Part 5 in a series about medical path-breaker Dr. Punyamurtula Kishore
This is the fifth in a series of articles about Dr. Punyamurtula S. Kishore, the Christian doctor who innovated the Massachusetts Model of addiction treatment. Conventional addiction therapies based on substitute narcotics (methadone and Suboxone®) leave only 2% to 5% of patients who don’t relapse back into full-scale addiction—with most of these alleged “successes” still being prescribed the substitute narcotic, creating other issues for the patients. In contrast, Dr. Kishore’s sobriety-based approach is non-narcotic in orientation. His method doesn’t lead to a miserable 2% to 5% success rate after a year, but a 37% success rate based on hard test data.
Massachusetts buried this medical miracle in its midst by incarcerating Dr. Kishore in September 2011 and withholding Medicare payments to his fifty-two treatment centers, causing their complete collapse. While the specious case against Dr. Kishore has dwindled despite the state’s dirty tricks (read the four earlier articles in this series for the details), its threats to compel him to plead guilty have grown more strident and outrageous. Massachusetts greedily insists on keeping the Medicaid money it owes for services that Dr. Kishore faithfully and properly rendered, expecting him to write off all claims against the deadbeat state.
I returned to Massachusetts to meet with Dr. Kishore and his associates over the last weekend of July 2014. There was more to learn on countless fronts. Two of the three stories we’ll explore in this installment involve grim developments: how Massachusetts successfully imposed its folly upon the entire nation by statist force, and how it imposed a social engineering project of unprecedented scale upon its own citizens without their knowledge or consent. The third story, however, focuses on a beam of light in the darkness: the friend who sticks closer than a brother (Prov. 18:24), the man who faithfully supported Dr. Kishore through his continuing trials. We’ll begin with this third story, which concerns the sentinel who stood by the side of the persecuted doctor in court hearing after court hearing, solely because he believed it was his Christian duty to stand with the innocent.
Being pulled out of your house by the police at night without warning, taken to various lockups and court hearings, finally released with a GPS bracelet, being hammered thereafter in hearing after hearing as you watch justice perverted, inverted, and subverted (see article one in this series): such a string of demoralizing evils, designed to wear you down and make you cave in, inevitably make an impact on the target. When even your own attorneys begin to pressure you to plea bargain (once the insurance money funding their work ran out), you look in vain for moral support. The temptation is to capitulate and abandon your search for justice.
One Christian in particular, who learned of Dr. Kishore’s situation in early 2013, was unwilling to see the doctor go to hearing after hearing all alone to wage battle against the mindless machine of statist force. Without this one man’s investment of moral support in Dr. Kishore, we might never have had this story to tell. The power of one Christian to change the course of critical events by the most humble and personal means is an untold part of the ongoing drama in Massachusetts.
Therefore, before we turn to the bad and the ugly in this article, we would do well to understand the power of good, of godly compassion, in the profoundly simple commitment of one Christian to stand by Dr. Kishore as a loyal sentinel. Although he maintained a silent vigil of prayer in each courtroom hearing, his presence was a bulwark against the pressures mounting against the doctor to give up. By standing by the doctor he had befriended, this one man insulated Dr. Kishore against the temptation to compromise his principles. He helped to sustain Dr. Kishore’s will to fight.
Closer Than a Brother
Herbert Uzochukwu, known as Brother Herbert, learned about Dr. Kishore’s plight from Jerry Perera, and began praying with his senior pastor for the doctor. He went out to lunch with Dr. Kishore after a church service and came to realize what the doctor needed spiritually. He shared the Scriptures with Dr. Kishore because “we can only present his situation before God, but it would help him to know this God for himself.” Brother Herbert perceived that Dr. Kishore needed prayer but also something more: he needed someone to be available for him as he continued to walk through this fiery trial.
“I felt deep compassion within me,” said Brother Herbert. “He needed my physical presence, praying with him before each court date, and continuing all the way through the proceedings.”
When asked about particulars, Brother Herbert answered that he was praying for three specific things on Dr. Kishore’s behalf: (1) for God’s strength in the doctor’s inner being to give him courage; (2) for vindication; and (3) for God’s intervention.
In sharp contrast to the state’s talking points about Dr. Kishore, Brother Herbert saw things very differently. “I believe he’s doing a good job. He has not invested of himself anywhere but in Massachusetts. He is helping addicts. He felt he was doing a service for society. He never had time for himself.” Despite these personal sacrifices for the afflicted that he was treating, Dr. Kishore came under the most savage legal attack. As a result, said Brother Herbert, “he felt betrayal from the system rather than appreciation.”
