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July
2000 Dr. Ramon Scruggs Part II
Let me start out by apologizing to Dr. Scruggs. When writing the first installment of this interview series, I absolutely butchered the spelling of his name, which is Dr. Ramon Scruggs. That's the last time I transcribe a tape after sniffing glue and drinking a 5th of vodka. For those of you not familiar with Dr. Scruggs, let me quickly introduce you to one of the most fascinating individuals I've ever had the opportunity to meet. Dr. Scruggs is an anti-aging and performance enhancement specialist. To be blunt, he prescribes steroids to both the aged and the athletes. Yes, I know, physicians don't prescribe steroids, right? Well, this physician does, I know not only because I've referred dozens of people to his practice, but also because I'm a patient myself. I urge you to read the first part of this interview, which can be found in the back issues section off the homepage. Ok, let's go! AE: I've been through the system twice myself, the worst being the first time when I was facing charges related to a $35,000 steroid deal. Everyone I've ever talked to who's been through the criminal justice system because of drugs has a negative opinion of our drug laws. I guess that's not so surprising, but you also find that the families of these people get an insiders look at the system and they also become jaded. There are so many people in this country who've been effected by these draconian laws, either through direct experience or through someone they know, that if we all were to speak up, I really think the drug laws in this country would change. The problem is that we're talking about a silent majority of people; a group that's afraid or embarrassed to voice an opinion they believe is unpopular. Scruggs: There are so many people in prison now, nearly 2/3 of the people in federal prison are there because of some non-violent drug offense, and practically every family in America has been affected. The harder law enforcement gets, the more serious they get about putting people away, the more they accelerate this disaffection on the public at large. I seriously believe we're reaching a point where the American public is going to demand a change. AE: I find that when you really engage people in a conversation about how they feel about current drug laws, you find more often than not that people are fed up! They're just afraid to speak their mind. Scruggs: It's almost like admitting you're gay. I think you find when you talk to people about this and let them run through their standard response first, you'll find that most people are willing to think about change. AE: Isn't it true that the AMA opposed the scheduling of steroids? Scruggs: I believe that's true, but since I'm going on the record here, I can't say so with 100% certainty. I did try to get in touch with the AMA this morning to get an exact quote from one of their people on the AMA's position on the Anabolic Steroid Act of 1990. I couldn't find anyone; they all either played dumb or really didn't know. I believe that's true. I do know that during the public hearings, representatives from the FDA, FTC, and Health and Human Services came out against the scheduling of steroids. Steroids are fundamentally different from the other drugs in that category, which are primarily narcotics. So I can't tell you exactly what the AMA's position was or is, but I do know these other agencies came out against the scheduling of steroids for a variety of reasons. Number one, it didn't make sense, number two it conflicts with other laws regarding the prescribing habits of physicians of legitimate drugs that have been FDA approved. There's a long history, both in statute and case law, which physicians can prescribe drugs for off label purposes. In other words, a physician can legally prescribe any drug that has been FDA approved for uses other than the FDA prescribed uses. So, this law conflicts with other laws and other court determinations. AE: Why do you then think the House and Senate ignored all of this expert testimony and went ahead and passed this into law? Scruggs: Oh, for the same reason they keep upping the ante in the war against drugs, it's just a reflex. If they say, "Let's lower taxes", everybody applauds. If you say, "Let's get tougher on drug dealers and drug users", everybody applauds. It's a cheap and quick way for them to look like they're taking care of us because they've scared us so much about drugs and steroids. It's just cheap politics. I guess I shouldn't say cheap politics; I don't want to point fingers at people. Our politicians reflect us, they are a mirror of who we are. I can't project on to them and disown what is in me that I'm seeing in the politicians that represent me. As peoples' beliefs about drug laws change, politicians will change as well. We get what we deserve. One of our problems as a people is our narrow selfish interests. We all want politicians to cut out the fat but we want them to bring home the bacon. We don't want them to give anyone else anything, but when