Dear Friends in Pain,

Dr. Bill's story is a story of compassion, strength, knowledge, and the
courage of ONE physician who went to "any lengths" to help those who
suffer NIP.

He was shut down once before. He could have opened practice
elsewhere. He did the "next right thing" although a physician is
human, does HE NEED TO AWAIT a DEA plant who is not a client, or
watch witnesses appear who are promised "something" to testify
against a physician who is ALL of what physicians who treat pain
should epitomize.

He did not fear the "addict" in pain, he treated them. Medically
and ethically WE must; we can be sued for malpractice for abusing
the term addict in those who are in pain (yes M.D's and nurses).

Today his life is over, if indeed he spends years in prison, without
the ability to treat clients, educate other physicians, and be a part
of the fight against the police state of medicine.

Do you want your medical practice orchestrated by seasoned
professionals or by law enforcement officers.

We have discussed the true problem and it comes down to this
"not chasing legal pain medications in the hands of drug addicts" but
CHASING THE SYSTEM to prevent the ADDICT from not being treated,
imprisoned, and removed from the class of client with KNOWN
pain, and who is penalized instead.

Your specialist should not have to think before he writes your
scrip for Oxycontin; he should comfortably evaluate your situation,
know that your pain relief increases your quality of life and also
even a return to work--never should he consider "what if her meds
end up on the street, what's the going rate for Oxy, and if she
gets busted will I?" THIS IS THE PROBLEM and the solution
remains in separation of POLICE MATTERS from medical matters.

So many in pain support groups walk around touting the tune,
"Oh no not my doctor ever never, not he!" and this is the very sad
truth--none are immune nor are you! Not until this occurs.

The next time someone states oh these bad doctors deserve what
they got I lead you to read this story, and Dr. Bill went a step further.
But look where he sits today. What can we do?

Demand the CRIMINAL element who abuses Class 1's which are
never LEGAL and who obtain Class 2's which MEDICALLY are
needed are:

1. Incarcerated for life if need be.
2. Keep in ongoing treatment with UA's for 10 years or longer.
3. Put in federal prison for the obtainment of any medical
misuse of drugs which are prescribed for those in viable
pain.
4. Do thorough investigation to find out how, when, why, and
the true source of this prescription medication.
5. No trade offs.

Until this hard core manner of treating CRIMINAL versus MEDICAL
occurs there is no recourse but to see GOOD physicians and their
VIABLE patients JAILED, sometimes for life. Not only that but the
DEA makes a fortune out of this.

Comments appreciated!!

Peace,
Karen



The Case Of Dr. Hurwitz
November - December
2004







Facts Learned Since
The 'Guilty' Verdict


It was reported in the Washington Post: "Court testimony indicated at least
one patient received a prescription for 1,600 pills a day." This was shown in
court to be a clerical error that never got past the pharmacist. The nurse
multiplied by the wrong multiplier.
The Post reporter was asked to clarify the 1600 pill detail in his report. He
said he felt that because he put it in quotes and was careful to note that
the government had asserted it, that this put it in context. So 1600 pills a
day" was a clerical error that the judge allowed left in.
The number of good patients that can be presented is determined by the judge.
Dr. Hurwitz' defense was grudgingly allowed 5 patients. The prosecution put
on a total of 63 witnesses.
This is a letter signed by 6 past presidents of the American Pain Society
addressing many misrepresentations by the government's key witness, Dr. Michael
Ashburn.
December 10, 2004
Marvin D. Miller, Esq.
P.O.Box 663
1203 Duke Street
Alexandria, VA 22313
Dear Mr. Miller,

