The drug war against addicted and recovering doctors in this country is motivated by ideology rather than by the much publicized motive of public safety, exactly like the McCarthy war on communists in the 50s. Similarly, this war has been significantly compounded by superstitious beliefs, ignorance, and irrational fears disseminated by biased public figures and cooperative media. Its instinctive basis, the human instinct xenophobia, has caused past salem witch hunts, and is causing present day racism, homophobia, anti-Semitism, and all genocides around the globe. Not too many people realize they're addictophobic because it is completely politically correct to discriminate against addicts (although not always legal to do so, at least recently). Addict discrimination is not perceived as a kind of racism¹ because most people, even the addicts themselves², believe addicts are bad and scum of the earth. This addictophobia is an insidiously damning attitude as well as invisible because it is the most easily rationalized and publicly acceptable example of xenophobic targeting. Besides, it stems from completely irrational and insidiously unconscious motivation. As such, it is unassailable by any sort of reasoning process. Thus, to root out racism from the population is impossible. To root out racist policy makers and administrators can only be accomplished when we are able to distinguish and identify them despite their protestations to the contrary supported by their almost plausible rationalizations of their beliefs and behaviors^1b, much like trying to convince William Buckley, Jr. that his belief in creationism and arguments against evolution are irrational. I am one of the few who knows this to be the case because I know who and what I am. I used to have the same fears and hatreds toward addicts as the majority of people have today. Addictophobia is the last socially acceptable form of bigotry, and bigots, Uncle Toms, and stoolies^2b abound in the area of addictions, addictionology, and addiction policies.

The doctor drug war is also most assuredly a show of power against a group of people who happen to have a disease that is misrepresented as a social and political defection and as a willful disregard of authority for the short-term benefit of personal selfishness, "getting high." How shortsighted an attitude. No doctor in his right mind, which includes 99% of addicted doctors and me, would risk his patient's health and welfare, no less his own life, family and career, just to get high and to be a willful social pariah. That extremely shortsighted perception of addicted doctors who are currently being burned at the stake in the name of public safety is so pathetic as to be ludicrous if it weren't so damaging and unjust. Doctors who have spent a large part of their lives becoming physicians and have sacrificed much immediate gratification for the desire and privilege to be doctors are being categorized as thieves of the public trust if they happen to have the disease of addictions and find themselves addicted, especially to controlled drugs. These addictions are misrepresented as criminal behavior rather than as a manifestation of the disease of addiction found in upwards of 10% of the general human population, the same percentage as in the medical population. This disease is erroneously believed to be either psychosocial, psychological, or psychopathological in origin when in actuality it is neurobiological in origin.³ Yet, despite all the evidence to the contrary, addiction in doctors is seen as willful and criminal behavior. Moreover, to get out of the public health jail, recovering doctors are subject to the same requirements as murderers facing a parole board, subjectively judged rehabilitation and remorse⁴, rather than objective recovery. Do you actually believe addicted doctors are BAD and need to be handled as societal defectors by the drug war police?

Despite all evidence, and much as in the nationalized drug war currently being perpetrated on the entire country by General McCaffrey and his goon squad, supported and mandated by the U.S. government, the drug war against addicted doctors has no effect on public safety and thus the motives for this war need to be examined closely. When this is done, we see that the motives are either about power, control, respect, subservience, acquiescence, and relinquishment of civil liberties to the government or the fallacious and biased fear producing generalizations that addicts are sociopathic, dangerous, immoral, and mentally ill, rather than the purported motives of safety or prevention of addiction, neither of which is accomplished by the drug war policy or public health police. Following their biased and perverted beliefs, regulatory administrations extrapolate to, "doctor addicts are dangerous in all these ways and they must prove they aren't dangerous in order to resume practice." Prove innocence? No. How does one prove one isn't dangerous? As an addicted physician you are beholden to prove not just your recovery, which is straightforward, but your fealty and the surrender of your thoughts and beliefs to their system, from the Medical Society to the CPH (who are supposed to be your advocates but are instead their thought police⁵), to the Health Dept. to the Education dept. Fealty is proven by 1) believing and reciting their conception of addiction, that you are bad and promise to be good. 2) getting clean and sober their way and in their time frame (as if it were under their or your control). 3) being agreeable to their punishments and destructive retribution for any breach of their ideology or mandated demands. Their demands to the addicted doctor are no different from the church's ecumenical rules of obeisance where excommunication is the consequence of any perceived heresy. It is not about public safety. It's about control, not only of behavior and recovery, but also of your thoughts, beliefs, and feelings.⁶ Only when these last, and absolutely personal, requirements are met are you then allowed to resume practice. No other disease or disability is handled this way in our society.

