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Three years to the day after 31-year-old Skye Van Epps died of a drug overdose in his Old Saybrook home, his sister plans to go to court to oppose a pretrial diversionary program for the doctor charged with illegally prescribing him drugs.
Dr. Scott W. Houghton of Madison, who is charged with 47 felony crimes involving the illegal prescription of controlled substances, is due in Middlesex Superior Court Friday, his 45th birthday, for a hearing on his application for accelerated rehabilitation.
Houghton applied for accelerated rehabilitation almost two years after being arrested and stripped of his right to prescribe controlled substances and voluntarily agreeing to the suspension of his medical license. He has been free on a $250,000 bond while his case was pending.
If Judge David P. Gold grants the accelerated rehabilitation program, the charges against Houghton would be dismissed after he completes a probationary period. He might be able to return to practicing medicine.
"When I read that, I felt like all of the blood just drained right out of my body," said Shannon Van Epps.
Skye R. Van Epps died from an overdose of alcohol and Xanax on Feb. 22, 2010, inside the family-owned home at Ragged Rock Marina, which is at the mouth of the Connecticut River in Old Saybrook. He is referred to as "Patient 19" in a court document that alleges Houghton wrote Van Epps overlapping prescriptions.
Defense attorney William F. Dow is expected to argue at Friday's hearing that Houghton acted in good faith in caring for his patients.
"This is an outstanding and talented doctor, a family man and a great resource in the community," Dow said. "Even to this day, he has widespread support from many, many patients."
Prosecutor Russell C. Zentner is expected to oppose Houghton's application for accelerated rehabilitation, a program intended for first-time offenders who are not charged with serious crimes and are not likely to reoffend.
'The candy man'
In 2008, the operator of eight substance-abuse recovery houses reported that recovering drug addicts were referring to Houghton as "the candy man" because it was easy to get medication from him in exchange for cash, according to the arrest warrant affidavit.
The state alleges Houghton didn't require some patients to enter an examining room during their office visits. Instead, he would meet them in the hallway and hand them their prescriptions. If they ran out of drugs before their next scheduled visit, he would simply write them another prescription. Rarely would he require drug-addicted patients taking maintenance drugs to prove they were undergoing the required counseling, and most of the time he didn't even take their blood pressure or pulse, according to the warrant.
Houghton admitted to an investigator that he accepted free concert tickets and hotel stays from a high roller at Mohegan Sun who came into his office up to three times a day for injections of the pain reliever Demerol, according to the warrants. He conceded that the gifts, including tickets to REO Speedwagon/Styx and Beyonce concerts, may have "skewed" his view of the patient when prescribing her narcotics.
The state also alleges that Houghton continued to write prescriptions after agents raided his office at 929 Boston Post Road in Old Saybrook and revoked his prescription license.
Houghton's attorney said he would be outlining flaws in the arrest warrant at Friday's court hearing.
"Contrary to the implications, he did not engage in criminal conduct," Dow said in a phone interview. "As a physician, he acted in good faith to care for his patients."
Patients who took Suboxone, a maintenance drug for those addicted to heroin or opiate-based pain pills, were a small percentage of Houghton's practice, Dow said. The patient who had received the Demerol shots had a long history of that type of treatment from previous doctors, which Houghton simply continued, Dow said.
Dow also contends there was no wrongdoing with respect to "Patient 19," Skye Van Epps.
Addiction to painkillers
Shannon Van Epps, 37, has since moved into the house where her brother died. She thinks Houghton took advantage of her brother, who had started seeing Houghton after completing a drug rehabilitation program at Stonington Institute.
"I felt like he (Houghton) was doing it for the money," Van Epps said. Like other patients who took Suboxone, Van Epps paid Houghton in cash for his prescriptions.
Van Epps had become addicted to painkillers following a serious car accident in Arizona in 2002, according to his sister. He was riding in a Ford Mustang convertible that flipped five times, end to end, and ejected all five passengers, she said. He broke his femur and pelvis and almost lost a leg when road rash from the accident became infected, she said.
"My brother always hurt after this accident," she said. "He was just constantly in pain."
In 2007, Van Epps admitted he was addicted to painkillers and needed help. He checked himself into Stonington Institute and completed his treatment in a sober house. Upon his discharge, he started seeing Houghton, who was authorized to prescribe the Suboxone Van Epps had been taking to ease his withdrawal.
Van Epps told a friend that when he complained about paying $100 in cash for his prescriptions, the doctor's response was, "It's still cheaper than buying it on the street," according to the warrant.
Van Epps later told a friend he stopped taking the Suboxone due to the expense, according to the warrant. Houghton, in the meantime, began prescribing Xanax after Van Epps complained of anxiety. A family member called Houghton to ask why he would prescribe Xanax to a drug addict, but Houghton refused to discuss the matter, citing the health information privacy law (HIPAA), according to the warrant.
Shannon Van Epps has been preparing for Friday's hearing. She compiled a folder of documents related to her brother's death, including an autopsy report and pharmaceutical records. She talked to a victims' advocate and said she would be telling the judge that she opposes Houghton's accelerated rehabilitation application.
"It's so crazy," she said. "Thirty of the charges against him hold a (potential) 10- to 20-year prison sentence, and he thinks he's going to get accelerated rehabilitation."
A cocktail of alcohol, pills
Skye Van Epps had a successful property maintenance business, doing landscaping and plowing at local shopping centers and for other customers, his sister said. Her brother was supposed to go to the casino with her the night he died, but Shannon Van Epps said when she didn't hear from him, she figured he had gone on a date instead. He was also supposed to watch his mother's dog that weekend.
The family started worrying when nobody heard from Skye. An uncle who went to check on him found him dead on the living room couch. He was lying under a blanket with the TV remote control in his hand.
His sister learned later that Skye had had a few beers when he went to pay his workers that Friday night in February 2010. She said he returned home with a friend. They ordered Chinese food and watched a movie. Skye called the friend at 11:15 p.m. to be sure he had made it home safely, and nobody heard from him after that.
According to the arrest warrant affidavit, police found six prescription pill bottles while investigating Van Epps' untimely death, two of which had been prescribed by Houghton. A vial from a Suboxone prescription that Houghton had written Van Epps in September 2008 contained three pieces of Viagra pills, the warrant said. A vial from a 60-tablet Xanax prescription that Houghton had written Van Epps in November 2009 was empty.
Van Epps had 10 Xanax tablets and one Roxicodone pill in a bottle from a Xanax prescription that had been written by Dr. Michael Baldwin in December 2009, according to the warrant. Another vial, labeled as a lorazepam (Ativan) prescription from Baldwin in July 2009, was empty. A vial that had no label contained a "roach," which is the end of a marijuana cigarette.
Shannon Van Epps said there was no alcohol in the house and that the autopsy indicates her brother's blood alcohol level was just 0.003. The state Office of the Chief Medical Examiner ruled that the cause of death was "acute intoxication due to the combined effects of Ethanol (alcohol) and Benzodiazepines." Xanax is a benzodiazepine.