By Keegan Hamilton

First, there was the double suicide—a husband and wife from Georgia who took their lives one week after the Drug Enforcement Administration (DEA) suspended the license of their doctor, David Bockoff, a pain specialist in Beverly Hills. After Bockoff lost his ability to prescribe fentanyl and other powerful painkillers on Nov. 1, dozens of his patients became “opioid refugees” with nowhere to turn. The third death came barely a month later.

Another ex-Bockoff patient, 42-year-old Jessica Fujimaki, died Dec. 10 at her home near Phoenix. Autopsy results are pending, but her husband said he believes the cause of death was complications related to opioid withdrawal and medical conditions that caused severe chronic pain. She left behind two daughters, ages 13 and 11.

The DEA alleges Bockoff prescribed “alarmingly high dosages” of opioids to multiple patients, posing an “imminent danger” to the public. The doctor—who does not currently face any criminal charges—is attempting to fight back in civil court, denying any misconduct and alleging that DEA agents are the ones responsible for harming the public by effectively shutting down his practice with no consideration for people who relied on medications he prescribed.

“Much like a diabetic is dependent on insulin,” Bockoff’s attorney wrote in one court filing, “taking away the controlled substances allowed only by prescription from a DEA registered physician can be life threatening.”

On Tuesday afternoon, a federal judge in Los Angeles denied Bockoff’s request to override the DEA and restore his authority to prescribe, citing “serious concerns about the improper dispensing of highly addictive and frequently abused substances that can have devastating consequences.”

But exclusive interviews with Bockoff patients and court documents reviewed, make it appear as though the devastation came only after the DEA intervened against Bockoff, sending his patients into desperate spirals to stave off withdrawals and manage their pain.

Jessica Fujimaki’s husband Tad said his wife was a gymnast and ballroom dancer when she was younger, but she suffered from a rare disorder called arachnoiditis, which in recent years combined with other health problems to leave her unable to function without pain medications.

Jessica began seeing Bockoff in late 2021. After years of the DEA cracking down on over-prescribing and billions of dollars worth of settlements against the pharmaceutical industry for helping to create an overdose crisis, finding a pain doctor was no easy feat. While illicit fentanyl smuggled across the border by Mexican cartels is fueling record overdoses, prescription medications have become more tightly controlled, with doctors, pharmacists, and insurers becoming highly restrictive with opioids under the threat of DEA raids and civil litigation.

The 80-year-old Bockoff had been a specialist in the field for over two decades and was one of the few physicians willing to treat Fujimaki and others with complex conditions and dependencies on high levels of opioids. In court filings, his lawyers called him “the last option for many patients with severe chronic pain.” Records show a medical expert consulted by the DEA raised concerns about five patients on unusually large doses of fentanyl and other drugs.

In a phone call, Bockoff said of those five cases flagged by the DEA: “They typify my patients—I try to give absolutely the best quality of care possible.” Court records show those five patients disagree with the DEA expert’s assessment and are willing to testify on behalf of Bockoff in his efforts to get his DEA license renewed.

Bockoff said he fell into pain management as a speciality 30 years into his medical career, taking satisfaction in improving the quality of life for people with excruciating conditions.

“There have been ups and downs through the decades with regard to the governmental view of opioids,” Bockoff said. “Hopefully we’re in a climate now where we’re a little more supportive of intractable pain patients, but I’m not sure.”

The DEA has also taken issue with Bockoff’s record keeping and patient intake process, but Tad Fujimaki said Bockoff was always professional with his wife’s treatment, requiring a thorough screening and regular check-ups to get prescriptions renewed. Her last visit was Oct. 31, a day before the DEA visited Bockoff’s office and suspended his license. Their pharmacy declined to fill the prescription, leaving her with a limited supply.

“It’s not like my wife could see a primary care provider and have him prescribe Percocet or something,” Fujimaki said. “No, it doesn’t work that way. We tried so many pain management doctors and nobody would take her because she’s so complicated.”

The Fujimakis ultimately resorted to taking a trip across the border from Arizona into Mexico, where they purchased opioid pills at a pharmacy to help Jessica manage withdrawals. “But the day before Thanksgiving shit hit the fan, basically,” he said. It seemed like she was having a heart attack and couldn’t move, he recalled. She went to the emergency room and received some opioids, but not her normal prescription. She died two weeks later.

Tad believes her death was caused by stress on her organs and high blood pressure linked to the withdrawals. She was stable until the upheaval caused by the DEA action against Bockoff.

“Whoever signed off on the decision to suspend Dr. Bockoff’s license must’ve had a healthy family to go back to,” Fujimaki said. “They just don’t understand why we need these medications. They don’t even think about it. But there are patients who need this medicine to have a decent quality of life.”

In court filings, lawyers for the DEA said Bockoff’s patients needed treatment because of “his unsafe practices contributing to their opioid dependency and addiction,” adding that, “while it would be regrettable that Dr. Bockoff’s patients may face hardships,” there are other resources available, such as detox and rehab programs. The patients who arrived at Bockoff’s office after the DEA suspension received a list of emergency rooms in the LA area where they could be treated—not for their pain issues, but for their severe withdrawal symptoms from losing their prescriptions.

For the patients and their advocates, the notion that they were addicts or victims is absurd. One wrote a letter to the court in Los Angeles saying the doctor’s care had given them a new lease on life.

