A Criminal Mind – Why did a respected psychiatrist became a drug dealer?(story.californiasunday.com)
story.californiasunday.com
A Criminal Mind – Why did a respected psychiatrist became a drug dealer?
https://story.californiasunday.com/joel-dreyer-criminal-psychiatrist
9 comments
More on that:
http://www.denverpost.com/news/ci_27673196/nearly-all-denver...
How sad.
http://www.denverpost.com/news/ci_27673196/nearly-all-denver...
How sad.
Is prison a risk factor for brain trauma or is brain trauma a risk factor for prison?
Something to consider: just because there is a widely present neurological basis for criminality doesn't mean we shouldn't segregate those suffering from it from society. They're still a risk and real danger to everyone around them.
It would be nice, though, if we could move away from the idea that we need to be the implementers of some grand cosmic justice, where every sin of the accused must be punished by inflicting pain and suffering on them (up to and including brutal gang rapes, which are popularly joked about and sometimes even celebrated, at least in America). That might require re-evaluating or even disposing of traditional notions of moral guilt and punishment, though.
It would be nice, though, if we could move away from the idea that we need to be the implementers of some grand cosmic justice, where every sin of the accused must be punished by inflicting pain and suffering on them (up to and including brutal gang rapes, which are popularly joked about and sometimes even celebrated, at least in America). That might require re-evaluating or even disposing of traditional notions of moral guilt and punishment, though.
This. Segregation, not punishment. I believe as neuroscience advances way fewer things will be ascribed to amoral choices. Explaining crime with free will is often like explaining natural disasters with God's will - mere supersition.
Remember, we have to think about rehabilitation, otherwise segregation is just another form of punishment.
So, it seems that segregation implies: There is something wrong with the individual, therefore we have to keep them from being within harm's reach of the general populace.
This is a binary, on-off mechanism. That is why society, I guess, opted for unpleasant segregation, as a means of doling out a variable "fix" to the problem (mild for petty crimes, heavy for serious ones). Otherwise, you'd have to segregate each individual that ever does any sort of wrong, or breaks any violent law, etc.
So, it seems that segregation implies: There is something wrong with the individual, therefore we have to keep them from being within harm's reach of the general populace.
This is a binary, on-off mechanism. That is why society, I guess, opted for unpleasant segregation, as a means of doling out a variable "fix" to the problem (mild for petty crimes, heavy for serious ones). Otherwise, you'd have to segregate each individual that ever does any sort of wrong, or breaks any violent law, etc.
So we need a new Australia where we send all our criminals?
How is "segregation, not punishment" materially different from what we do now with prisons.
How is "segregation, not punishment" materially different from what we do now with prisons.
One asks us to adopt a frame of criminal justice as a social harm reduction policy; the other encourages us to think of criminal justice as a way of doling out pain to monsters totally unlike us.
It's still not at all an easy problem to solve--a whole lot of what makes prisons so shitty is the other prisoners, but enforcing a total isolation on the criminal from anyone he may hurt or be hurt by is probably more harmful than a shiv, which is the deep tension that any solution will have to work around. But the bigger thing standing in the way of a solution is the belief of most people, which is rarely even thinly veiled, that most criminals deserve whatever they get.
Which is understandable: many times (most of the time?) the criminal has actually done something heinous, and I suspect we're programmed to depersonalize and even hate people who commit asocial crimes. But it does lead to barbaric results that a civilized society should reject.
ETA: Just to be explicit that there are ways to make the experience of prisons better: don't charge a prisoner $20 for a 15 minute phone call. Allow them internet access. And, more controversially, implement the panopticon--right now there's little to no accountability for the things that happen within prison walls.
It's still not at all an easy problem to solve--a whole lot of what makes prisons so shitty is the other prisoners, but enforcing a total isolation on the criminal from anyone he may hurt or be hurt by is probably more harmful than a shiv, which is the deep tension that any solution will have to work around. But the bigger thing standing in the way of a solution is the belief of most people, which is rarely even thinly veiled, that most criminals deserve whatever they get.