If their motives, to this day in fact, were about public safety⁷, they would never have revoked my license, there was no need for that, they would have treated me like this---Because you have a disease that is potentially dangerous to your patients, we want you to stop practicing until you are in recovery. We will not tell any other person you are addicted. Join your medical society's monitoring program. No punishment or criminal prosecution will ensue during this process. We will protect your job and position. Come back for your license when you have met our clear and objective criteria for relicensure based on documented clean urines for such and such a length of time and your agreement to be continuously monitored when you resume practice.--- This would ensure public safety at the level of the patients and would not have led to my partners kicking me out of the practice and all the other damaging things that happened to me as a result of their police tactics and criminalization of my addiction. It's a funny thing, and part of the discrimination known to occur at the dept. of education, but the dept. of education says it has that exact program in effect for all public employees and licensed professionals except doctors. They revealed this to me during my last hearing in Albany. Thus, they are clearly aware and intentional about their own motivation concerning doctor addicts. It is punitive and discriminatory, pure and simple, not related to public safety at all. Revocation has no effect on public safety, but it does allow them to get rid of me indefinitely. Revocation has its place for seriously dangerous doctors, not addicted ones who never did and never would injure a patient. Most nonaddict doctors who have repeatedly injured patients never get revoked. Revocation for doctors like me is for revenge, pure and simple.

Let me put it succinctly: They are not fearful for public safety, they are fearful for themselves, their power, their bigotry, their addictophobic beliefs/religion. They are not protecting the public, they are protecting their religion, their beliefs, their right to discriminate, their control, their power, their hearings, their PRIDE, the worst of the seven deadly sins. I am not only being censured, I am being censored. It is arbitrary, discriminatory and illegal.

Year after year the same number of new addicts appear from the population of practicing doctors. Not only doesn't the supposed public safety policies of the health dept. reduce the appearance of new doctor addicts each year or of medical mistakes and disasters in general, it actually ensures that any damage that does result from these addictions will be magnified and multiplied by the necessity of the addicted doctors to remain hidden and underground fearing discovery and destruction of their practices and lives by the health dept.'s drug police. A noncriminal, nonpunitive, and protective and purely objective rehabilitative approach would actually have the corrective, protective, and constructive effect the public wants but is not allowed to have because of the power and self-serving needs of these administrations. Currently, a thousand doctors a year are DYING just from drug overdose while in practice (mostly anesthesiologists who inject their drugs intravenously) because they are afraid to come out of the closet of their secret addiction. Only the rehabilitative and medical approach to addiction among physicians would allow the inevitable new crop of addicted doctors each year to actively seek the recoveries they would rather have and would seek if only there was no threat of personal destruction if they were to come out of hiding on their own. Tell me we devalue trained and proficient doctors so much as to continue to allow this treatment of addicted doctors in the name of the drug war witch hunt.

The public has no idea this scenario exists, occurring to their actual detriment, and therefore is unable take action against the drug war on addicted doctors. The public has been made so irrationally fearful and prejudiced of drugs and addicts by the propaganda lies publicized by the same groups that are running the drug war. People will go along with any policies they are told will protect them from addicts including the fascist activities of these anti-drugs-and-addicts-at-all-costs state agencies. These activities, especially in the case of doctors, are all unconstitutional and equivalent to the Russian Gulag described by Solzhenitsyn. They are run by an administrative law process that is legally and conceptually alien to anyone who knows their legal rights under the constitution of the United States.

