In a case highlighting the addiction-fighting capabilities of the New Jersey Prescription Monitoring Program, the Office of the New Jersey Coordinator for Addiction Responses and Enforcement Strategies and the Division of Consumer Affairs today announced that a Middlesex County doctor has been permanently barred from practicing medicine in New Jersey after records revealed that during a one-year period he prescribed patients more than 150,000 units of the powerful opioid painkiller OxyContin, exceeding recommended daily morphine levels in 80 percent of the prescriptions.
According to authorities, Dr. Eddie Gamao, a general practitioner in Piscataway, agreed to the permanent revocation of his license in a Consent Order with the Board of Medical Examiners that resolves allegations he indiscriminately prescribed highly addictive opioid painkillers, in excessive amounts and dosages, to his patients between February 2017 and February 2018. Gamao’s prescribing habits came under scrutiny after a pharmacist filed a complaint on the NJPMP’s Suspicious Activity Report online portal alleging Gamao may have been indiscriminately prescribing controlled dangerous substances to three generations of a Middlesex County family, including an 88-year-old grandmother.
A subsequent review of Gamao’s prescribing history on the NJPMP revealed that during a 12-month period, he prescribed more than 9,000 oxycodone pain pills in the strongest available dosages to the elderly woman and two family members in dosages that more than tripled the CDC’s recommended daily morphine milligram equivalents (“MME”) limit for each person. Gamao also prescribed more than 1,000 units of powerful opioid painkillers to two other members of the family in dosages that met or exceeded the recommended limit.
The revocation of Gamao’s license marks the first time a New Jersey doctor has been permanently barred from practice as a result of allegations that were reported by a pharmacist using the NJPMP SAR portal, and substantiated by a review and analysis of NJPMP records and data.
“This case demonstrates that that partnerships we’re building and the programs we’re implementing to fight New Jersey’s opioid crisis are working,” said Attorney General Grewal. “Thanks to an alert pharmacist and the capabilities of the NJPMP, we were able to identify and shut down a dangerous flow of opioids into our community and put this problem prescriber out of practice for good.”
“We have called on pharmacists to keep an eye out for signs of prescription drug abuse and diversion and to use the SAR portal to report suspicious activity,” said Sharon M. Joyce, Director of NJ CARES. “As this case shows, one tip is all it takes to stop dangerous prescription drugs from being diverting into the wrong hands where they can lead to addiction and fatal overdoses.”
A review of Dr. Gamao’s entire prescribing history on the NJPMP revealed that his alleged indiscriminate prescribing of opioids was not limited to the family in question, it spread across his entire patient base.
Officials say in March of 2016, the CDC issued guidelines advising prescribers to use caution when prescribing opioids at any dosage and to start with the lowest effective dosage; to carefully reassess the risks and benefits when considering increasing a patient’s dosage to 50 or more MME per day; and to avoid increasing dosage to 90 or more MME per day, or to carefully justify a decision to titrate dosage to that level. Gamao’s prescribing records showed that during a 12-month period he prescribed “Schedule II” opioids, those considered to have the greatest potential for abuse, like oxycodone, morphine, and fentanyl to 106 patients.
An analysis of the prescribing data revealed that:
More than half of all the 1,040 Schedule II opioid prescriptions Gamao wrote resulted in daily MMEs of 270 or higher – more than five times the CDC’s 50 MME threshold and almost three times the upper limit of 90 MME.
Nearly 99 percent of the 639 prescriptions Gamao wrote for oxycodone immediate-release prescriptions resulted in daily MMEs that exceeded 90 MME.
In the case of the 88-year-old woman, Gamao routinely wrote high-quantity, high-dosage opioid prescriptions for 30mg oxycodone days apart from one another, which resulted in a combined daily MME of 810 – more than sixteen times the 50 MME threshold and nine times the CDC’s recommended upper limit of 90 MME.
Maintained some patients on morphine levels that ranged from 330 to 960 daily MMEs.
According to authorities, in March 2018, the Board temporarily suspended Gamao from practice pending the outcome of the allegations against him. On October 31, Gamao entered a Final Consent Order with the Board resolving the matter. In addition to permanently revoking Gamao’s medical license, the Consent Order permanently revokes Gamao’s NJ CDS registration that allowed him to prescribe controlled dangerous substances in this state.
Under the terms of the Consent Order, Gamao is precluded from managing, overseeing, supervising, or influencing the practice of medicine or provision of healthcare activities, including testifying as an expert witness in New Jersey. He is also prohibited from charging, receiving, or sharing in any fee for professional services rendered by others, and required to divest himself from any current and future financial interest in or benefit from the practice of medicine.
Patients who believe that a licensed health care professional is prescribing CDS inappropriately can file an online complaint with the State Division of Consumer Affairs by visiting its website or by calling 1-800-242-5846 (toll free within New Jersey) or 973-504- 6200.