A Bulwark Against Compromise
While diplomatic in tone, Brother Herbert’s observations inside the courtroom were direct and to the point concerning Dr. Kishore’s original set of attorneys. “Their advice to plead guilty was just for their own benefit. They were more interested in how much money they’d make out of it.” When the insurance monies ran out, their strategy changed, and the pressure to plead guilty became intense. It was presented as the way to stop the hemorrhage, to stanch the bleeding, to stop the torture.
Brother Herbert had a “word in due season” for Dr. Kishore at this crossroads. “What will be the outcome of your pleading guilty?” he asked the doctor, and then shared the story of the four lepers who sought relief from famine in the land of their enemies (2 Kings 7:3-20). As Brother Herbert explained it, the lepers reasoned among themselves in this way: “If we stay here, we’ll eventually die, but there’s food in Syria. If we go there, we’ll either eat or be killed. We face death either way.” So into enemy territory they went, God miraculously scattering the Syrian host so that the lepers fed not only themselves but all of Israel as well.
“Fight forward into enemy territory,” Brother Herbert exhorted Dr. Kishore. “You must defend what you believe in, even if it puts you into the hands of your enemies.” So Dr. Kishore wouldn’t misunderstand the underlying point, Brother Herbert made it clear that there’d be no deliverance on the human plane. Dr. Kishore had to throw himself fully onto God at this point: “Trust in God isn’t an empty slogan. There is no human solution. We believe in the God Who has all the power.” In effect, Brother Herbert was inculcating in his embattled friend the spirit of Shadrach, Meshach, and Abednego (Dan. 3:16-18): God can deliver me from the state’s hands, but even if He doesn’t, I still won’t bow down to it.
Brother Herbert took note of Dr. Kishore’s hunger for the Word of God. “Every friend makes a difference to him,” says Brother Herbert. “He told me, ‘Now I’ve finally seen the truth, despite all I’ve learned in years of study and practice.’” Most importantly is the consensus that has since arisen, says Brother Herbert. “All his Christian friends want him to keep fighting, to keep moving forward.”
Just Being There for Him
The only times Brother Herbert has missed a court hearing with Dr. Kishore is when he was on a mission trip. “Most hearings I was there,” he says. He’s not there to understand the hearings (arguments over complex points of law), but “to pray throughout the proceedings and to lift up Dr. Kishore before God.”
“God will give me the words to share with Dr. Kishore to encourage him,” says Brother Herbert. “I see him not just as a public servant but as a human being, a brother, someone who has been doing the work of the Kingdom even while a nonbeliever, waiting for the appointed time to know God for Himself.” In Brother Herbert’s view, God used the “fire of affliction, the persecution, to bring Dr. Kishore to Himself.”
Brother Herbert sees God’s hand behind all that has happened to Dr. Kishore. “I believe strongly that God wants to use what’s already inside of him, what he’s already been doing, but to do so now in the Name of the Lord, consecrating his efforts unto Him.”
And what of the impact of Brother Herbert’s simple presence and prayers and exhortations upon Dr. Kishore? Let the doctor speak for himself on that point: “Brother Herbert spent countless hours, unpaid, with me. He’s like a rock. What a man. Not like my lawyers. Especially when I was down and out. He understands the person standing in front of him. His prayers are like no others.”
People take different roles in how they support Dr. Kishore. Brother Herbert was more a spiritual mentor1 to the doctor, one who helped strengthen the doctor’s resolve to press forward against the massive weight of the state pressing down upon him. In the sixth article we’ll focus on another important supporting role: Dr. Kishore’s new attorney, who took up key elements of his case while the original attorneys were trying to squirm out of their role. In that future article, we will contrast his sacrificial work with that of Dr. Kishore’s nemesis: the Attorney General of Massachusetts, Martha Coakley.
Having reviewed the Good above, it is time to consider the Bad and the Ugly. The Bad boils down to this: citizens of Massachusetts reading the first four articles in this series knew they were in the midst of the tragedy being described. Citizens of the other forty-nine states, while distressed that the great strides made by Dr. Kishore’s research wouldn’t be exported any time soon to their states, at least had peace of mind that the Luddite policies of Massachusetts would stay in Massachusetts. “We may not see the benefits of Dr. Kishore’s work,” they thought, “but at least we’re insulated from the system that set out to destroy him, the system that promotes inferior status quo treatment regimens. We’re relatively safe because we don’t live in that state.”