it comes to our special interests, they'd better take care of me. AE: When it comes down to getting re-elected, drug laws are one of the things politicians will point to more than anything else. God forbid someone vote against any new drug legislation, obviously they don't care about your children as much as I do. People buy into this finger pointing and accept it at face value, without even investigating the laws. A lot of bad drug laws have been passed simply because lawmakers fear voting no on any drug legislation, be it good or bad. Voters rarely take the time to investigate the reasons why someone might have voted no, so doing so is almost a death sentence in politics. Scruggs: Any time I'm faced with someone who has the attitude that our drug laws are fine or need to be even tougher, I ask them a series of questions. Do you have a son or daughter? Do you love them? Well let's say, your son or daughter gets caught with drugs. Would you rather have your son or daughter go to a drug rehabilitation and education program, or would you rather they have their business confiscated, all their assets confiscated, spend 4 or 5 years in prison, and have their spouse and children on welfare? Faced with that situation, how would you want a politician to vote, and which way do you think is taking better care of your children? AE: God forbid we were to take the money that's being spent of incarcerating all of these people and spend it on treatment programs. Scruggs: We know that method works far better for the person who really is abusing drugs and is hurting themselves and their family. We know that rehabilitation and education is far better than incarceration. AE: Are you concerned with the way you're perceived by your peers and most of society for the work you do at New Hope Med? Scruggs: Yes, I am, I'm concerned about it. However, I feel like I've been led along a certain path in life and it's almost as if I'm supposed to do certain things by fate. I would have, had it been my choice, done things differently from how they've actually happened. But I accept that there are no mistakes, which God has us do the things He would have us do, despite what our little self may want, and I feel directed. So yes, I am concerned about it, but at the same time, I know I'm right! I feel very comfortable in the choices I've made and the reason for those choices. I know that I'm helping people far more than I'm hurting them. If you want to know the truth, I don't like taking 22 or 23 year-old and putting them on steroids, it makes me nervous. Yet, I'd rather have them come to me and manage their steroid use, and then have them do it on their own. AE: Because they're going to do it anyway. Scruggs: Of course, yes. They're going to do it anyway. Just as a large number of kids are going to smoke pot and snort coke, no matter what anyone says to them. Now, I don't have many patients that young. As I said, most of my patients are over 40. I agonize over this issue of managing steroids for young adults, because I don't need the money and I don't need the hassle. But I'd rather that person see me and do it under my direction than to try and take steroids on their own illegally. AE: Obviously you're a trailblazer for other physicians to follow; do you sometimes view yourself as a martyr for these causes? Scruggs: I don't plan to be a martyr! My plan isn't to hang myself out on a cross. I want to be ahead, but I want to be as smart as possible too. Just like in the 60's, although I was a Marine, when I got out I was against the war. Now I wasn't about to desert the Marine Corps and make myself an example. Similarly here, although I'm willing to speak out and take some risks with this, I don't want to be martyred. AE: On that note, have you ever been contacted by any law enforcement agency, questioning what you're doing? Scruggs: No. I've only been questioned once in the history of my practice by the medical board and that was in the case of a chronic pain patient. It was a legitimate, clinically justified use of pain medication. Here was a person who was traumatized, he'd had several back surgeries, and was literally being driven crazy by pain. I was giving him large doses of oral narcotics. It then turned out that he was addicted, he was getting scripts from several other physicians, and he was getting it from the streets. One of the pharmacists I worked with objected to one of my prescriptions. I did the stupid thing; I got angry with the pharmacist and began to lecture him about how he was wrong clinically. So, he went ahead, filled the prescription, and out of vindictiveness reported me to the medical board. This is relevant to what were talking about here. This is a story of how physicians get chilled in how they practice medicine. It took 3 months for me to get a hearing in front of the medical board. When I finally got there, it was completely friendly. They agreed that I did all the right things, and they found no fault with me. The only thing they said I could have done differently was to pull in a university consultant earlier. I had other