Cinde Warmington, a leading Democratic contender for governor of New Hampshire and the only Democrat on the state’s Executive Council, served for years as a lawyer to a pain management clinic network implicated in the Granite State’s opioid crisis.
As Warmington has made combating the state’s fentanyl crisis a central part of her campaign, the extent of her relationship with the firm now called PMC Medical Group, best known for its PainCare and Granite State Pain Associates facilities, is deeper than previously known. In fact, the clinics’ parent company and owner became major contributors to her campaigns for New Hampshire Executive Council and governor.
In her two runs for Executive Council in 2020 and 2022, and in her current run for governor, Warmington received a combined total of $49,000 in campaign contributions from Dr. Michael J. O’Connell, the owner of the pain clinic operation, and from the PMC Medical Group, the current name for the parent company of O’Connell’s network of pain management clinics.
O’Connell’s $10,000 donation to Warmington’s gubernatorial campaign in April is the only contribution that either O’Connell, or the medical business he founded, have made to Warmington’s most recent campaign. (O’Connell, who died of lung cancer earlier this month, made most of his contributions to Warmington’s campaigns, including the most recent one, through an entity called the Michael J. O’Connell Revocable Family Trust.)
Now some Granite State Democrats fear that Warmington’s ties to an opioid provider with a shady history will be a political liability in the race against the Republican gubernatorial nominee in the 2024 general election. Former U.S. Sen. Kelly Ayotte and former state Senate President Chuck Morse are the two candidates competing for the Republican nomination. The gubernatorial primary is scheduled for Sept. 10 of next year.
“I like Cinde a lot, but I am convinced it will be an issue. Republicans will just make a big issue of it, because New Hampshire has had such a problem with respect to opioids,” said Kathy Sullivan, a former chair of the New Hampshire Democratic Party backing Warmington’s primary opponent, Manchester Mayor Joyce Craig. “It’s just been a huge problem for years.”
A substance abuse recovery advocate living in Somersworth, which is home to one of O’Connell’s most controversial pain clinics, told HuffPost that they would never vote for Warmington because of her work for O’Connell and the clinic network once known as PainCare. The advocate, themself in recovery for methamphetamine addiction, blames O’Connell and PainCare for getting their mother and aunt hooked on opioids through the frivolous prescription of OxyContin.
“It makes me feel sick to my stomach,” said the advocate, who requested anonymity to protect their still-struggling mother. “Anybody that can stand and receive blood money … that’s a person that speaks out of both sides of their mouth.”
“Where is she going to align on all this, when push comes to shove?” asked the advocate, a political independent and swing voter who is not supporting a particular candidate in the race.
Warmington has already faced substantive criticism and political concern about her past representation of infamous OxyContin-maker Purdue Pharma in the early 2000s, first reported in the New Hampshire Union Leader in June. Despite already emerging evidence that OxyContin abuse was leading to addiction and crime, Warmington deadpanned in the New Hampshire legislature in 2002 that while OxyContin was indeed subject to abuse by some users, it was also being abused “in the press” with unduly negative coverage.
Warmington’s campaign noted that attorneys often represent clients with whom they do not agree, and argued that her record on the Executive Council speaks to her commitment to fighting opioid addiction and improving mental health care. For example, Warmington voted to approve state funding in 2021 for additional youth psychiatric treatment beds at a facility in neighboring Vermont.
“Cinde spent over 20 years as a respected attorney working for hundreds of health care clients including hospitals, mental health centers, abortion care providers, nurses, and doctors in all different specialties,” Philip Stein, Warmington’s campaign manager, said in a statement. “On the Executive Council, Cinde has been the leading advocate for expanding access to substance abuse treatment and mental health services and, in her personal capacity, she has served on multiple community mental health and substance use disorder treatment program boards.”
The campaign also provided a statement from former New Hampshire Attorney General Joe Foster, who is backing Warmington.
“I strongly believe that attorneys should not be attacked for the actions of their clients,” Foster said. “Efforts to impugn the character and qualifications of a proven leader like Cinde based on cherry-picked clients she’s represented demonstrate a fundamental misunderstanding of how our legal system functions.”
Warmington is listed as a registered agent for Pinewood Professionals LLC, one of several names of companies that succeeded the defunct PainCare network, in its annual report in 2022. But the Warmington campaign told HuffPost that she has not represented PMC Medical Group or any of its affiliates since taking office on the Executive Council in December 2020.