We are Past Presidents of the American Pain Society and have decided to take
an unusual step in writing you about the expert testimony that you have heard
at the trial of Dr William Hurwitz. We are deeply concerned that serious
misrepresentations in the testimony provided by the government¹s expert, Dr.
Michael Ashburn, will undermine the welfare of patients who suffer in chronic
pain.
Our concern is that the role of key government expert will lend credibility
to Dr. Ashburn¹s statements about the treatment of chronic pain, many of
which
we believe to be factually wrong or serious misstatements of consensus in the
field. The credibility accorded this testimony, when disseminated or used to
justify future investigations, threatens the public good. We felt morally
compelled to inform you of our profound concern.
There are several points of sharp disagreement:
Dr. Ashburn repeatedly stated that the use of ³high dose² opioid therapy
is
an indication of drug abuse in populations with chronic non-cancer pain. It
is factually untrue that this is a consensus opinion of pain experts. We
strongly hold the view that patients with non-cancer pain may benefit from
opioid
therapy and that the dose necessary to control pain may be high. Use of ³high
dose² opioid therapy for chronic pain is clearly in the scope of medicine.
Dr. Ashburn asserts (page 23 of the transcript) that morphine at a dose of
195 mg/day constitutes a high dose. This statement is without foundation in the
medical literature and we believe that it is, on its face, absurd.
Dr. Ashburn implies that opioid treatment of a patient with a known addiction
is medically wrong and worsens the addiction. This is not the view of
experienced clinicians in the field. It is unacceptable to promulgate the view
that
the disease of addiction automatically denies patients with severe pain the
possibility of relief through careful opioid therapy.
He states (page 37) that high dose opioids produce hyperalgesia (increased
pain) and therefore may worsen the clinical pain problem. Although this has been
raised in the literature as a theoretical concern affecting some patients,
neither the prevalence nor the clinical significance has been established and
its putative risks have not led to any change in clinical guidelines.
Dr. Ashburn speculates (page 37) that high dose opioids may compromise the
immune system. Again, this is considered to be a theoretical risk, one balanced
by the potential dysimmune effects of unrelieved pain itself; it has not found
its way into any accepted guideline for opioid use in any population.
In the past, each of us perceived Dr. Ashburn as a respected colleague and
his selection as an expert by the government as understandable. We are stunned
by his testimony. As leaders in this field, we feel compelled to correct the
errors in his testimony, lest it be used in the future in a manner that worsens
the national tragedy of untreated pain. We will try to correct the public
record after the trial concludes and sincerely hope that the government and the
court will consider this information now.
Respectfully submitted,
Russell K. Portenoy MD
Chairman
Department of Pain Medicine and Palliate Care
Beth Israel Medical Center
New York, New York
Professor of Neurology and Anesthesiology
Albert Einstein College of Medicine
Bronx, New York
Chief Medical Officer
Continuum Hospice Care/The Jacob Perlow Hospice
New York, New York
James N. Campbell, M.D.
Director, Blaustein Pain Treatment Center
Johns Hopkins University Medical Center
Kathleen Foley, M.D.
Pain&Palliative Care Services
Memorial Sloan-Kettering Cancer Center
Charles Cleeland, Ph.D
Director, Pain Research Group
U.T.M.D. Anderson Cancer Center
Christine Miaskowski, R.N. Ph.D. FAAN
Professor & Chair, Department of Nursing
University of CA San Francisco
Richard Payne, M.D.
Director, Duke University on Care at the End of Life
Duke University Divinity School