Which is understandable: many times (most of the time?) the criminal has actually done something heinous, and I suspect we're programmed to depersonalize and even hate people who commit asocial crimes. But it does lead to barbaric results that a civilized society should reject.
ETA: Just to be explicit that there are ways to make the experience of prisons better: don't charge a prisoner $20 for a 15 minute phone call. Allow them internet access. And, more controversially, implement the panopticon--right now there's little to no accountability for the things that happen within prison walls.
In theory? Not much. In practice? No beatings, more rights and permissions etc.
Sounds better. More therapeutic.
Many prisons are built to be awful places on purpose. That needs to stop.
Be careful, though, with the natural swing the other way, towards the medicalization of deviance.
Although there are no shortage of people who do terrible things due to impaired capacity, there are plenty of healthy people who cognizantly do make choices negative to others. They're fully rational and logical, but from the external view, terrible. These choices may be grounded in emotional or intellectual "idiosyncrasies", but you can't quite call them medical, and the "oh that poor dear" narrative isn't helpful. You can treat illness, but you can't treat worldview and behavior.
The other problem with this train of thought is that then, other "amoral" choices become medical. For instance, when many believed homosexuality was a terrible horrible amoral sin, there was a push to consider it a "disorder" (with the complicity of the psychological community), which merited psychological or other medical interventions. This lead to the idea of "conversion therapy", because an "illness" can usually be "cured". Similar views have been proposed for other socially unacceptable behaviors, and later discredited when the wider moral viewpoint shifted.
When this decade's "morality" crisis is treated as medical, you open the door to medical (mis)treatment of anything society doesn't care for, and that's, in many ways, worse than the current approaches. You can release somebody from jail when we realize a law is stupid, but 10 years of Psychiatry's Favorite Hot New Substance in a small padded room runs the risk of depriving people of far more than just time.
I agree that the motive of the legal system should be less about revenge, but a "people who do bad things are all mentally ill" narrative doesn't fix that. If done poorly, it mostly means that people doing things we don't like will spend their lives drugged out of their heads in padded rooms, rather than sober in concrete ones.
So, we need to keep a strong line between "people making bad choices" (which requires behavioral interventions) and "people unable to make choices in reality" (which requires medical or psychiatric ones). These are two different situations, and as our current system proves, neither intervention suffices for both.
Although there are no shortage of people who do terrible things due to impaired capacity, there are plenty of healthy people who cognizantly do make choices negative to others. They're fully rational and logical, but from the external view, terrible. These choices may be grounded in emotional or intellectual "idiosyncrasies", but you can't quite call them medical, and the "oh that poor dear" narrative isn't helpful. You can treat illness, but you can't treat worldview and behavior.
The other problem with this train of thought is that then, other "amoral" choices become medical. For instance, when many believed homosexuality was a terrible horrible amoral sin, there was a push to consider it a "disorder" (with the complicity of the psychological community), which merited psychological or other medical interventions. This lead to the idea of "conversion therapy", because an "illness" can usually be "cured". Similar views have been proposed for other socially unacceptable behaviors, and later discredited when the wider moral viewpoint shifted.
When this decade's "morality" crisis is treated as medical, you open the door to medical (mis)treatment of anything society doesn't care for, and that's, in many ways, worse than the current approaches. You can release somebody from jail when we realize a law is stupid, but 10 years of Psychiatry's Favorite Hot New Substance in a small padded room runs the risk of depriving people of far more than just time.
I agree that the motive of the legal system should be less about revenge, but a "people who do bad things are all mentally ill" narrative doesn't fix that. If done poorly, it mostly means that people doing things we don't like will spend their lives drugged out of their heads in padded rooms, rather than sober in concrete ones.