In a recent book, To Err Is Human⁸, and report concerning the massive numbers of medical errors, 40% of which are fatal, across the country done by the National Academy of Science, an independent research group in Wash, DC, there was no mention of addicted doctors as a cause of these injuries and mistakes. Similar studies have recently been done by the Veterans Administration and by the National Center for Public Safety. No one even mentioned that this finding wasn't mentioned! No mention is made of "impaired physicians⁹" nor of their major role in causing medical mistakes and disasters. In fact, there is no data anywhere suggesting that there is more medical negligence caused by addicted doctors than non-addicted ones. This is one of the myths perpetuated to justify the drug war against addicted doctors. All the data show the same amount of medical damage caused by addicted doctors as by those who aren't addicted. Addiction is not equivalent to impairment as the health dept. would have us all assume.

Addicted doctors are being used as scapegoats, and their disciplining as public evidence that the health departments are acting to reduce patient injury. Not only is this not valid, it is wrong and actually reversed. The disciplining of addicted doctors is not reducing medical errors and disasters, and the heath department's actions to reduce medical disasters have been misplaced and misdirected due to their ignorance, morality based biases, and lack of appropriate study of this problem. Pinpointing the addicted physicians as its cause and ruining their careers and lives as its cure is done merely for show because of intuitive belief and public support that it is true and makes sense. As it turns out, this intuitive truth is wrong and the health dept.'s destructive scapegoating of addicted doctors is criminal. Intuitive beliefs about the danger of drug addicts in general and thus our need for the doctor drug war stem from the same myths and ignorance. Impairment and danger must be judged by actual specific medical practice behavior, the same as with nonaddict doctors, not by the presence or absence of addiction and the incorrect belief that addiction equals impairment equals actual patient damage requiring discipline and punishment. When impaired practice occurs, discipline needs to be meted out as a separate issue just as it is in nonaddicted doctors. This is fair as much as it is right and just. The fact that these authorities know they are scapegoating doctor addicts merely for public display makes these actions intentional and subject to the full force of the current laws prohibiting such outright discrimination. Not a single case of this widespread discrimination and persecution has yet been prosecuted. Failure of the U.S. Justice Department to take legal action on these cases shows the hypocrisy rampant in our government despite the presence of laws prohibiting scapegoating and discrimination based on generalizations about addictions and addicts (Americans With Disabilities Act of 1992). This absence of federal support and local legal action also reflects the intimidation¹⁰ felt by addicted doctors and their advocates to oppose their own discrimination.

The main thrust of this article concerns the discriminatory differentiation of the disease known as drug addiction from all, and I mean ALL, other diseases known to humans. This differentiation has to do with the discrimination and criminalization of particular disease associated behaviors of drug addicts that have no effect whatsoever on any other person as if addiction was equivalent patient damage and physician negligence and harm. There is no other disease I know about where characteristics of the disease itself (as defined by medical experts in the field) having absolutely no effect on another person have been criminalized and deemed worthy of the patient-victim being punished and his life ruined for merely having the disease. This is because addiction is misperceived as voluntary and willful misbehavior despite its definition (below) which doesn't include any reference to it being willfully or voluntarily induced. That the state regulatory agencies can so blatantly define addiction any way they desire to suit their biased administrative stances is absolutely bizarre and occurs in no other area of their dealings with other medical diseases. Moreover, they even distinguish between different groups of addicts (and within these groups as well) under their jurisdiction based on their particular jobs and positions, rather than on their addiction behavior. In other words, the entire process is arbitrary, not conducive to public safety or public well-being or public anything but public discrimination.

