Should the nurse practitioners who ran the former Payette Clinic be allowed to prescribe again, despite a record of complaints, investigations and a death?
- Yes, if the state says it's OK, it must be OK. 16%
- No, the state is wrong. It's too risky. 71%
- Undecided. I need more information. 13%
83 total votes.
Some of the faces and stories of the Payette Clinic are familiar.
There’s Harold Andres, the Vancouver Payette patient who robbed three pharmacies to get his oxycodone fix. His addiction landed him in prison for more than four years.
There’s Larae Corzine, who spent more than a year in prison for robbing pharmacies. The Vancouver woman became addicted to Oxycontin while a patient at the Payette Clinic.
And then there’s Rachel Daggett, the 18-year-old Oregon girl who died after smoking an oxycodone pill. The high school senior bought the pill from a Payette patient.
In March 2009, among allegations of overprescribing narcotic medications and prescription drug diversion, the federal Drug Enforcement Administration raided the Payette Clinic and, ultimately, ended its narcotic drug-prescribing operation.
The closure sent ripples through the community as hundreds of patients were left with nothing more than their addiction.
For every familiar story, hundreds of unknown stories exist.
Stories of the ashamed and embarrassed who will forever be labeled “addict” in the eyes of their family and friends.
Stories of the angry and disappointed, who put trust in their physician and felt betrayed.
Stories of the remorseful and apologetic, who are rebuilding relationships one piece at a time.
Here are the stories of two former patients who, after three years, are still putting their lives back together.
Their stories have been among the hundreds of unknown.
Trina Munson was a typical mom.
She kept a clean house. She devoted
herself to raising her two kids. She was a soccer mom.
“I was the most straightlaced person you could ever meet until 2005,” Munson said.
In 2005, Munson became addicted to narcotic pain medication. Her kids left her to live with their grandparents. And Munson’s life began to spiral out of control.
“My family has gone through hell and back,” Munson said.
The addiction began with legitimate pain.
Years earlier, Munson had six surgeries on her right knee and another surgery on her left knee. A car crash left her with back pain.
Munson went to the Fisher’s Landing Urgent & Family Care clinic searching for pain relief.
She found Kelly Bell.
Munson had been taking 5 milligrams of Vicodin eight times a day. The Vicodin was relieving her pain. Munson just needed a refill.
Bell, an advanced registered nurse practitioner, said she was concerned by the amount of Tylenol Munson was taking. She prescribed Munson 5-milligram oxycodone pills, Munson said.
Later that year, Bell was fired from her job at the Fisher’s Landing Clinic. When she opened her own practice in the VanMall neighborhood, the Payette Clinic, Munson followed.
Here is Munson’s account of her time under Bell’s care.
“The first time I saw her in that office, she prescribed me 600 oxycodone,” Munson said.
Those were 5-milligram pills. When Munson returned two weeks later, Bell prescribed her 500 15-milligram oxycodone pills and told Munson to take two at a time. Bell also prescribed 100-milligram morphine pills and told Munson she could take four a day.
A week later, Munson’s oxycodone pill prescription went from 15 milligrams to 30 milligrams. She was taking 1,200 a month, Munson recalled.
From then on, Munson visited Bell every two weeks. Usually, she left with a new prescription.
More pills. Higher doses. New medications.
By late 2006, Munson was taking 1,080 milligrams of oxycodone, 600 milligrams of morphine, 16 to 20 milligrams of Xanax and 150 milligrams of methadone every day.
“Everything I had was a lethal combination,” Munson said.
On Christmas Eve in 2006 -- just two days after receiving the methadone prescription -- Munson slumped over at the dinner table. Then, she stopped breathing.
Her family called 911, and Munson was rushed to the hospital. She had overdosed.
Munson was on a ventilator for three days. When it was time to leave the hospital, Munson called Bell. The hospital staff had taken away her prescriptions and she needed more.
“The day I got released from the hospital, she had my prescription waiting for me,” Munson said.
Throughout it all, Munson’s parents were fighting for their daughter’s life.
Munson said her mother went to the clinic repeatedly and told other patients that Bell was killing them. Munson said her father pleaded with Bell to stop prescribing to his daughter after her overdose.
They sent letters to the state nursing board. They begged Munson to stop seeing Bell. Munson asked Bell several times to help her detox from the medications. Finally, in 2007, Bell told Munson she would have to find a new doctor.
Munson called doctor after doctor. Nobody would see her. She was running low on medications and growing more and more desperate.
She started picking up other people’s prescriptions from pharmacies and wrote stolen checks to pay for the medications.
She was arrested in 2007 and was forced to the detox unit in jail. In March 2009, she was sentenced to two years in prison for identity theft, fraud and theft.
At first, Munson was angry.
She blamed Kelly Bell. She blamed her addiction. She blamed the court. She blamed everyone but herself.
“I was still the same drug addict inside,” Munson said. “I was blaming Kelly Bell because it wasn’t my fault.”
But one day, during a prison visit from her daughter, Munson realized her anger was misplaced.
“It was Brittany that opened my eyes,” Munson said of her now 22-year-old daughter, Brittany Moulton. “She told me I wasn’t the victim. That’s something that I’ve never, ever forgotten.”
After that visit, Munson’s anger started to dissipate.
“I wasn’t a typical prison girl,” Munson said. “It was an eye-opener. I have a purpose on this earth, and it’s not to be doing what I was doing.”