The man who was in charge of the Massachusetts Department of Public Health Division on Drug Abuse at the time of Dr. Kishore’s arrest is no longer a Massachusetts official, when the damage he inflicted was limited to his own state and its jurisdictional limits. He worked at the Massachusetts Department of Public Health between 1994 and 2012, the last nine years of which he served as the director of substance abuse services. The takedown of Dr. Punyamurtula Kishore occurred on this man’s watch. Dr. Kishore is certain that this man was the logical source of the misleading statement reported by NPR news correspondent David Boeri shortly after Dr. Kishore’s arrest: “WBUR has learned that Dr. Kishore never got a state license from the state Department of Public Health to run addiction treatment programs.” In this man’s mind, “addiction treatment” means “methadone maintenance” or “Suboxone® dispensary,” and since Dr. Kishore didn’t use addictive substances to treat substance abuse, he was falsely smeared as an unlicensed practitioner of addiction medicine. No mention was ever made of his vastly superior success rates through sobriety maintenance and sobriety enhancement, the cornerstones of the Massachusetts Model he developed.
Before we reveal that official’s name (if you haven’t already guessed it), it is time to take a good hard look at that 37% success rate of Dr. Kishore’s that we disclosed in the second article in this series. In contrast to conventional treatment programs that yield a 2% to 5% success rate after a year of treatment, this 37% is impressive—a figure that understandably fuels much of the outrage over the mindless attacks upon so miraculous a success. Is it an honest figure? Let’s see.
The 37% Solution
In 1994, Dr. Kishore sent in four years of his practices’ data for review, independent evaluation, and consideration for the AMERSA (Association for Medical Education and Research in Substance Abuse) award. This is the first time the 37% figure appeared, documented with sufficient rigor that Dr. Kishore received the AMERSA Award on November 17, 1994. The annual figure for his growing practices fluctuated between 30% and 40% up until July 2006, when once-a-month Vivitrol injections came on the market. When integrated with the Massachusetts Model, the sobriety rate changed.
In 2006, Vivitrol was only approved for treating alcohol addiction, but so many of Dr. Kishore’s patients were polysubstance abusers (not merely “pure” alcoholics) that its effects on opioid addiction were being documented on the fly (rather than on the sly). How then did Vivitrol ever get approved for treating opioid addiction? What motivated the FDA to approve it for such use in September 2010?
In the third article of this series, you learned about Dr. Kishore’s National Library of Addictions and its ambassador program. Some of these ambassadors, including Thomas “TJ” Voller, went to Washington D.C. to testify about Vivitrol’s impact on their addiction treatment. In a CNN news story of October 12, 2010, Voller can be seen on a brief video2 discussing the impact of Vivitrol on his life. While mention of Dr. Kishore and the Massachusetts Model was conspicuously edited out, the voice-over narrator describes the “one doctor” who administered Vivitrol to Voller. That doctor was Dr. Kishore, whose work3 was a factor in fast-tracking Vivitrol for treating opioid addiction.
At this point, Dr. Kishore’s sobriety rate far exceeded the 37% rate documented sixteen years earlier: the one-year-treatment success rate varied between 50% and 60% with the integration of Vivitrol into the Massachusetts Model. That means we have actually underreported the value of Dr. Kishore’s work. And it was at this time that the state began its attacks on Dr. Kishore in earnest, culminating in his arrest eleven months later in September 2011.
Where Was the Official in Charge of the State’s Drug Abuse Policy?
One would think that the Massachusetts official in charge of substance abuse treatment would be well-versed on these developments, instead of attacking Dr. Kishore and thereby maintaining the miserable cap of expectations that methadone and Suboxone® place on those in bondage to those treatment regimens. If he was unaware of Dr. Kishore’s work and its significance, his competence in the role of the state’s director of substance abuse programs must be called into question: how can this man not know about the Massachusetts Model publicizing such well-documented results? And if he did know what Dr. Kishore had achieved, what motivated him to help kill this revolution in addiction medicine?
Neither of the options is particularly flattering to this official. On either basis, should he not have been removed from his position?
From one point of view, he was removed from his position. Michael Botticelli, the Massachusetts official in question, no longer works for the Massachusetts Department of Health. In 2012 he became the Deputy Director of the federal Office of National Drug Control Policy, and then became the Director in March 2014.
