using his emergency powers, Attorney General Porrino has initiated changes in state regulations to impose a five-day limit on initial prescriptions of opioid painkillers to treat acute pain. In initiating the change, Attorney General Porrino said reducing the current 30-day supply limit for opioids will lower the risk of patients becoming addicted, and will reduce the chances of unused drugs falling into the hands of those who might abuse them, or sell them for abuse.

• Investigation of “Off-label” Prescribing of Painkiller “Subsys” – Responding to growing concerns about doctors who disregard federal prescribing restrictions on a spray-form of fentanyl painkiller marketed as Subsys, the Division of Consumer Affairs launched a statewide investigation to identify doctors who were prescribing the drug beyond its federally-approved use as a cancer pain medication. The probe began just days after the State filed action against a Cherry Hill doctor for allegedly indiscriminately prescribing Subsys to three patients, one of whom died. Three doctors have been disciplined since the investigation began in October 2016.

• Emergency Ban on Counterfeit Fentanyl – Intervening to stop an imminent threat to public safety and health, the Director of the Division of Consumer Affairs executed an Emergency Order banning the manufacture, distribution, sale, and possession of seven illegal knock-offs of the highly addictive opioid fentanyl. The Order added the seven “fentanyl analogs” – derivatives of the regulated prescription drug - to the list of Schedule I Controlled Dangerous Substances (CDS) in New Jersey, subjecting them to the strictest level of state control. Prior to the ban, the drugs, which are produced in clandestine labs in countries like China, Germany, Japan, and Mexico, were not recognized as CDS by the U.S. Drug Enforcement Administration (DEA), stranding them in a legal grey zone that permitted them to be peddled in New Jersey with virtual impunity.

• Expansion of the New Jersey Prescription Monitoring Program (NJPMP) – The Division continues to expand and improve access to this searchable data-tracking system that keeps records of prescriptions filled in New Jersey for CDS. The information can be used by prescribers to spot patterns of prescription drug diversion or misuse by their patients, including “doctor shopping” to obtain CDS from multiple providers. Most recently, the Division expanded its interstate data-sharing capabilities to include New York, Delaware, Connecticut, Virginia, South Carolina, Rhode Island, and Minnesota have also linked their prescription monitoring systems to the NJPMP.

• Expanding “Project Medicine Drop” to 215 Locations Across New Jersey – The Division developed Project Medicine Drop as an important component of its effort to halt the abuse and diversion of prescription drugs. It allows consumers to dispose of unused and expired medications anonymously, seven days a week, 365 days a year, at "prescription drug drop boxes" located within the headquarters of participating police departments. Since its launch in 2011, the Project Medicine Drop program has collected more than 78.5 tons of unwanted medicine and destroyed it safely through incineration.

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