So, we need to keep a strong line between "people making bad choices" (which requires behavioral interventions) and "people unable to make choices in reality" (which requires medical or psychiatric ones). These are two different situations, and as our current system proves, neither intervention suffices for both.
I agree that medicalization of everything is the wrong course to go down. My perspective is more this:
Criminals have often done terrible things, whether because of "they make bad choices" or "they are unable to make sane choices." In the worst case scenario, these things are incurable, either by medical procedures or by punishment, and their criminality is likely to recur. How do we deal with these broken people? "Humane" prison (comfortable-enough segregation from the general population, coupled with real, universal observation to protect them from each other) seems to me to be the best route, with the death penalty as a distant second.
That has the added benefit of serving people better who are the same but treatable, either via behavioral, psychiatric, or medical interventions. At the very least, it doesn't make things worse for them, which prisons as-they-exist-today currently do.
Criminals have often done terrible things, whether because of "they make bad choices" or "they are unable to make sane choices." In the worst case scenario, these things are incurable, either by medical procedures or by punishment, and their criminality is likely to recur. How do we deal with these broken people? "Humane" prison (comfortable-enough segregation from the general population, coupled with real, universal observation to protect them from each other) seems to me to be the best route, with the death penalty as a distant second.
That has the added benefit of serving people better who are the same but treatable, either via behavioral, psychiatric, or medical interventions. At the very least, it doesn't make things worse for them, which prisons as-they-exist-today currently do.
Agreed completely! And improving our mental health system would have the added bonus of giving more options to people who see a child/parent/spouse/friend clearly losing touch with reality and becoming dangerous, beyond our current "48 hour medical hold" or "Wait until they do something that can get them jailed".
> Something to consider: just because there is a widely present neurological basis for criminality doesn't mean we shouldn't segregate those suffering from it from society.
I think buying that criminal behavior is caused by disease or brain structure (disease when the perpetrator is a middle-class white male, brain structure otherwise) is a problem. If criminality has a physical cause, than law is a natural phenomenon, and the law-makers are law-makers due to natural order rather than culture and dominance.
It would be scary if we started testing people for reified diseases of disorder, and banishing them based on the results.
I think buying that criminal behavior is caused by disease or brain structure (disease when the perpetrator is a middle-class white male, brain structure otherwise) is a problem. If criminality has a physical cause, than law is a natural phenomenon, and the law-makers are law-makers due to natural order rather than culture and dominance.
It would be scary if we started testing people for reified diseases of disorder, and banishing them based on the results.
Every mental state is precipitated by the physical state of the brain. The only difference between a criminal who does something "intentionally" and someone like this is a difference of degree. Unless someone wants to demonstrate supernatural free will, we need to stop pretending that anybody does anything completely on their own. This doesn't mean we should let dangerous people roam free, but it means that we should let evidence decide the most effective response to unwanted behavior rather than our desire for retribution.
Hate to be the grammar nazi, but there's an error in the title: "become" and not "became"
Such a sad story. It's as if he knows what's going on, but he can't do anything to stop it.
Or doesn't even care about stopping it.
That's because he's crazy. The sad part is using prison as a mental health treatment facility.
I suspect being locked up with crazy people does nothing good for genuine criminals, with respect to constantly interfering with the guards and safety procedures and whatever little rehabilitation might exist.
I suspect being locked up with crazy people does nothing good for genuine criminals, with respect to constantly interfering with the guards and safety procedures and whatever little rehabilitation might exist.
And can't care about stopping it.
I'm not going to defend all actions of this psychiatrist, but know there's a war going on with the DEA and medical doctors(mainly Psychiatrists and and doctor who deals with patients in pain--Pain Specialists).
I discount all the testimony on his first wife, and children; I just don't know if he did anything illegial. Yes, it might have been weird, but not illegal. He married a much younger wife--not unheard of? I recall one med student joke about having a medschool spouse, and that was comming from a woman.