Dr. Hurwitz Convicted on 50 Counts
Faces Life in Prison





DR. WM. HURWITZ DEC/2004
Prominent Northern Virginia pain management specialist Dr. William Hurwitz
was viewed as a savior by his patients, some of whom traveled hundreds of miles
to see him, but a federal jury in Alexandria, Virginia, yesterday found him
guilty of being a drug dealer. After six weeks of testimony and four days of
deliberations, the jury convicted Dr. Hurwitz on 50 counts of a 62-count
indictment, acquitted him on nine others, and was unable to reach a verdict on
the
remaining three counts.
On the orders of presiding Judge Leonard Wexler, the nationally known pain
treatment pioneer was immediately hustled off to jail. In the best case --
assuming the verdicts will be overturned on appeal -- Dr. Hurwitz will probably
spend between two and three years behind bars. In the worst case, he will die in
prison as a convicted drug dealer.
Testimony showed that Dr. Hurwitz had prescribed huge amounts of opioid pain
relievers to his patients, some of whom diverted some of them to the black
market. But expert defense witnesses testified that while Dr. Hurwitz's
prescriptions might appear outlandish to medical novices, in reality they were
in line
with accepted medical practice in opioid pain treatment.
The case has focused national attention on the increasingly heated dispute
between federal law enforcers and pain care advocates over whether aggressive
opioid pain treatment is good medicine or criminal drug-dealing. In recent
years, dozens of doctors across the country have been subjected to criminal
trials
for prescribing pain pills, while hundreds more have been taken before state
medical boards. The contradiction between the imperatives of pain management
and those of drug law enforcement has only heightened this year, as the Drug
Enforcement Administration (DEA) and the federal drug czar, John Walters,
unleashed a campaign against prescription drug diversion and abuse.
Hurwitz patients and pain treatment advocates attended the trial and reacted
to the verdict with anger and disappointment. "I just feel very sad, very bad
for Billy and the Hurwitz family," said Siobhan Reynolds, director of the Pain
Relief Network (http://www.painreliefnetwork.org), a leading advocacy group
for pain patients and doctors. "It is really frightening to see this whole
federal drug apparatus go into high gear to destroy that which it has targeted.
To
watch what is really a cynical political prosecution being carried out in
what used to be our hallowed courts is really distressing," she told DRCNet.
"We are so far away from our original ideals. We are letting federal law
enforcement regulate medicine through the criminal courts and allowing the
opinions of prosecutors to override the medical judgments of highly trained
physicians. If this doesn't serve as a wake-up call, then I don't know what
does."
Unsurprisingly, US Attorney Paul McNulty, whose office prosecuted the case,
had a different take. "This sends a major message to anyone who would use the
treatment of pain as a cover for being a drug trafficker," he told reporters
after the verdicts were read.
Reynolds agreed that the verdict sent a strong message, but said that message
was one that would result in people in chronic pain going untreated.
"Any doctor encountering a patient in pain will now run for the hills," she
said. "We are already hearing reports of doctors saying they will be more
punitive with patients who make them nervous. This is a public health disaster.
Twenty years ago, many doctors were afraid to treat patients with AIDS, and the
government took steps to ease that fear. In this case, we have the same sort of
public health catastrophe, but instead of helping the problem, the government
is only exacerbating it."
"No doctor in his right mind would prescribe for chronic pain patients now,
knowing that their misuse of the drugs could be tied back to the doctor and he
could be accused of being a drug dealer," said attorney Ken Wine, part of Dr.
Hurwitz' defense team. "It is as if each prescription he writes is like heroin
being sold on the street. There is no middle ground in the law: Either the
prescribing is okay or you might as well be selling crack on the street. The
only defense doctors traditionally have is the good faith defense, but that did
not work here," he told DRCNet.
Much of the most damaging testimony against Dr. Hurwitz came from a group of
related patients from Manassas who had been arrested on drug charges and who
worked with prosecutors in the effort to win a conviction. Those patients test
ified that they duped Hurwitz into prescribing large amounts of opioids, then
sold them on the black market. While they did not testify that Dr. Hurwitz was
a knowing conspirator in their drug trafficking, their cumulative testimony
aided prosecutors in portraying him as a doctor who ignored signs of drug abuse
among his patients.
If those patients were Dr. Hurwitz' downfall, other patients testified
fervently that the physician was the only one who would help them with their
chronic
pain. They testified that Dr. Hurwitz was a caring and courageous physician
who was willing to prescribe what it took to treat them.
But jurors were more interested in the patients who took advantage of Dr.
Hurwitz than those he helped. In their first question to the judge after they
began deliberations, the jurors asked whether it was illegal to prescribe
opioids
to people who use illicit drugs. While the answer to that question is yes --
patients with substance abuse problems can be treated for their addiction at
the same time they are being treated for pain -- Judge Wexler refused to
instruct the jury thus.
"There will be an appeal, and it will be on the jury instructions," said
Wine. "The judge basically refused to allow the good faith defense. Under the
law,
if he practiced medicine with good intentions, the jury could not find him
guilty. But the judge limited the jury instructions so severely that it had
little choice but to come back with a guilty verdict."
Now, Dr. Hurwitz is a federal prisoner, and more prosecutions of pain
management doctors are already in the pipeline. In the battle between the
imperatives
of the drug war and those of medicine, the drug warriors have prevailed for
now. But as Wine noted, "This is just one battle; the war is far from over."
For the Pain Relief Network, the Hurwitz verdict has prompted a call for an
immediate moratorium on DEA prosecutions of physicians and a public examination
of the Controlled Substances Act.
"This is the 21st Century. The Department of Justice is imposing its
antiquated notions about opioid pain medicines on the American people. Millions
of
innocent sick people are suffering horribly," said Reynolds. "This simply has to
end."








