Tucson Physician Faces License Suspension for Opioid Overprescription

The Arizona Medical Board has suspended the medical license of Tucson-based Dr. David A. Ruben for improper prescribing of opioids. This decision was communicated by board executive director Patricia McSorley, who announced that Ruben is currently on summary restriction status, barring him from practicing medicine.

Dr. Ruben, a 1974 graduate of the University of Arizona College of Medicine, contends that his prescribing practices were necessary and that his actions have helped his patients manage their pain. “All the patients I prescribed for were on low doses and helped by their treatment,” he stated, asserting that they had not reported adverse effects.

The board’s past findings indicate that Ruben prescribed opioid painkillers carelessly and potentially put patients at risk for addiction. Notably, he wrote 25 prescriptions for Schedule II controlled substances, including Percocet and Norco, between September 2016 and March 2017, despite being under a two-year prescribing censure that began in February 2016. This restriction explicitly prohibited him from prescribing such medications.

The U.S. Centers for Disease Control and Prevention (CDC) has advised physicians against prescribing opioids for chronic pain, unless in specific circumstances such as active cancer treatment or palliative care. This guidance aims to curtail the risks associated with opioid addiction.

In a recent interview, board investigators noted that Ruben was unaware that Percocet and Norco were classified as Schedule II drugs, highlighting what the board described as a significant gap in his medical knowledge. Their unanimous vote to suspend his license reflects serious concerns over his understanding of the rules governing these powerful medications.

Ruben’s disciplinary history includes multiple reprimands dating back to 2009, when the board determined he may have contributed to a patient’s drug addiction. Other incidents resulted in further limitations on his prescribing privileges, including accusations that he could not justify the need for certain prescriptions.

Amid the ongoing opioid crisis, Arizona Governor Doug Ducey declared a statewide health emergency in June 2017 due to rising overdose deaths. The Medical Board has made complaints regarding improper prescribing a priority in their investigations. In the current year, 16 of the 52 disciplinary actions have involved similar allegations, with a notable nine cases concerning opioid prescriptions.

The board plans to implement new rules requiring physicians renewing their licenses to complete at least one hour of education focused on safe opioid prescribing practices. Ruben has expressed disappointment with the board and the legislature, emphasizing a disconnect regarding the challenges of pain management amidst stricter prescribing regulations.