Warmington’s relationship with PMC Medical Group and PainCare, the main pain clinic network owned by O’Connell during the period in question, dates to at least 2011.
“I do see a pattern as executive councilor where she has tended to exercise fiduciary responsibility to the public and not serving the industry.”
At that time, O’Connell faced complaints before the New Hampshire Board of Medicine that he had engaged in romantic relationships with two women he had previously treated, in violation of the board’s ethics rules. Warmington represented O’Connell in a 2011 settlement with the board, where O’Connell would permanently surrender his medical license in return for the charges not being subject to formal adjudication.
In 2014, by which time there were 12 PainCare clinics across the state, O’Connell was indicted by local prosecutors for allegedly tampering with one of the witnesses in the 2011 case before the board, though he was apparently not convicted. His defense attorney in that case was Bill Christie, Warmington’s husband.
Later, in 2015, Warmington represented O’Connell when the health committee in the state House of Representatives was considering a bill that would require physicians with revoked or suspended medical licenses to cease ownership of a health care facility or practice. Warmington argued that the bill was being pushed by a jilted former colleague to punish O’Connell. The bill was unanimously rejected.
The most controversial part of PainCare’s history, however, involves a PainCare physician assistant, Christopher Clough, who was convicted by the federal government of accepting illegal kickbacks from fentanyl spray manufacturer Insys that coincided with him massively overprescribing Subsys, the company’s fentanyl spray. Clough was sentenced to four years in federal prison in 2019.
Clough — and by extension, PainCare — played a role in worsening the opioid crisis in New Hampshire in the mid-2010s. Clough’s actions and the clinic’s apparent negligence are still reverberating throughout the state’s seacoast region in particular.
In 2013 and 2014, Clough issued 760 prescriptions for Subsys — about 84% of the prescriptions for the drug in New Hampshire, at a time when the state had the second-highest per capita rate of prescribing the drug. That period coincided with a massive uptick in opioid overdose death rates in New Hampshire, which had the second-highest opioid overdose deaths per capita — after West Virginia — in 2014 and 2015. And Strafford County, home to the main PainCare clinic that employed Clough in Somersworth, remains one of the state’s overdose death hot spots.
Some of Clough’s former patients sued Clough, PainCare and Insys, settling for undisclosed sums in 2017.
Warmington’s involvement in managing the fallout from Clough’s actions appears to have been limited to representing Clough’s supervising physician, Dr. John Schermerhorn. After a former employee of PainCare made a whistleblower complaint about Clough in 2013, the New Hampshire Board of Medicine’s investigation of the incident led it to find that Schermerhorn failed to provide adequate supervision of Clough. In a settlement that Warmington helped negotiate, the board reprimanded Schermerhorn.
O’Connell and the now PMC Medical Group, his network of pain management clinics and addiction recovery centers, apparently paid it forward to the firm’s lawyer when she first entered politics.
For her re-election bid in the 2022 cycle, PMC Medical Group contributed the maximum amount of $15,000, and O’Connell gave $10,000, prior to the $10,000 he contributed toward Warmington’s gubernatorial campaign earlier this year.
The recovery advocate in Somersworth doesn’t trust anyone who worked for, or received money from, O’Connell. While Clough is the only ex-employee of O’Connell’s to be charged with and convicted of crimes related to the opioid crisis, the recovery advocate maintains that O’Connell was running a legalized pill mill as far back as the 1990s
The advocate was especially angry to see O’Connell opening up a chain of additional facilities to treat opioid addictions that the advocate believes O’Connell’s own pain management clinics fueled.
“He was a predator and he used the population, a lower-income population, to his advantage,” the advocate said. “This guy has affected generations of people.”
HuffPost spoke to progressive former state lawmaker and present-day radio host Deborah “Arnie” Arnesen, who was largely unbothered by Warmington’s work for PainCare and O’Connell, and the donations she subsequently received.
“I do see a pattern as executive councilor where she has tended to exercise fiduciary responsibility to the public and not serving the industry,” said Arnesen, who was the state’s first female gubernatorial nominee in 1992, and has not publicly endorsed anyone in the current race. “I can’t defend her, but I can’t finger her either, because she’s got an interesting background.”
Arnesen did concede that the prospect of Republican attacks against Warmington over her past ties to makers and providers of opioids made her “physically nauseous.”
Need help with substance use disorder or mental health issues? In the U.S., call 800-662-HELP (4357) for the SAMHSA National Helpline.