Va. Doctor Guilty of Drug Trafficking

Wed, Dec. 15, 2004 ALEXANDRIA, Va. - A pain-management doctor who frequently
prescribed high doses of opiates to patients across the country was convicted
Wednesday of drug trafficking in the fatal overdose of one patient.
A federal jury also convicted William E. Hurwitz, 59, of conspiracy and drug
distribution charges while acquitting him of some other counts. Jurors
remained undecided on still more charges and was to resume deliberations
Thursday.
Three of 50 counts on which Hurwitz was found guilty - distributing drugs
resulting in one fatal and two nonfatal overdoses - carry sentences of 20 years
to life in prison, said Assistant U.S. Attorney Mark Lytle.
During the trial, Hurwitz testified he knew some of his patients were drug
abusers who were illegally taking cocaine or abusing his prescriptions. He said
he felt compelled to continue treating them with drugs like OxyContin because
abruptly terminating their prescriptions would be "tantamount to torture."
Hurwitz frequently prescribed 100 tablets or more of OxyContin tablets for
his patients as they developed tolerance to lesser doses. Court testimony
indicated at least one patient received a prescription for 1,600 pills a day.
Hurwitz treated nearly 500 patients from 39 states from the late 1990s
through 2002.
The jury acquitted Hurwitz on some charges: six counts of distributing a
controlled substance, one count of engaging in a continuing criminal enterprise
and two counts of scheming to defraud a health care benefits program.
It still must rule on a charge of distributing drugs leading to the death of
another patient, one count of distributing drugs resulting in a nonfatal
overdose and one count of distributing a controlled substance.








Fate of McLean Doctor up to Jury

December 14, 2004 - After hearing 21 days of testimony, 76 witnesses and
exhibits from 31 notebooks containing thousands of pages of documents, an
Alexandria jury of seven men and five women began deliberations last week in the
trial
of Dr. William E. Hurwitz, 59.
A By The Connection's Tuesday presstime, the jury had deliberated more than
23 hours to determine whether prescriptions Hurwitz wrote for chronic pain
patients, some who turned out to be criminal drug dealers, some addicted to
opioids including OxyContin, warrant locking the McLean 'pain doctor' in federal
prison.
"I was engaged morning, noon and night in my practice. I bent over backwards
in terms of being available to my patients as much as I possibly could have,"
Hurwitz said Monday, Dec. 13, as the jury deliberated over his fate. "I felt I
was doing the best I could as a doctor to relieve pain."
Many past patients came to the United States District Court in Alexandria to
offer support the last six weeks of his trial. “I know, in my mind, I did
everything in good faith to help people,”
Hurwitz said. HURWITZ, WHO CLOSED his practice in December 2002, faces a
62-count indictment, including charges of conspiracy to traffic in controlled
substances, drug trafficking resulting in death and serious bodily injury,
illegal
distributions, engaging in continuing criminal enterprise and health care
fraud. Hurwitz’s trial is not the typical case involving someone charged
with
conspiracy to distribute drugs. The prosecution never claimed that Hurwitz
directly profited from illicit drug sales.
His attorney Patrick Hallinan told the jury that Hurwitz's salary —
$286,000 in 2001 and $317,000 in 2002 — was hardly extravagant for a
Washington
area physician, and small when compared to the amounts of money some former
patients, now facing jail time, said they made selling the pills he prescribed.

Story continues here:
http://www.connectionnewspapers.com/article.asp?article=44058&paper=68&cat=104








Tue, 14 Dec 2004
Friends,
After 4 days of deliberations, the jury is still out. Today, they had only
one question. They wanted to know if a wired up government agent can be part of
a conspiracy. They can't.
The jury still appears stressed, but not as badly as they were yesterday.
Frank