I believe the DEA, did an accounting of his prescribing practices between 2004 and 2007. We all read those huge amounts of drugs he was dispensing, but why did they count the number of pills, and not the correlate that to patients. They said he prescribed 37,000 Xanax in in those years. That's also 1223 patients in that time period with a script for 30 pills? The hydrocodone was 2630 scripts for 30 pills.
This is a well know Psychiatrist in his 60's. He must have thousands of patient he's treating? He's lived through the SSRI lies? He knows what works, and what doesn't. I don't know why he was prescribing a Fetnal type drug, other than maybe he was seeing cancer patients, or he took pity on patients who just had pain other physicians refused to treat?
He was investigated by three agencies. I don't belive the local police investigation; I have seen them lie too frequently to make their case. I am Leary of the DEA undercover investigation. I'm not Leary of the California State licensing Board. In that instance he offerd advise and warnings.
"In March, an undercover agent from the California Medical Board came to Dreyer, saying she had a sore throat and cramps. He told her she was “very pretty” and inquired if she was single. She asked for Xanax, and Dreyer said he worried about her “getting all these crazy meds,” adding, “I don’t want to hook you, baby.” He prescribed 30 doses of Xanax and 60 doses of Vicodin."
He shouldn't have flirted with her, but he warned her about addiction, and didn't give an unreasonable amount of medication--especially if he wasen't going to see her for months? We don't have the transcript of that office visit.
My point is he's a older physician who dealt with patients whom were in psychological, and physical pain. He was taught in med school to alleviate pain, and misery.
Through out the article, everyone was astonished he was Not making much money 'doing these illegial acts'? He was charging $100 a visit, which in my neck of the woods is a bargain. Most of these Psychaitrists are charging $350-$500 an office visit, and you leave with a safe, and so many times ineffective SSRI, and a business card of a MFCC.
My point is I'm not sure he was so reckless; he should be in prison? Psychiatrist deal with people in pain. How many patients are they allowed to see? Just how many scripts are they allowed to write? Maybe they should tell doctors exactly what, and whom to prescribe too?
I usually don't defend doctors, but know the DEA is after them on a large scale. One day, you might be in a Psychiatrist office and you won't get that medication that stops a panic attack dead in its track?
I guess what I'm trying to say is I would like to see all the transcripts. I would like to know how many of his patients were diagnosed with terminal cancer, or another deadly, painful disease?
I Don't want to argue with anyone, he's in jail--Yay right? Just another drug dealer? Maybe misunderstood, by a paranoid government agency? An agency with agents, administrators who didn't go to medical school?
Again--I fear a medical establishment that won't treat pain(psychological/physical) because they don't want the DEA breathing down their backs. Hell, it's happening right now. Good luck with that slipped disc. They just aren't prescribing drugs that actually work--out of fear.
Yes--we have a problem with opoid/benzo addiction, but their are people who benefit from these drugs too. Why, in America, do we need to solve complex problems with a hammer?
I discount all the testimony on his first wife, and children; I just don't know if he did anything illegial. Yes, it might have been weird, but not illegal. He married a much younger wife--not unheard of? I recall one med student joke about having a medschool spouse, and that was comming from a woman.
I believe the DEA, did an accounting of his prescribing practices between 2004 and 2007. We all read those huge amounts of drugs he was dispensing, but why did they count the number of pills, and not the correlate that to patients. They said he prescribed 37,000 Xanax in in those years. That's also 1223 patients in that time period with a script for 30 pills? The hydrocodone was 2630 scripts for 30 pills.
This is a well know Psychiatrist in his 60's. He must have thousands of patient he's treating? He's lived through the SSRI lies? He knows what works, and what doesn't. I don't know why he was prescribing a Fetnal type drug, other than maybe he was seeing cancer patients, or he took pity on patients who just had pain other physicians refused to treat?
He was investigated by three agencies. I don't belive the local police investigation; I have seen them lie too frequently to make their case. I am Leary of the DEA undercover investigation. I'm not Leary of the California State licensing Board. In that instance he offerd advise and warnings.