consultants, but not a "university" consultant. The medical board wasn't that concerned about this from the beginning, but I bit my nails for 3 months, waiting for it, trying to prepare for it. Now, even with patients where there is no question of the need for a narcotic prescription I hesitate before I write one. AE: It does seem a bit ridiculous that a licensed physicians, with all the years of education and training, would be asked to consult with another doctor before writing a prescription. Scruggs: Well, you see the government is regulating every aspect of our lives. This has created an enforcement industry and institutional structure that continually gets larger and has now become self-perpetuating. So, like these other agencies, you've got a medical board that has to act like they're doing something to justify their careers. If they have to destroy a few physicians every once in a while to justify their own existence, so be it. This is very frightening. Anyone can call the medical board and make a complaint; it can even be an anonymous complaint as in the case of the Medicare administration. The constitution gives each citizen the right to know who his accuser is. And yet a criminal investigation can be initiated against a physician by an anonymous complaint. The physician has no right to learn the identity of his accuser. Little by little, we are losing our constitutional rights, in the name of taking care of us. AE: Is it a situation where you are considered guilty and must prove yourself innocent? Scruggs: That's right, and it's frightening what physicians can get into. Physicians have to be very careful about how they do things. There are two areas where medical boards just go absolutely berserk on physicians. One is the prescribing of steroids or narcotics; the other is the relation of physicians with patients of the opposite sex. Just going out to lunch with a patient of the opposite sex could be grounds enough for the medical board to take action against a doctor. It's interesting that sex and drugs, which this culture traditionally has had a problem with, seem to be the areas that physicians can so easily get into the most trouble as well. We've always had problems dealing with and defining who we are, in terms of how we change our consciousness and how we relate to each other sexually. This country has agonized over these two questions for decades and persecuted anyone acting outside of the narrow culturally prescribed behaviors. These harsh, narrow societal prejudices are reflected in the way we treat and judge physicians. AE: It's always surprising to me how advanced this country is in almost every area, that we really are behind the times regarding our views on drugs and sex. You look at most European countries; they have completely different attitudes towards sexuality and drug use. Scruggs: It is truly amazing, Jason, truly amazing. I don't get it. But many of the people who founded this country were trying to get away from European liberalism and they were trying to find a place where they could practice a more stringent and acetic spiritual lifestyle. The most repressive people left Europe to come here to practice their religion and professions without being tempted by a larger, more liberal culture. I don't think it's any coincidence that those some people created together the most onerous system of slavery known in history here in the Americas, and committed genocide on Native Americans. Somehow all of these things are related. They come from the same kind of judgmental, anti-pleasure punishing attitude and approach towards life. I'm not being superior when I say this, because we've all been trapped by it. Everyone is trapped and everyone's life is compromised as a result. There is no "they or them"; we are all in this together, the accuser and the accused, the abuser and the abused. We're all in this together, and we're all hurt by it. AE: Let's discuss the cost breakdown of your services. Scruggs: Sure. I have an initial consultation, and I break that down into two parts. If you're not sure about seeing me, I can give you a 15-minute consultation for $55. I don't make up a chart we just talk. If you decide you want to be a patient, then we go on to a new patient consultation, which is $275. That $55 fee is rolled over and deducted from the $275 consultation. Usually there are one or two follow-ups over the next 30-45 days, we need to talk about the blood work results, and I want to see how the patient responds to the first 2-3 injections. Those are usually short consultations, and my fee schedule is based on what is customary and usual for a general practitioner or family physician in the Southern California area. I do charge a premium for what I do by applying additional costs to the steroids themselves. I must do this. The liability is simply to large and that liability must be paid for. The most popular dose schedule and agents are deca durabolin and testosterone and I prepare those in office, we supply pre-loaded syringes. Anyone is welcome they spend the $100 to get a quantitative