Mon, 13 Dec 2004
Friends,
The jury is still out. They had two questions today.
In the morning, they requested transcripts from trial testimony from a
toxicologist concerning one of the deaths. The also wanted to go over some of
Ashburn’s testimony. The judge did not grant their requests, and it
didn’t go
any farther.
In the afternoon there was a question about one of the diverters, and his
prescription. Before the attorneys could be assembled, a note was sent out
stating that the question had been resolved.
Deliberations ended today at 4:30 PM. At the end of the day, jury members
looked like they had been beating the Hell out of each other. I don’t
know
what it means, but that’s what happened.
Frank









Hurwitz Takes the Stand
Jury begins deliberations on the 62-count indictment against McLean ‘pain
doctor.’
Thursday Dec 09, 2004
Some past patients say Dr. William E. Hurwitz saved their lives.
Before he found Hurwitz on the Internet, Sylvester Boyd testified Friday,
Dec. 3 that he suffered 12 years with "constant, nagging, unrelenting pain
—
just pain, pain, pain — it nearly destroyed my life."
"I was at the end of my rope. It gets to a point where shockingly suicide is
not an option you're willing to dismiss," testified Boyd, 50, who suffered
bone fractures, muscle and cartilage tears in his back during a fall at an ice
skating party he held for his daughter about 15 years ago.
Boyd was not the only grateful patient.
"Dr. Hurwitz saved my wife's life," said Charles Barnhart, of New Mexico,
following his wife Molly Shaw's testimony last Thursday."I hope she got to the
jury; I know every time she talks about it, it gets to me."

This "MUST READ" article continued here:
http://www.doctordeluca.com/Library/WOD/HurwitzTakesTheStand04.htm








Thursday Dec 09, 2004
Friends,
The jury is deliberating. So far, they have asked one question. They want to
know if it is legal to prescribe opioids to a pain victim who is also
addicted.
The defense proposed that the jury be instructed that this is legal as long a
the physician prescribes opioids for the purpose of treating the pain. The
government objected to this, and prevailed upon the judge to make an instruction
that effectively obfuscates this simple issue.
If a conviction results, blame will accrue to a corrupt government working in
collusion with the DEA. Between the FAQs debacle, Dr. Ashburn¹s testimony,
and the sorts of judicial shenanigans described above, the effect of this trial
will be to criminalize the treatment not only of addicts for pain, but also
to criminalize the treatment of any patient who displays any aberrant
drug-related behaviors.
Under these circumstances, it is hard to imagine how one might go about the
practice of pain management without risking lifetime imprisonment.
Frank








Thursday Dec 08, 2004
Friends,
Mr. Hallinan’s closing statement was a magnificent performance. He
described how a sophisticated gang of predators took advantage of a
well-intentioned
pain doctor, and how the government conspired with them to help them take him
down. The jury sat riveted at the edge of their seats. Mr. Hallinan owned the
courtroom for almost an hour. This was one for the ages. I am still blown away
by the force of it.
The US Attorney on the other hand, while conceding that Dr. Hurwitz had many
legitimate patients, attempted to demonize him as the criminal mastermind of a
drug dealing empire that stretched all across the southeastern United States,
spreading misery and death as far as London, Kentucky. Mr. Rossi also accused
Dr. Hurwitz as having taken delight in getting away with the killing of a
number of his patients over the years, by outsmarting the DEA.
The jury will be charged tomorrow, and begin their deliberations.
Frank








Tuesday Dec 7th, 2004
Friends,
Most of today was taken up by an aggressive cross-examination of Dr. Hurwitz,
by Gene Rossi. Dr. Hurwitz held his position well. It remained clear that his
intentions were always to help his patients, and never to engage in any sort
of criminal activity.
Drs. Hill and Stinson finished the day by testifying that all of the
prescriptions found in the criminal charges were were reasonable, for a
legitimate
medical purpose, and well within the bounds of medical practice.
Cross-examination of these experts focused on the circumstances under which
it would be criminal for a physician to issue a prescription for opioid
analgesics. The government took the position that prescriptions should not be
issued
if there exists SUSPICION that they could be diverted. The consensus among
defense experts was that a physician should not prescribe when he ABSOLUTELY
knows that the drugs will be diverted. Clearly, there exists a conflict around a
physicians responsibilities in regard to the notion of the principle of
balance.
Closing arguments begin tomorrow at 12:30 PM.
Frank







Tuesday Dec 07, 2004
Va. Doctor Defends Prescribing Pain Pills

A prominent former pain doctor on trial for alleged drug trafficking defended
his treatment methods yesterday, saying he prescribed large dosages of
narcotics to patients who had been arrested or failed drug screenings because he
believed they were in chronic pain.
In one instance, William E. Hurwitz testified, he refilled a Dilaudid
prescription for a woman who said her dog had eaten the original one. "The issue
of
whether the excuse was believable or credible or truthful is hard to assess,"
said Hurwitz, who practiced in McLean until 2002. "I think it is possible that
someone's dog may have mangled a prescription."

