Perth Amboy Doctor Loses License After Overprescribing Opioids

PERTH AMBOY, NJ — A Perth Amboy doctor had his license to practice medicine permanently revoked by the state after investigators said 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 those prescriptions.

Dr. Eddie Gamao has been permanently barred from practicing medicine in the state of New Jersey. He voluntarily agreed with the state's consent order to revoke his license.

He was a general practitioner in Piscataway. The state Board of Medical Examiners said 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 (“SAR”) 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.

“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," said New Jersey's attorney general.

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.

“The numbers don’t lie,” said Paul R. Rodríguez, Acting Director of the Division of Consumer Affairs. “Dr. Gamao was prescribing powerful pain medication to more than 100 patients at a staggering rate and in dosages that defied any medical justification. Only a permanent revocation of his license could adequately protect the public from this man and we are pleased that the Board took that step.”

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.

In March 2018, the Board temporarily suspended Gamao from practice pending the outcome of the allegations against him.

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