You see, Michael Botticelli is this nation’s drug czar. From deep inside the state of Massachusetts to your doorstep: Massachusetts’s problem is now everybody’s problem. The systematic neglect and burial of Dr. Kishore and his Massachusetts Model now receives the impress of federal fingerprints upon it.
The Root of the Problem
The so-called Peter Principle asserts that individuals are promoted to their level of incompetence. That principle doesn’t apply here, because the problem is more deep-seated than Botticelli’s competence. The problem is that the definition of success has become disfigured beyond recognition. One is tempted to ask, “Cui bono? Who benefits?” But we are victims of media nonsense through self-inflicted ignorance: this is a real and present danger in our society. Let’s consider an example.
Vivitrol should never be administered outside of a program like the Massachusetts Model, but even if it is, its value is completely misinterpreted. You and I become dupes under such misinterpretations. An Associated Press article on Vivitrol use in Ohio appeared on June 22, 2014, quoting a sheriff’s critique of a pilot program that “only three of 12 subjects completed the program and stayed off drugs.”4 If you weren’t aware that 2% to 5% is the best that traditional treatment programs deliver, you’d think the 25% success rate being criticized by the sheriff represented terrible statistics.5 The unwary would think, “Only 25% stayed off drugs? Dump Vivitrol and go back to methadone!”—namely, back to a five times worse success rate. This is why the traditional success rate chart hides the first month’s 80% recidivism rate by simply cutting it off, as explained in detail in the first article in this series. That doctored chart (no pun intended) is reproduced in the reference of endnote 2 below.
Michael Botticelli operated in terms of popularly-held and militantly-propagated fictions during his tenure in Massachusetts. With his promotion to the position of national drug czar, the damage he has been inflicting has been wider in scope, deeper in impact, and longer-lasting than that of his predecessor. It would be easy to provide dozens of references to document the ongoing controversies in which he is mired. Your state may already have had the pleasure of a visit from Mr. Botticelli.
The point of all this, however, is a simple one. What was once merely a Massachusetts problem is now everyone’s problem, as that state has exported its false expertise to the federal level. If you’ve been reading this series thinking the issues involved were provincial ones, think again. The man who evidently threw Dr. Kishore and the Massachusetts Model under the bus is now in charge of our nation’s drug abuse policy.
But in respect to long-lasting damage, there’s a worse problem than the promotion of Michael Botticelli to the position of the nation’s drug czar. Our culture is sustaining long-lasting damage in a form that has gone virtually unreported. It behooves us to now move from consideration of the Bad to an unnerving look at the Ugly: the actual long-term effects of methadone on personhood and gender identity.
We must tread carefully here as we now enter the waters of a controversy so volatile, even doctors publishing in refereed journals avoid connecting the dots. Note the technical citations in the endnotes for this final section, which are necessary to preempt charges that we’ve put forward specious ideas without adequate foundation.
The effects of methadone in the body last much longer than that of heroin. Taken daily (as usually prescribed), its effects are effectively continuous. Some of these effects have not been fully reported or appreciated. One wonders if wider publication of these effects would have an impact on the methadone industry that authorities would deem unacceptable. Perhaps these effects don’t receive airplay for a reason—particularly the effects upon males using methadone.
If that sounds conspiratorial in tone, consider a statement reported by CBC News on August 26, 2014: “Debbie Bang, the manager of St. Joseph’s Healthcare Womankind addictions service, says she worries that this kind of research might dissuade men from entering a methadone program if they really need it.”6 Research into what? The article’s headline gives us a clue: Methadone suppresses testosterone in men, McMaster research suggests. The researchers were obviously surprised at their results: “In fact, when the study’s researchers first started checking results, they actually had to go back and make sure they didn’t accidentally test women by mistake because the testosterone levels were just so low.”
Tip of the Iceberg
But even this report held back information. It’s not merely that methadone use drives testosterone levels down in males; it also boosts female sex hormones in them. To compound these effects further, methadone affects the levels of prolactin in male patients, among other important hormones. A National Institutes of Health study published in November, 1981, “Hormone levels in methadone-treated drug addicts,” documented these changes more than thirty years ago.7 Nonetheless, the chance that you know anything about this is essentially nil.