Moreover, if the person with the disease, the addict, doesn't appreciate society's (via these administrative boards) criminalization, abuse, and punishment in response to his disease, he is considered antisocial and defiant and of the most disagreeable character, psycho or sociopathic, by the administrative system doling out its punishments. This misrepresentation, backed by irrational fear and drug war propaganda lies, allows the destruction of perfectly valuable and competent doctors (and the resulting loss of his services to his patients) to continue. No one has yet asked any of my patients how they feel about losing me as their doctor. Why? Because they would all say they miss me and are angry about being deprived forever of my services to them.

Let me ask you: Do you know of any sick person who would appreciate public ridicule, stigmatization, and punishment for just being sick as defined by the doctors taking care of him? This appreciation of personal injury and destruction is a requirement in my case for relicensure. In the report summarizing one of my education dept. hearings for relicensure, the lawyer for the panel complained, "Dr. Umanoff doesn't accept his ostracism!" This peculiar societal disconnect, for addicts only, is not realized by most people because they automatically discriminate in their minds against and about addicts to begin with. "Why should drug addicts complain about abuse? They brought it upon themselves and deserve it," is a common statement.

The issue in this article is whether there is any justification for withholding licensure or continued career destruction of recovering drug addict doctors who have never injured a patient or done any illegal behavior outside the typical addiction behavior, the obtaining and use of the addictive drug. All biases aside, should doctors manifesting this kind of nondamaging addiction behavior, known to be an illness, be treated by regulatory and licensing agencies any differently than doctors having any other chronic illness?

Because of the innumerable misconceptions in existence concerning every area of addiction, and each misconception needs an aside, there might be quite numerous asides in this article. I will try to hold the number of asides down. They will appear as endnotes.

The past and ongoing outright abuse of me, Dan Umanoff, M.D., due to my addiction is the motivation for this article. I assume also that if this kind of stuff happened to me, the same things have happened to other doctors and other nondoctors dealing with administrative bodies. I am writing this article to communicate with other addicts who may have been abused similarly and as a rallying point for us to come together as a network to incite change in the system that has been perpetrating this kind of damage and discrimination.

My entire exemplary medical practice and ability to make a living doing what I do best, being consistently helpful to my patients and colleagues, was extricated from me under the force of the public health law and the war on drugs simply because I was sick. This article is about my disease and my story, how I was handled by my doctors, "advocates,"; authorities, society, family members, and business partners, and my response to that. If you want to relate to this article personally, just substitute your addiction (or disease) and those who discriminated against you or could have. As you will see, this story is long and convoluted. I even left a lot of it out to be able to stick somewhat to the point. Be that as it may, I told much of this story at my license revocation hearing (5/92) in a misguided attempt to show how I meant no harm to them or my patients and was deeply sorry for my behavior. They judged this story as "rambling" and used it as one of three reasons for justifying the revocation of my license. That word "rambling" was meant, I guess, to either say I was on drugs at the time, despite consistently clean urines over the previous 7 months the result of which they had in their hands, or that I was mentally impaired in some way. Laugh out loud! In this process they can say whatever they want to justify their abuse and discrimination. The other two justifications for the license revocation, other than my addiction and the felony of writing prescriptions for myself during relapses (called "practicing medicine without a license" by the US Attorney) while I was attempting to the best of my ability to get back into recovery were: 1) No previous sobriety despite previous addiction (wrong - that I had 8 years of previous sobriety 1978-1986 which I accomplished voluntarily and unbeknownst to them was discounted and ignored. The present addiction (1986-89) was a relapse. This was all in the record.) and 2) Poor prognosis¹¹ (Based on what, a crystal ball? I was sober 7 months at that time and have been continuously sober for over 8 years now, but according to them, I had a bad prognosis then and their license revocation action stands despite my proving them wrong. They categorically refused to consider suspension or probation as equitable punishments, only revocation which is the harshest and most difficult to come back from as I was to discover.) That these three justifications were incorrect has not helped me get my license restored because just mentioning that discriminatory and unjust revocation hearing is impermissible (water over the dam) and is also used against me; evidence for lack of remorse, lack of acceptance of my revocation. Every forensic expert writing about these hearings calls them unfair, but when I do, it's evidence for lack of remorse and needing of further punishment (for the sake of public safety?). I guess remorse means accepting being abused and discriminated against in a legal system invented to remove all legal rights we were all given under the constitution. That's administrative law.¹² Actually, lack of remorse, as you will see, is a code word for, "We don't like his attitude. He doesn't agree with us about how bad, dangerous, immoral, irresponsible, and negligent we believe he is," despite no evidence for these assumed behaviors and actions. When you're an addict, you're assumed to embody these characteristics and it is your burden to disprove them, "You are guilty until you prove yourself innocent." This is the reverse of due process, a constitutional right of every American.