analysis of the syringe to see what's in it. AE: Now is one of the reasons you do that because of the difficulty a patient would face having those prescriptions filled? I know from personal experience that most pharmacies will not fill prescriptions of this nature. Scruggs: They're two reasons. There are a few steroid friendly pharmacies that will fill prescriptions like this, but you have to know who they are. If you get the wrong pharmacist, remember, he's just as caught up in the drug hysteria as everyone else; he'll make a call to the medical board. That's one reason. However, the main reason is, in California at least, the thing that really gets the board upset is too many prescriptions written for things that are packaged by the manufacturer. That also includes selling things that are off-the-shelf out of the office. It's really the packaging they don't like, because they assume that anyone who receives a bottle of testosterone is immediately going to sell it on the street. That's why we break it up into doses, with each syringe being an individual dose for a patient. It's definitely a lot harder for a patient to abuse that, to sell it or share it with someone else. So I really do it to avoid generating interest in what I'm doing from certain regulatory agencies due to my prescription writing habits or the fact that I sell pre-packaged schedule III pharmaceuticals out of the office. AE: I have prescriptions for both propionate and deca and getting those filled was an absolute nightmare. Scruggs: No, you really can't get them filled anywhere. AE: It wasn't only that they wouldn't fill it, but I would get these incredulous looks from these pharmacists like, "What are you doing taking these drugs?" It's really irritating, a pharmacist's job is not to chastise me or to question what I'm doing, and it's to fill my prescription. Scruggs: Yes, it's to fill the prescription, not to question my patients or call the police. AE: Let's look at some cost of medications. When I've had prescriptions filled, the cost of the deca was around $27 for 200 mg. Scruggs: Yes, the cost will range anywhere from $24-$30 for each 200 mg vial of deca. I believe the cost of a 10 ml bottle of testosterone cypionate is now around $90. This is from the pharmacist. If you get it from me I out a hefty premium of this cost because of the high liability involved. AE: Do you also prescribe growth hormone? Scruggs: Growth hormone? Oh sure. AE: What's the cost per IU and what brand of GH are you using? Scruggs: I refer this to Stephens Pharmacy here in California and they provide the lowest cost that's available, I believe its $12.20 a unit. I believe it may have dropped to $12.00. I use it primarily for anti-aging. I could make a lot of money selling it here out of the office, but a lot of the GH entrepreneurs have really turned me off to this. AE: I'm sure you're familiar with Dr. Lester Lee down in your area? Scruggs: Oh sure. Dr. Chin also. He's probably the biggest growth hormone doctor in the country. These guys who claim to be pioneers, and I'm not talking about Lee or Chin particularly, they don't know what they're doing. Most of the doctors who work with growth hormone really don't know that much about it. I think that's one reason why they prescribe the same lame doses of 4-8 units per week. That's not enough. AE: It's almost pointless. Scruggs: Particularly if you intend on using GH for anabolic purposes to increase strength or muscle mass. AE: I really don't think you'll see any kind of effect at all on less than 2 IU's per day. Scruggs: No you won't, you won't, absolutely not. And we're talking 2 IU's a day, 6 days a week with one day off, that's the lower limit. AE: Sure, if someone can afford it, I would advocate between 4-6 IU's daily. Scruggs: 36 units a week is more about what you would need to get any kind of anabolic effect. Even when you're talking about anti-aging therapy, 12-15 units a week is a starting dose. I take 24 units a week, and every 3 months I bump it up to 36 units a week for 3 months before going back down again. AE: Let's talk a little more about cost. Anadrol goes for about $10-$13 a pill, is that correct? Scruggs: Yes, that's right. I don't put any money on top of those, I simply write the prescription and have my patients get it filled at the pharmacy of their choice. Unless all I am giving them are oral agents. For that, I charge a monthly maintenance fee of $50 dollars per month. Again, because of the great liability in what I do it simply is not worth it for the cost of a consultation. AE: How about anavar? Scruggs: Same thing, it's about $3.82-$4+ per tablet. That's for a 2.5 mg tablet. That's it folks. We'll have the final installment of the Dr. Scruggs interview in a future issue of Anabolic Extreme. Dr. Scruggs has a website at www.newhopemed.com and can be reached at 714-771-9655. Copyright 2000 Jason Meuller and Anabolic Extreme. This material may not be copied, reproduced, or transmitted without the express written permission of the copyright owners. |
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