“This pain medication allows me to practice law and serve as a prominent traumatic brain injury litigator for the largest personal injury firm in California,” wrote the patient, identified by the initials E.C., in a letter reviewed. “Dr. Bockoff counsels me on how to manage my pain and prescribes medication for me that allows me to manage my pain so I can be a contributing member of society.”

Another patient, identified by the initials D.L., wrote to the court that they and other Bockoff patients were “in unbearable pain and many contemplating suicide” since the DEA action.

“No human being, already going through such a difficult life of pain, should have their only relief and hope pulled out from underneath them in a moment, with absolutely no advance notice to prepare, at a time and environment when the vast majority of pain doctors aren’t even taking new patients,” the patient wrote.

Another Bockoff patient, 61-year-old Danny Elliott died by suicide on Nov. 7, 2022, along with his wife Gretchen. Danny left a post on Twitter saying Bockoff was his third pain doctor to be shut down by the DEA since 2018. They tried to find another doctor with no avail, and although Gretchen was not a pain patient she chose to end her life at the same time as her husband.

Danny’s brother, Jim Elliott, shared an excerpt from a note Danny left behind after his suicide: “I just can't live with this severe pain anymore, and I don't have any options left,” he wrote. “There are millions of chronic pain patients suffering just like me because of the DEA. Nobody cares.”

Experts have warned for years that abruptly cutting off opioid users increases the risk of overdose and death, and authorities responded by forming the Opioid Rapid Response Program, “an interagency, coordinated federal effort to mitigate drug overdose risk among patients impacted by law enforcement.”

According to statements from the DEA and Centers for Disease Control and Prevention issued previously, the Opioid Rapid Response Program was called into action when Bockoff’s license was suspended. But the CDC said that while it can notify local public health agencies and other stakeholders, it does not receive lists of affected patients or offer any direct outreach or resources to those affected, such as connecting them with another pain specialist.

In effect, patients like the Elliotts and Fujimakis—who have done nothing beyond taking medications prescribed by their doctor—are abandoned and forced to navigate the system with no support from the authorities that upended their lives in the name of public health and safety.

A former CDC staffer who helped develop the Opioid Rapid Response Program, Jennifer Carroll, described an effort with good intentions that has struggled to gain traction amid bureaucracy. Carroll, now a professor at North Carolina State University, blamed the DEA for much of the dysfunction.

“These clinic closures are outrageously disruptive—I’m surprised more people aren’t dead,” Carroll said. “The DEA operates this culture of control and fear, justified by control of drugs, that prevents us from keeping people from dying. It not only causes the problem, it prevents the solution to the problem.”

While the judge in Los Angeles declined to reinstate Bockoff’s license this week, he still has an opportunity to plead his case in the DEA’s administrative law courts, which adjudicate licensing disputes between doctors and the agency. Those proceedings are sealed from the public, but scheduled to start on January 19. Court filings indicate both sides plan to call witnesses, with the DEA focused on Bockoff’s allegedly inadequate record keeping practices and the fact that he prescribed “several million dosage units for mainly opioids.” Federal authorities have also seized money from Bockoff, including over $140,000 cash (much of it Euros) from his home and nearly $1 million from his business bank accounts.

The money was seized through civil asset forfeiture (a process that will require the government to show it was acquired illegally in order to confiscate it permanently), and when asked about it Bockoff said he was unfamiliar with the legal process. He noted that he’s been paying out of pocket to keep his office open to help with patient referrals. He called the deaths of his patients who lost access to medication “recurring tragedies.”

“It apparently doesn’t matter to the DEA that they’re abruptly stopping patients’ medications,” Bockoff said.

The doctor, according to court filings, plans to testify in defense of his medical practices as he petitions the DEA’s administrative law judge to reinstate his license. Independently, a group of Bockoff patients has filed a rare attempt to intervene in the DEA administrative court, according to records.

John Flannery, a lawyer representing the patients, said in early December that they had so far received “no reaction from the administrative court” regarding their petition.

“The chronic pain patients continue to suffer without their medication,” Flannery said. “As far as we can tell, Dr. Bockoff was a healing physician and thus DEA’s false charges and the suspension of his authority to prescribe for his patients has created an ‘imminent danger’ to every one of 240 suffering pain patients.”

Another ex-Bockoff patient, Anne Fuqua, said that after the DEA action she was forced to start visiting a methadone clinic near her home in Alabama because she could not immediately find another chronic pain specialist who would treat her for a condition she described as similar to Parksinson’s disease, causing muscle spasms. While the methadone helped prevent withdrawals, Fuqua said, her pain has returned.

An activist in the chronic pain community, Fuqua has been tracking suicides since 2014 in cases where patients abruptly lost access to their medical provider. So far, according to a database she shared, she’s tallied more than 1,000 deaths using obituaries and other public records. That staggering total, she said, is likely only the tip of the iceberg as many deaths go unreported as suicides.

Fuqua said she’s heard from other ex-Bockoff patients who are considering suicide because they can’t find another doctor. An informal support network has popped up, she said, but facing a medical system that seems indifferent to their plight makes it difficult to endure.

“I don’t want to die,” Fuqua said. “There are so many others. I have all these people calling saying ‘How are you doing?’ We’re all doing that to each other. It’s basically code for, ‘Are you alive?’”