Valley doctor fighting state accusations of dangerous prescription practices

A Spokane Valley doctor accused of recklessly writing prescriptions for painkillers said the state investigation is a vengeful effort to discredit his practice.

Dr. Merle Janes has treated 70,000 patients since 1969 and has earned a reputation as a medical doctor that bucks the system, embraces forms of alternative medicine and needles state regulators, said his attorney, Pat Stiley.

Janes has never been sued for malpractice, Stiley said.

The attorney said the state has been trying to chase his client out of medicine for decades, filing multiple administrative claims against him. Each time they have failed, Stiley said.

In this latest case, the state’s Medical Quality Assurance Commission accuses Janes of prescribing opioids to 18 patients “in a remarkably dangerous fashion.”

Investigators allege Janes failed to perform standard physicals and review patient histories before prescribing opioids. In one case, the investigators accuse Janes of continuing to prescribe prescription painkillers to a patient who attempted suicide.

Stiley said he plans to issue a formal response to the state administrative charges in September.

But Janes said via email that his prescription policies have never hurt or led to the death of any patient. Furthermore, the patients cited in the state’s administrative complaint haven’t been treated by him in years, according to Stiley.

Stiley said Janes stopped prescribing opioids for new patients six years ago. He stopped prescribing the addictive painkillers for older patients two years ago, having weaned them from the drugs.

“MQAC is hanging me for old patients from 2005-2009, all of whom I had discharged by 2011,” Janes said in an email. “None of them were hurt by my treatment.”

In one incident, the state accuses Janes of prescribing up to 1,920 milligrams of oxycodone per day to a 41-year-old patient with fibromyalgia, sciatica and deep joint and back pain. That’s a dose many times greater than the guidelines for opioid dosing.

But Janes said the patient was taking four times the amount investigators allege he prescribed when the patient initially sought treatment from him in 2008. Janes said he reduced the dosage while initiating prolotherapy – an alternative medicine technique that includes injections of a sugar-water solution into joints, ligaments or tendons.

Today that patient is in the final stages of treatment and is taking very few opioids, Janes said.

Stiley said Janes will fight the state investigation. He has a long history of being at odds with state regulators – specifically those with the Department of Labor and Industries. Janes said his support of injured workers did not fit with the agency’s goals.

In 2008 he was part of a class-action lawsuit against the state of Washington, challenging its opioid dosing recommendations by saying it was driven by fears of such prescription painkillers. Janes and others characterized the state as gripped by “opiophobia.” A judge dismissed the suit in 2009.

He has remained an outspoken critic of state rules regarding opioid prescriptions at a time when the issue of overdoses has grown into a national concern, including a call by the Obama administration last week to rethink drug policies. About 29,000 Americans died from overdoses across the country in 2014.