By Pat Anson, Editor
A prominent California pain physician and a longtime champion of the pain community has announced his retirement. Dr. Forest Tennant, and his wife and office manager, Miriam, have informed patients that they are closing their pain clinic in the Los Angeles suburb of West Covina, effective April 1.
“On strong legal and medical advice, as I am 77 and Miriam 76, we are closing the Veract Intractable Pain Medical Clinic and taking retirement. I will write no additional opioid prescriptions after this date,” Tennant wrote in a letter to patients. “We very much regret this situation as the clinic is filled with patients we consider beloved family and friends.”
Tennant’s retirement is largely due to an ongoing DEA investigation of his opioid prescribing practices. DEA agents raided the Tennants’ home and clinic last November, while Tennant was testifying in Montana as a defense witness in the trial of doctor accused of negligent homicide in the overdose of two patients. The Tennants arrived home to find the front door of their home had been kicked in by DEA agents.
A DEA search warrant alleged that Tennant was part of a “drug trafficking organization” and had personally profited from the sale of high dose opioid prescriptions. Tennant has denied any wrongdoing and no charges have been filed against him, but the investigation remains open and the resulting stress and uncertainty have taken their toll.
“It’s hard to continue operating when they never closed my case, and so I’m going to retire and move on,” Tennant told PNN. “That’s on the advice of both my lawyers and my doctors."
Tennant is a revered figure in the pain community because of his willingness to treat patients with intractable pain who were unable to find effective treatment elsewhere or were abandoned by their doctors. Many travel to California from out-of-state, and some are in palliative care and near death.
Tennant and his colleague, Dr. Scott Guess, treat about 150 intractable pain patients with a complex formula of high dose opioid prescriptions, hormones, anti-inflammatory drugs and other medications.
Tennant says the DEA effectively forced him into retirement by refusing to drop the case.
“You can’t do the kind of work I do and operate in legal uncertainty,” Tennant said. "You’ve got to have legal backing to treat these individuals. And I don’t know what the law is anymore.”
‘Many Patients Will Die’
This was a difficult day for Tennant's patients -- as many see their lives dependent on his continued care and treatment.
“I believe many of Dr. Tennant’s patients will die because they will never find another doctor to treat their painful condition,” says Gary Snook, a Tennant patient who lives with adhesive arachnoiditis, a painful and incurable inflammation in his spinal nerves. “I haven't decided if I will even look for another doctor, nobody will take a patient like me. And to be honest with you, I am tired of looking, tired of being treated like an addict, tired of being treated like a curiosity and nothing more, not a human being with a serious health issue that deserves to be treated.
"I am completely devastated for myself and my family, for Dr. Tennant and Miriam, for his patients and their families, and for all those who could have benefited from his continued breakthrough treatments and research," said Denise Molohon, another Tennant patient who lives with arachnoiditis, in an email.
"But I am most deeply saddened today for the entire chronic pain community - both patients and providers - for the tsunami of injustices perpetrated by DOJ/DEA and CDC in their cruelty, ignorance and haste to appear as though they are fighting the opioid overdose epidemic by ruining the lives of many innocent physicians. Their combined actions have had the tragic result of harming untold millions and leading to the senseless, needless deaths of patients all across our country whose only fault was suffering from horrific, intractable pain."
"The government has stepped in and stopped doctors from treating patients. They have created a hostile work environment for physicians who refuse to conform. Physicians who refuse to let their patients suffer. Addiction is a huge problem but so is intractable pain, yet those of us who play by the rules are the ones who suffer," said Kate Lamport, a Tennant patient who has arachnoiditis.
"Dr. Tennant and Mrs. Tennant have been a Godsend to all whom have crossed their paths and will never be forgotten by the thousands of lives they have touched and saved. Our blood is not on their hands, it is on the hands of those who have taken Dr. Tennant and every other doctor from us by way of fear."
“Forest and Miriam treated me like a son as they did all their family, their patients. They did their best to take care of us," added Snook. "How could any doctor do so and pay $1,000 an hour in legal fees just to defend himself from false charges from the DEA?”
Tennant is referring all of his patients to new doctors, but in an age when many physicians are afraid of prescribing opioids, its unlikely they'll find similar care elsewhere. Tennant has operated his pain clinic basically as a charity for years and charged patients little, if anything. He and his wife live modestly, and drive cars that are nearly 30 years old.
“They (the DEA) think my clinic has been operated to make a great deal of money. Some years it loses money. The last two years, it actually lost money. We subsidize it,” Tennant explained.
‘Highly Suspicious’ Prescribing
One medical professional who has been critical of Tennant's prescribing practices is Dr. Timothy Munzing, a Kaiser Permanente family practice physician who was hired by the DEA to review Tennant’s prescriptions.
Munzing was quoted in a DEA search warrant saying it was suspicious that “many patients are traveling long distances to see Dr. Tennant” and that they were prescribed “extremely high numbers of pills/tablets.”
“I find to a high level of certainty that after review of the medical records… that Dr. Tennant failed to meet the requirements in prescribing these dangerous medications. These prescribing patterns are highly suspicious for medication abuse/and or diversion,” Munzing wrote.
Munzing has worked for several years as a consultant for the DEA and the Medical Board of California, creating a lucrative second career for himself.
According to GovTribe, a website that tracks payments to federal contractors, Munzing is paid $300 an hour by the DEA. In the past few months, Munzing has been paid over $250,000 by the DEA to review patient records and testify as an expert witness in DEA cases.
The agency recently created a task force to focus on doctors like Tennant who prescribe high doses of opioids. The task force appears focused solely on the dose and number of prescriptions, not on the quality of life of patients or whether they’ve been harmed.
After three years of investigation, the DEA has not publicly produced evidence that any of Tennant’s patients have overdosed, been harmed by his treatments, or that they are selling their drugs.
Tennant says he and his wife plan to retire to their home state of Kansas, where they have real estate investments. Once out of the picture, he hopes the medical profession and law enforcement will someday come to a sensible approach about how to deal with patients who need high doses of opioids.
“I have learned that my personality and my image is such that I think its prohibiting a good debate and discussion as to how the country is going to deal with people with really severe pain,” he said.
For the record, Dr. Tennant and the Tennant Foundation have given financial support to Pain News Network and are currently sponsoring PNN’s Patient Resources section.