Rhonda and Gordon Dutson don’t necessarily believe Dr. Tara Zandvliet is responsible for their son’s opiate addiction. But they believe she is complicit.
Trevor, their son, and his then-girlfriend both went to Zandvliet for the sole purpose of getting opioids, the Dutsons said. And, according to the Medical Board of California, they were not alone.
Zandvliet – who, Voice of San Diego revealed in 2019, helped hundreds of local families avoid vaccinations for their children – over-prescribed opioids to at least four of her patients, according to accusations filed by the Medical Board. In one case, she prescribed a woman 10 times the recommended daily dose of opioids for almost six years.
As part of a new settlement agreement, she won’t be able to prescribe narcotics for the next five years. She’ll also be required to take a class on best prescribing practices and undergo an evaluation of her clinical competence. The Medical Board had previously stripped Zandvliet of her ability to write vaccine exemptions.
“I wish she would’ve lost her license,” said Rhonda. “She enabled addicts. She didn’t ‘do no harm.'”
“I have very few patients overall on opioids so this won’t change my practice much,” wrote Zandvliet in an email. “However, this is a devastating blow for those patients. They have lupus, rheumatoid arthritis, multiple sclerosis, spinal compression fractures, and more. They and their specialists are grateful to me for writing the medications they rely on to function.”
Zandvliet said family members who are concerned their loved ones are addicted to pills need to reach out to the prescribing doctor.
“If they knew he was addicted, why didn’t they tell me?” she wrote about the Dutsons. “Doctors are not omniscient. We rely on families to tell us their concerns … Addicts are very good at playing the game to get their meds.”
The Dutsons said they didn’t learn their son was addicted to opioids until he was no longer under Zandvliet’s care.
Zandvliet has a small practice in South Park. She became frustrated with insurance companies and rushed visits, according to a 2012 North Park News article, so she stopped taking insurance. Patients instead pay cash and she regularly visits with them for 40 minutes or more, she has said.
Gordon Dutson once went with his son to an appointment with Zandvliet, as Voice previously reported when the charges against Zandvliet were first announced. (Voice previously used a pseudonym to identify the Dutsons because they were involved in ongoing legal proceedings over the custody of their granddaughter.)
“It was more like a drug deal than a doctor meeting with a patient,” said Gordon. “Like, ‘Here’s the prescription you want, give me the cash, see you next time.’ It wasn’t like, ‘How’s your knee? Do you have pain? Let’s get this leg feeling better.’”
Zandvliet says that she was working to wean Trevor off opioids.
Trevor remains addicted to opiates, his parents said. He has been in and out of jail recently and living in his car. They do not have a relationship with him currently, they said, but try to keep up with his whereabouts and help him as much as they can.
They’ve tried to help him directly in the past, but came to believe that only enabled his addiction, they said.
According to the Medical Board, Zandvliet was prescribing the four patients mentioned in the charges between 73 and 1,360 “morphine milligrams equivalent” per day. MME is a standard measurement for the strength of opioids.
The Centers for Disease Control and Prevention recommends an absolute maximum daily dose of 90 MME.
Prescribing more than the maximum dose actually backfires, Dr. Kelly Bruno, a pain management specialist with VA San Diego Healthcare System, previously told me.
High doses can create a “feedback loop,” Bruno said, that increases a person’s pain.
In March 2019, Voice first reported that Zandvliet had written 141 vaccine exemptions, accounting for nearly one-third of all exemptions for San Diego Unified School District. She later told investigators that she had likely written 1,000 in all. Zandvliet wrote many of the exemptions because her patients showed a family history of allergies or autoimmune disease. The American Academy of Pediatricians, as well as the vast majority of doctors, do not endorse these as legitimate reasons for an exemption.
After the story published, legislators passed a new law that placed additional scrutiny on doctors who write more than five vaccine exemptions in a single year.
According to the Medical Board’s findings, a trained physician like Zandvliet should have been able to spot her patient’s addictions and treat them for it.
“They needed a doctor, not a drug dealer,” said Rhonda. “She’s on the radar of the authorities now for painkillers as well as vaccine exemption. She’s gonna be under a magnifying glass and that’s where she needs to be.”