For patients like Stephen Szymoniak, the indictment of Dr. Eugene J. Gosy last week whipped up anxiety and confusion amid unanswered questions about care for pain.
“It’s a horrible position to be in, and I am quite terrified,” said Szymoniak, whose treatment for chronic pain from a shoulder injury includes buprenorphine, a drug that a limited number of physicians are certified to prescribe.
Federal prosecutors accuse Gosy him of providing painkillers to patients without a proper medical reason. He pleaded not guilty Wednesday but surrendered his license to prescribe controlled substances. Gosy kept his medical license.
Now, Syzmoniak and other patients - Gosy’s lawyer estimates the neurologist has between 8,000 and 10,000 patients - worry about being able to continue treatment and the extremely uncomfortable prospect of withdrawal.
“Not everyone is abusing narcotic drugs and trying to scam doctors to get them,” said Sue Nagy of Springville.
She takes the prescription painkiller oxycodone for spinal stenosis and has been reducing her daily dose to conserve pills. She walks with a cane and considers her chronic pain a legitimate condition that deserves treatment.
Other patients expressed fears that they will not be able to get relief from chronic relief that has nothing to do with addiction.
A message on the website of Gosy’s practice, which closed after the indictment, assures patients that appointments are expected to resume on Tuesday. His practice, Gosy & Associates on College Parkway in Amherst, includes another physician and nurse practitioners.
“We are aware of your needs and apologize for any inconveniences the current position our practice has been placed in may have caused you,” the office message reads.
But it’s unclear if the practice can handle all the patients without Gosy’s ability to prescribe controlled substances or if other physicians in the community can quickly absorb patients who want to find an alternative medical provider. Some pain patients are still recovering after surgery.
Syzmoniak, as a precaution, said he called 27 other offices that prescribe buprenorphine. They placed him on waiting lists, and only one accepted health insurance, he said.
“I learned that it costs an average of $200 to just have an intake appointment with a doctor licensed to prescribe me buprenorphine, and the lowest cost for appointments was $100 every two weeks. That’s unrealistic for me,” he said.
State and county public health officials recommended that Gosy’s patients contact other doctors if the practice is unable to see them at all or in a reasonable amount of time. They advised patients to consult with their insurance company, primary care physician, health centers or county medical society for assistance in finding a new pain management physician.
“Hopefully, this can act as a bridge for patients to get the care they need,” said Dr. Gale Burstein, Erie County health commissioner.
She advised patients to not wait until they run out of pain medication before checking with Gosy’s office or searching for another doctor.
“I can imagine that people on pain medications are in a panic. It would be like diabetics dependent on insulin,” she said.
But Burstein also said the circumstances offer an opportunity for patients to try weaning themselves off addictive painkillers and using different medications, such as over-the-counter pain relievers, or alternative therapies.
Nagy, of Springville, and others expressed shock over the allegations against the physician they had come to trust and depend on. They said opioid medications frequently are the only treatment that allows patients to live a life without chronic and, for some, disabling pain. They said patients should not be allowed to suffer or be treated like addicts.
“Going to another doctor is not as easy as it sounds. Even if you find one who will take you, you have to go through from scratch all the rigmarole to obtain pain medication,” said Nagy, referring to the protocol physicians follow for assessing pain and prescribing an opioid.
Gosy’s case comes as Western New York and the rest of the nation grapple with an opioid abuse epidemic. Five other doctors in the region have found themselves investigated and subsequently charged with illegally dispensing painkillers.
At the same time, many of his patients represent a portion of the striking number of Americans who report having pain.
A survey by the National Institutes of Health published last year found an estimated 25.3 million adults -- 11.2 percent -- who say they experienced chronic pain every day for the preceding three months. More than 126 million -- nearly 56 percent of all U.S. adults -- reported some sort of chronic pain over the same period.
Patients here also voiced frustration that they are largely relying on the media to find out what to do.
“There must be a better way to set up some sort of care plan for patients,” said Syzmoniak, of Williamsville.
Gosy’s indictment comes at a time when the health system is overwhelmed by fatal heroin and opioid overdoses, including from addictive painkillers, with an average 11 drug deaths a week in the county and a huge need for expanded addiction treatment. Doctors who prescribe powerful narcotic painkillers today face increased scrutiny.
Federal prosecutors accused Gosy of operating a criminal conspiracy that issued more than 300,000 illegal prescriptions in four years. The indictment alleges that the doctor set up a prescription-renewal process that resulted in 300 illegal renewals each day. Gosy is charged with conspiracy to distribute controlled substances and the unlawful distribution of narcotics.
When it was pointed out that Gosy has strong supporters among his patients, U.S. Attorney William J. Hochul Jr. said some of the prescriptions the doctor wrote were legal.
“I wouldn’t say that every single prescription he wrote was illegal,” Hochul said. “What the government has claimed is that he wrote about 300,000 illegal prescriptions.