"In March, an undercover agent from the California Medical Board came to Dreyer, saying she had a sore throat and cramps. He told her she was “very pretty” and inquired if she was single. She asked for Xanax, and Dreyer said he worried about her “getting all these crazy meds,” adding, “I don’t want to hook you, baby.” He prescribed 30 doses of Xanax and 60 doses of Vicodin."
He shouldn't have flirted with her, but he warned her about addiction, and didn't give an unreasonable amount of medication--especially if he wasen't going to see her for months? We don't have the transcript of that office visit.
My point is he's a older physician who dealt with patients whom were in psychological, and physical pain. He was taught in med school to alleviate pain, and misery.
Through out the article, everyone was astonished he was Not making much money 'doing these illegial acts'? He was charging $100 a visit, which in my neck of the woods is a bargain. Most of these Psychaitrists are charging $350-$500 an office visit, and you leave with a safe, and so many times ineffective SSRI, and a business card of a MFCC.
My point is I'm not sure he was so reckless; he should be in prison? Psychiatrist deal with people in pain. How many patients are they allowed to see? Just how many scripts are they allowed to write? Maybe they should tell doctors exactly what, and whom to prescribe too?
I usually don't defend doctors, but know the DEA is after them on a large scale. One day, you might be in a Psychiatrist office and you won't get that medication that stops a panic attack dead in its track?
I guess what I'm trying to say is I would like to see all the transcripts. I would like to know how many of his patients were diagnosed with terminal cancer, or another deadly, painful disease?
I Don't want to argue with anyone, he's in jail--Yay right? Just another drug dealer? Maybe misunderstood, by a paranoid government agency? An agency with agents, administrators who didn't go to medical school?
Again--I fear a medical establishment that won't treat pain(psychological/physical) because they don't want the DEA breathing down their backs. Hell, it's happening right now. Good luck with that slipped disc. They just aren't prescribing drugs that actually work--out of fear.
Yes--we have a problem with opoid/benzo addiction, but their are people who benefit from these drugs too. Why, in America, do we need to solve complex problems with a hammer?
Without knowing all the full transcripts it is of course possible we are hearing an editorialised version of events, but things like this:
Plus he didn't seem interested in checking whether people were in pain beyond an "are you in pain?".
Sure, you could argue that he was still "just trying to help people", but short of having all prescription drugs laid out on supermarket shelves for anyone to pick up whenever they want, there has to be a line drawn somewhere for "how to be responsible about giving out dangerous drugs", and giving them to anyone who asks for them is not on the right side of that line.
“Why are you here to see a shrink?” he asked.
She explained that she needed prescriptions for her boyfriend, who’d hurt his
foot.
Dreyer asked if she was having pain, too.
She shook her head no.
“Cramps?” Dreyer asked.
“I mean that makes sense, cramps.”
“Well, we’ll get you covered,” Dreyer said. “And you know it’s a hundred-dollar
charge.” After she paid him, he told her, “And that, my love, is the game.”
Plus he didn't seem interested in checking whether people were in pain beyond an "are you in pain?".
Sure, you could argue that he was still "just trying to help people", but short of having all prescription drugs laid out on supermarket shelves for anyone to pick up whenever they want, there has to be a line drawn somewhere for "how to be responsible about giving out dangerous drugs", and giving them to anyone who asks for them is not on the right side of that line.
Wow, this story is pretty nuts and well written.
Did anyone else find the prose style overblown, turgid and treacly, a bit like a cross between Tom Wolf, John Updike and Dame Beryl Bainbridge :)
Is this the plot to American Beauty?
"In March, for example, researchers from the University of Denver found that 96 percent of all inmates screened at the Downtown Detention Center in Colorado had brain trauma, mostly from blunt-force injuries to the head — much higher than the estimated 6 to 8.5 percent of the general population."