In the following discussion, if you have any trouble relating to or identifying with the word addict, just replace it with the word Leukemic. This word replacement helps in removing bias from the sentence being read. Personal bias associated with the word addict or addiction interferes with the flow of the argument. Leukemia is also a chronic, relapsing disease just like addiction (manifest, however, by different behaviors, no less destructive or detrimental to people and society, and likewise involuntary).

Definition of Drug Addiction: Addiction is a chronic, relapsing disease manifest by the continued and compulsive use of a mood altering drug by an addict (despite harm to himself, family, job, country, etc., if any has actually occurred) that is recoverable. The words in parentheses are expansive and not necessary for the definition. Notice please that there is no part of this definition that states any of this is "Willful" (or misbehavior for that matter). The NYS health and ed. dept.'s definition of addiction is "Willful misbehavior consisting of abuse of controlled substances and therefore willful misconduct." NYS government uses a nonmedical definition of addiction that they invented to suit their discriminatory needs. Can you imagine if they made up definitions of other disease such as leukemia to suit their needs? They would be forced to change it immediately. Not so for addictions.

There are several words in the real definition of addiction that need to explored just a bit, moreover, the definition holds for all drug addict doctors, not just me: 1) chronic - Is part of the addict's life indefinitely. A part of chronicity is the inevitable relapses and remissions which may or may not be under the control of the treating physician or patient. It is rare if not nonexistent for any medical patient to be blamed for these relapses except in addictions. Since no one acknowledges full understanding of these events in addictions any more than they do in other medical diseases, and probably much less so if they're honest, making a relapse a criminal act, as it is in addictions, is preposterous if not outright cruel. Anyone who knows a smoker attempting to quit knows about the frequent relapses they experience on the road to recovery. Yet, for some reason, opiate relapses are perceived as criminal while alcohol and cigarette relapses, part of the same disease, are accepted as part of the recovery process. Making the occasional and recreational use of opiates illegal makes sense in the context of preventing opiate use among the general population, but once a person is addicted to opiates and is medically perceived as sick, making the same use of opiates illegal is cruel and nonsensical as it would be in a Leukemic or smoker. 2) relapsing - The chronic disease may be in remission at some times and active at others. The occurrence of the relapse is not under control of the patient-addict, and by definition should not be judged as intentional. Using the relapse as evidence of insincerity and lack of cooperation with people attempting to help (demanding and mandating) him to recover is irrational, ignorant, and abusive, if not just ignorant. My relapses on the road to my recovery were used exactly in this way. 3) disease - this refers to the fact that it is not intentionally caused by the patient (addict). By "it" I mean the addiction or the behavior associated with the use, obtaining or possession of the drug, an inextricable part of the disease of addiction. Thus, motivation and character disorders are not to be inferred from relapses as they aren't in any other disease. Should a leukemia relapse be judged as a character disorder or as lack of cooperation? Addiction and possession of the drug are likewise not evidence of bad character or motivation because by definition, the disease and the use of drugs occurs against the will of the addict exactly the same as with Leukemics having anemia or a high/low white count.