“I found who Trina is in prison,” she added. “And I found how to deal with problems and pain.”
In November 2010, Munson was released from prison. She remained on supervised release until March 2011.
Today, Munson said she has been sober for 2 years.
“I work on it every day,” she said. “I don’t take it for granted.”
Munson is a full-time student at Clark College and is pursuing her drug and alcohol counseling license. While in prison, she completed two degrees and started her associate of science degree. But her criminal background has prevented her from getting a job, leaving her financially dependent on her parents.
She’s also working to rebuild the relationships her addiction destroyed.
“I lost all trust with my family, with my kids,” Munson said. “I was an embarrassment to them.”
Moulton spent her teenage years being anything but a typical teen. She worked two jobs, went to school and helped care for her younger brother in her mother’s absence.
But today, Munson and Moulton have stitched together their once-severed relationship.
“I don’t go a day without talking to her,” Moulton said. “I can talk to her about anything. I can trust her again.”
Munson takes pride in knowing her children again and in the fact that her granddaughter has never seen her high.
Munson still has pain in her knee. But rather than narcotics, she takes Tylenol and deals with the pain.
“There is just nothing that would stop me today,” Munson said. “My life is amazing today.”
Rhonda asked that her last name not be used by The Columbian.
Rhonda has known pain most of her life.
As a young adult, she was diagnosed with fibromyalgia and chronic migraines. She’s also been diagnosed with osteoporosis, scoliosis and arthritis.
For 10 years, Rhonda had been prescribed narcotics for her pain. She took three 25-milligram Vicodin and three 20-milligram oxycodone every day. She also took Fioricet for migraines.
But in 2006, Rhonda started experiencing loss of function in her hands. First her left hand. Then her right. Then her left again. Each time it was weeks before she regained function and feeling in her hand.
She had to quit her job and sell her stick-shift car and went on disability. The pain persisted.
“I was still having problems,” Rhonda said. “My pain wasn’t being controlled at all. I wanted a doctor that was compassionate.”
Her friend Deborah Reid suggested Kelly Bell. Rhonda had her first appointment at the Payette Clinic in 2006.
During that first visit, Rhonda said Bell upped her dosage for the oxycodone, Vicodin and Fioricet.
Every 28 days, Rhonda returned to Bell’s office. Over time, Rhonda said Bell increased her medication dosage.
At her peak, Rhonda said she was taking up to 800 milligrams of long-acting morphine every eight hours, 120 milligrams of fast-acting morphine every three hours, Valium for muscle spasms, Ambien to help her sleep and Fioricet for migraines.
And then, in March 2009, the clinic was shut down by the DEA.
Rhonda tried, without luck, to find a new doctor.
“As soon as I said I was a Payette patient, they’d send me to the door,” she said.
“I had massive medical records, but because I was a Payette patient, they were too scared to prescribe to me,” she added.
Within a couple of weeks of the closure, Rhonda was going through withdrawals.
She spent days vomiting as Bell tried to keep her hydrated with IVs. But within a few days, Rhonda landed in the hospital.
Rhonda was convulsing, hallucinating and losing her vision. A few days later, she stopped breathing and was put on a ventilator.
“They told my husband and children that I probably wasn’t going to make it,” she said.
After three days on the ventilator, Rhonda started breathing on her own again. And 11 days after being admitted to the hospital, Rhonda was discharged. Doctors prescribed her narcotic fentanyl patches to help with the pain.
But Rhonda had more obstacles to face.
She and her husband lost their home and car. Her husband lost his job of 10 years. They couldn’t pay their bills, and the fentanyl patches -- at a couple hundred dollars each -- were further breaking the bank.
Rhonda followed up with the a new physician after being released from the hospital. Her skin wasn’t absorbing the medication from the patches, so her doctor prescribed morphine.
Rhonda stayed on lower doses of morphine -- 125 milligrams three times a day -- Fioricet and Ambien. But when she and her husband moved out of the state, Rhonda had difficulty finding a physician who would prescribe narcotics.
So, in June 2011, she decided to quit using narcotics. The lower dosage, however, made withdrawing from the morphine less severe. Still, she was sick for two months.
“But I’m glad for it now. I’m glad,” Rhonda said. “I’m just not a slave to it anymore.”
Rhonda and her family moved back to Clark County in June 2011. And today, Rhonda’s only medications are Fioricet and Ambien, neither of which are narcotic. Every once in awhile, when her migraines are particularly severe, she’ll take a Vicodin. But never more than one or two pills per month, she said.
Rhonda, at age 46, still has pain every single day. But she has turned to alternative methods of pain management, such as exercise, stretching, heating and icing. Still there are days she wants to give in.
“It’s 100 percent worth it,” she said. “But then there’s days when I hurt so bad I want to pick up the phone and call the doctor for prescriptions.”
Rhonda is also working to rebuild relationships with her family and to shed the stigma of a drug addict. Regaining her family’s trust has taken time. And Rhonda is full of guilt and anger.
“I just was following my doctor’s orders,” she said. “Now I’m a drug addict, and I have to live with that.”
Still, Rhonda doesn’t place all of the blame with Bell. She blames the DEA and Washington State Department of Health investigations, which she said made local physicians frightened to prescribe narcotics. That fear meant Rhonda had to quit cold turkey.
She also takes personal responsibility for continuing to take the medications even as the dosage climbed.
The experience is one Rhonda vows to never relive.
“I have too much to live for,” she said. “My sense of survival is strong.”