Christina Collins, a nurse practitioner in Knoxville, Tennessee, is accused of prescribing ‘colossal’ doses of opioids to an unsuspecting patient.
According to The Tennessean, the prescription ‘began with 32 tablets of methadone, a powerful opioid painkiller, swallowed eight a time throughout the day.’
Soon thereafter, the patient was instructed to take another opioid, Roxicodone, four times per day. Six Xanax were administered throughout the patient’s stay.
The order, which totaled 51 pills per day, exceeded medical recommendations by a large margin.
The prescription was written by Christina Collins, who, says the Tennessean, ‘was once one of the top opioid prescribers’ in the state.
The patient taking the horrific regimen of opioids didn’t die, most probably because they didn’t follow Collins’ instructions. Investigators say the prescription would surely have killed anyone who’d attempted to consume the full dose.
And in east Tennessee, communities are hard-hit by the nationwide opioid crisis.
Collins, in effect, sent thousands of pills out across the state, exacerbating what was already a tragic situation.
“In short, Mrs. Collins was a machine that dispensed prescriptions without regard for any professional responsibility,” said Mary Katherine Bratton, a Health Department attorney. “Her own lawyers argued that Mrs. Collins engaged in patient-led prescribing, simply giving patients whatever dangerous drugs they requested.”
Health officials tried to seize Collins’ license but to no avail. Instead, the Tennessee Board of Nursing put the nurse practitioner on ‘professional probation.’
Under its terms, Collins can keep writing prescriptions. She still works in medical offices around Knoxville, TN, where she first garnered a bad reputation for over-writing opioids.
The Nursing Board’s decision was blasted by state attorneys, who say it cannot be allowed to stand.
‘Earlier in the year,’ writes The Tennessean, ‘the Health Department and the attorney general’s office asked a state court judge to intervene’ in the case and order officials to reconsider Collins’ case.
A Tennessean-led overview of Collins’ records shows that she’d continued writing ‘whopping’ opioid prescriptions ‘even after patients failed drug tests, lost pills, overdosed, or told suspicious stories about why they needed drugs in the first place.’
In one case, Collins told a 47-year old woman to wear three fentanyl patches at once. She also recommended that she take two separate varieties of opioid, along with ‘at least three drugs that can be dangerous to mix with opioids.’
That patient purportedly tested negative for opioid use, suggesting that she may have been transferring the prescriptions to another individual or other parties.
Collins’ attorney says his client is a well-intention nurse practitioner—one who did what she could with opioids before the crisis turned into a national-level epidemic.
“This case stretches from 2011 and 2012, which was a time before Tennessee really began looking at the prescribing of opioids and other controlled substances for pain, and there was really a very limited amount of guidance for practitioners on what was expected and what were the best practices,” said attorney Eric Vinsant.
“She became a victim of her environment and the medical community and the ideas that were floating around out there at that time period.”
The nursing board never reacted to a government-led petition to revoke Collins’ license.
The Tennessean’s perusal of board meeting transcripts shows that some members believe Collins was guilty of ‘dramatic overprescribing.’ They did not, however, believe that she’d put out large quantities of opioids with any malicious intent.
“Do I think she is a danger?” asked one member, herself a nurse practitioner. “No. I think she stopped when she realized that this is not correct. I just think it should have been recognized sooner.”