Article Continues Here:
http://www.washingtonpost.com/wp-dyn/articles/A41320-2004Dec6.html?sub=AR








12/6/2004
Pain doctor accused of drug trafficking
testifies in own defense
ALEXANDRIA, Va. - A prominent pain-management doctor accused of using his
office as a front for drug trafficking acknowledged Monday that he prescribed
massive amounts of opiates for some of his patients, but said he always had a
medical reason for doing so.
William E. Hurwitz, accused in U.S. District Court of drug trafficking
resulting in the deaths of two patients and other charges, took the stand in his
own
defense Monday.
Hurwitz testified that he knew some of his patients were drug abusers who
were illegally taking cocaine or abusing his prescriptions. But he said he felt
compelled to continue treating them with drugs like OxyContin--or at the very
least to refrain from abruptly canceling their prescriptions--because of the
withdrawal they would suffer after taking such high doses.
"Abrupt termination of these medicines is tantamount to torture," Hurwitz
testified.
Hurwitz frequently prescribed 100 tablets or more of OxyContin tablets for
his patients as they developed tolerance to lesser doses. Court testimony during
the trial indicated that at least one patient received a prescription for
1,600 pills a day.
Hurwitz, who has had frequent run-ins with state medical boards, testified
that the body quickly develops a tolerance for opiates such as morphine and
OxyContin. The best way to combat that, Hurwitz said, is to rotate the drugs
used
and to increase the dosage when needed, often by doubling it.
He said the human body can tolerate massive amounts of opiates without
physical damage and that the risk of addiction is overstated. He also said that
the
physiology of such drugs leaves a user with an increased sensitivity to pain
if they are abruptly taken off a drug.
One of Hurwitz's patients, according to testimony, obtained an early refill
of an OxyContin prescription by telling Hurwitz that the dog had eaten the
initial prescription. Hurwitz had also seen what appeared to be track marks on
the
woman's arms, which she said she had received by hauling some wood.
Hurwitz said he didn't necessarily believe her excuses, but continued her
treatment because "if the treatment was going to be terminated, it should be
done
in a tapered, rational way."
Some of Hurwitz's patients were using the prescriptions they received to deal
drugs; many have struck plea bargains and testified against him at trial.
Prosecutors have played audiotapes to the jury that they say are proof that
Hurwitz knew these patients were dealing drugs and that he turned a blind eye.
Hurwitz testified that he did not know any of his patients were dealing
drugs.
Expert witnesses have testified for both prosecutors and the defense,
differing on whether Hurwitz's prescriptions were medically justified. Among the
doctors to testify on Hurwitz's behalf was Russell Portenoy, chairman of the
pain
management department at Beth Israel Medical Center in New York and considered
to be one of the world's leading experts on pain management.
Hurwitz treated nearly 500 patients from 39 different states in the late
1990s through 2002, receiving a $1,000 initiation fee and monthly fees of up to
$250 for each patient in the practice.
The trial was to resume Tuesday with Hurwitz's cross-examination and is
expected to go to the jury this week after more than one month of testimony.
He faces up to life in prison if convicted on the most serious charges.