The effects of opioids (like methadone) have been revisited in the literature repeatedly.8 The increased concentration of prolactin in male homosexuals was noted as early as 1971 in The Lancet.9 But the clincher is how far back such effects of opioids have been observed. In 2005, Nathaniel Katz, M.D., publishing under the auspices of Massachusetts General Hospital and Harvard Medical School, lamented the lack of reporting on the hormonal effects of opioids: “Unfortunately, while barely discussed in the modern medical lexicon, opioids have negative effects on the endocrine system that have been observed for at least a century.”10 Disturbingly, he opens his article by quoting from an 1839 report on the tea plantations of Assam: “the feeble opium-smokers of Assam … are more effeminate than women.”11
Suboxone® (buprenorphine) also exhibits parallel effects on prolactin levels and more12—it’s not just methadone that’s the problem. To be free of these effects, look to the sobriety-based Massachusetts Model, not to the status quo treatments with their hair-of-the-dog solutions, miserable outcomes, and spurious side effects.
Dr. Kishore has personally observed the feminizing effects of methadone on males being treated with it. Breast enlargement, development of female habitus (body shape), increased grooming behaviors, and more are part of the package. Use of methadone blurs gender distinctions. This makes for two strikes against reporting these effects: (1) fear that men who allegedly “need” methadone will spurn it once they discover the truth (see Debbie Bang’s telling confession above), and (2) the explosive nature of gender politics and fear of backlash (making it remarkable that Katz was bold enough to even include “loss of gender role” in Table 2 of his study13).
Loss of Gender Role
We’ve reported earlier that Massachusetts, rather than adopt the Massachusetts Model and work towards sobriety, continues to aggressively call for more methadone and more Suboxone®. By deceiving the public on the resulting implications for human endocrinology and its impact on gender roles, it appears as if a massive social engineering experiment is being conducted on the population without informed consent. This is, in fact, what Dr. Kishore believes is the case.
While true that homosexuals are disproportionately affected by drug addiction (at two to three times the rate of the general public), there remains a question of cause-and-effect. Stigma and social pressures are logically cited in this connection.14 Dr. Kishore believes there’s a second element at work: drug addicts develop homosexual tendencies due to the blurring of gender roles by way of altered endocrinology. Both factors are actually in play, but the documentation of the more controversial second factor has been muted. We only hear about the first factor, which provides a useful weapon for shaming an ostensibly intolerant culture.
If Dr. Kishore is correct, one must wonder if the national and state authorities aggressively pushing narcotic substitutes like methadone (rather than sobriety) on their populations are aware of the societal changes their policies are creating. The shifting of gender roles, the blurring of distinctions, even the mutation of political orientations under the influence of biochemical changes engineered through pharmaceuticals, could well be a powder keg waiting to explode. Dr. Kishore sees these drug policies as embodying the Biblical idea of “pharmakeia,” a pejorative term that, as used here, means not only the poisoning of individuals but of society.
The facts are beyond dispute, but there are those who dispute the right to disclose the facts, as illustrated above and elsewhere. There are those who believe in methadone and Suboxone® so blindly that they’ll charge us with irresponsibility for pointing out the side effects of these “valuable” drugs. Our view is that thereal irresponsibility is the destruction of Dr. Kishore’s PMAI treatment centers, which were then enjoying a 50% to 60% twelve-month success rate, to instead promote treatments with a miserable 2% to 5% twelve-month success rate (such as methadone).
It is far more irresponsible to promote abject failures like methadone, and to hide the massive social engineering project imposed on hundreds of thousands of people without their consent or knowledge, than to promote sobriety-based treatments that have worked miracles without tampering with gender roles within the state’s population.
Until the critics confront these issues, their objections will continue to smack of total hypocrisy, and we are under no obligation to take seriously any backlash emanating from individuals or groups whose motives are so easily subject to moral challenge.
The secret they’re hiding is an ugly one. Pray for courageous men to release us from its shackles.
1. Herbert Uzochukwu is the co-founder of a non-profit organization to help widows and orphans, New Hope Ministries. Their website is http://www.globalnewhope.org
3. His landmark clinical results from between 2006 to 2010 were presented at the American Association of Treatment of Opioid Dependence Conference held in Chicago October 23-27, 2010. The summary results can be viewed here: http://www.punyamurtulakishore...
5. Law enforcement officials like Butler County’s Sheriff Richard Jones actually have other agendas in respect to drug abuse treatment: they’re more interested in reducing crime than facilitating recovery from addiction, which is why they favor the use of methadone. See http://thechart.blogs.cnn.com/...
11. Charles Alexander Bruce, “Report on the Manufacture of Tea and on the extent and produce of the tea plantations in Assam,” Calcutta, 1839, quoted by Katz in previous endnote.
13. See table 2 on page 3 in the reference provided in endnote 10.