Dec 02, 2004
Friends,
The government rested its case against Dr. Hurwitz yesterday. Significantly,
they failed to deliver on a promise made during opening statements. They had
promised that undercover tapes would prove that Dr. Hurwitz was aware of
ongoing diversion of controlled substances and continued to prescribe anyway.
They
presented no such evidence.
Today was the first full day of defense testimony. Steve Passik spent the
morning on the witness stand discussing conceptual issues surrounding the
controversy about aberrant drug-related behaviors. He made it clear that these
behaviors are not in and of themselves automatically diagnostic of anything, and
that complex clinical judgments are required in order to assess their meanings.
Dr. Passik pointed out that these criteria are better characterized as
AMBIGUOUS drug-related behaviors.
A registered nurse who worked in Dr. Hurwitz' office gave a fair and accurate
representation of what went on there. She discussed the difficult decision
making process that occurred in dealing with patients who were less than
compliant with their treatment plans.
Finally, three patients testified today. All made it clear that Dr. Hurwitz'
heroic treatment had been life saving. This occurred after the remainder of
the medical establishment had failed them, sometimes for more than a decade.
The testimony of a nice lady from New Mexico moved moved members of the jury,
and courtroom staff to tears. She described the torment that had reduced her
to years of a bedridden existence, consisting of pain and vomiting, prior to
Dr. Hurwitz' treatment restoring her to a functional existence.

Frank








Dec 1, 2004
Nurse wanted to oust 'seedy' patients
from doctor's drug practice By MATTHEW BARAKAT
Associated Press Writer
http://tinyurl.com/3ljkn
ALEXANDRIA, Va. -- A nurse who worked for a McLean doctor accused of using
his office as a front for drug trafficking testified that the doctor rebuffed
her concerns about patients who were "a little bit creepy or seedy characters"
and frequently demanded a high volume of drugs.
Susan Cruz of Herndon, a nurse practitioner in the pain-management clinic of
William E. Hurwitz, said Tuesday at Hurwitz's trial that she recommended
Hurwitz discharge from the practice a group of patients from Manassas who
frequently demanded early refills of their prescriptions for potentially illicit
drugs
like OxyContin.
In some cases, Cruz said she was concerned because of the patients' incessant
demands for drugs. In one case, she had learned that a patient was facing
drug charges.
"I felt they were a little bit creepy or seedy characters," she said. "It was
just a feeling I had about those patients."
Hurwitz, though, decided to keep treating the patients and prescribe opiates
in amounts that were at times massive, as much as 1,600 pills a day in one
case.
"Dr. Hurwitz said that first of all, a person is innocent until proven
guilty. He also said (my concerns) could be a social bias, because these people
came
from a blue collar background," Cruz said. "And he said that even if a
patient has a problem with addiction they still deserve pain treatment."
Many of those patients have struck plea bargains on drug charges stemming
from the investigation and testified against Hurwitz at trial.
Federal prosecutors have charged Hurwitz with numerous counts of drug
trafficking, including two cases that resulted in death. He faces up to life in
prison if convicted.
Prosecutors say he knowingly prescribed massive amounts of drugs to addicts
and drug dealers. They also allege that two patients who came to him seeking
legitimate pain treatment were prescribed such massive amounts of drugs that he
was responsible for their overdose deaths.
Hurwitz's lawyers dispute that Hurwitz's prescriptions were the cause of
those patients' deaths. They acknowledge that he prescribed at times massive
amounts of opiates to the 300 or so patients enrolled in his clinic, but say it
was
part of an emerging medical trend that encourages high-dosage opiate t
reatment for pain management.
Cruz, a defense witness, testified that Hurwitz employed a collaborative
approach with his patients to ensure that they were receiving adequate pain
relief.
"Only a patient can tell us how much pain he has," she said.
It was under cross-examination from prosecutor Gene Rossi that she testified
about her concerns about some of the clinic's patients.
Prosecutors rested their case Tuesday after nearly four weeks of testimony.
The defense team's first witness--William Barr, a pharmacology professor at
Virginia Commonwealth University in Richmond--was barred from offering most of
his testimony when U.S. District Judge Leonard Wexler ruled that the defense
had improperly failed to notify prosecutors about the substance of Barr's
testimony.
The trial is expected to go to the jury next week.









Epic and Turbulent Times
By David Borden - Drug War Chronicle


Dec 2004 - These are turbulent times in issues related to the drug war. In
one frightening criminal trial, Mb>Dr. William Hurwitz, a Virginia physician who
has helped numerous chronic pain patients whom other doctors wouldn't, is
facing drug charges -- charges many observers consider unreasonable if not
trumped up. And in an epic case coming to the US Supreme Court Monday morning,
patients who use medical marijuana are arguing that the federal government
overstepped its authority when it interfered with their lives.
Dr. Hurwitz is a long time hero to the pain patient movement. In 1996 he was
exonerated by the Virginia Board of Medicine after an ugly investigation that
drew calumny upon the board and drove at least one of Hurwitz's former
patients to suicide for lack of treatment. Not satisfied, federal prosecutors
targeted him again.
During the multi-week trial, which is ongoing at the Alexandria, Virginia,
federal courthouse, DAs have trotted out addicted drug convicts who went to Dr.
Hurwitz for prescriptions. These former Hurwitz patients -- who presumably are
being compensated with leniency in exchange for their testimony -- claim to
have sold some of the opiate drugs Dr. Hurwitz prescribed to them. Prosecutor
Paul McNulty is arguing that Hurwitz must have known they weren't being honest
with him about their pain levels, and that by prescribing them what they
wanted he crossed the line "from healer to dealer." If he convinces the jury of
this, Dr. Hurwitz could go to prison for life.
Frank Fisher, another doctor who faced down the authorities over pain control
at great personal cost, describes Dr. Hurwitz as the "most ethical" doctor in
the pain movement. Hurwitz treats the patients other doctors are most scared
to treat -- pain patients whose backgrounds or histories, including addition
difficulties, might make them more of a risk of abuse or drawing prosecution.
Hurwitz treats them, according to Fisher, because medical ethics,
humanitarianism itself, requires they be treated. Fisher told me, following a
recent
Congressional briefing on this subject organized by the Association of American
Physicians and Surgeons, that the question lying at the heart of the Hurwitz
case
is whether there is a class of people who are not allowed to receive
appropriate treatment for chronic pain.
Angel Raich and Diane Monson, medical marijuana patients, and their two
anonymous caregiver/growers, brought suit against John Ashcroft after the Dept.
of
Justice initiated raids three weeks after 9/11/01 against medical marijuana
cooperatives across the state of California. The heart of their case is a
challenge to the government's interpretation of the Interstate Commerce Clause
in
the US Constitution. Raich and Monson charge that provision of marijuana, to
patients who need it as a matter of medical necessity, by private growers
intra-state (within the state's borders), is not interstate commerce (across
state
lines). The government contends that any activity involving marijuana can be
regulated by Congress, because in theory the marijuana could cross state lines
and be sold elsewhere -- even if it's not. The case is considered one of the
most important on the court's docket.
As Dr. Hurwitz's trial was looming, the DEA and a number of medical
organizations and experts released a "consensus statement" on pain control.
Then, a few
weeks later, DEA suddenly retracted the statement, saying it contained errors
but not explaining what they were. Pain advocates charged it was because the
document was cited by Dr. Hurwitz's lawyers in his defense, and DEA didn't
want anything out there that might help him. A short statement published this
month seemed to indicate that DEA's motives included a desire to preserve
unfettered the government's ability to investigate and prosecute any doctor at
anytime. Drug War Chronicle tried to write an article for this issue about this
latest DEA communique, but neither the DEA nor any of the several medical bodies
involved in the consensus statement whom we contacted returned our phone calls.
There seems to be a lot of embarrassment about this. To which I say, there
should be, at least on the DEA's part.
With Raich v. Ashcroft looming, the plaintiff's side gained some unexpected
allies in the form of the attorneys general of three southern states. They are
not pro-medical marijuana -- one of them told Time magazine he considers the
state medical marijuana laws to be "misguided" -- but for them it is about
states' rights. We'll see what happens.
Regardless of the outcomes, patients should not have to resort to the courts
to claim their natural rights against the government; and doctors practicing
honest, compassionate medicine should not have to be dragged through the courts
to prove that they shouldn't spend their lives in prison for doing it. On
both counts, this court of public opinion finds the federal government guilty.












November 10, 2004
Pain Doctor’s Trial Begins


Was McLean doctor a criminal drug dealer, or a compassionate doctor
victimized by a few patients?
By Ken Moore


DETOX FROM OXYCONTIN for Cynthia Denise Horn, the U.S. government's second
witness in its case against McLean doctor William Eliot Hurwitz, took place in
an Alexandria jail.
At the time of her July 8, 2002, arrest for conspiracy to distribute
OxyContin, Hurwitz was writing prescriptions to Horn for thirty 160-milligram
OxyContin pills per day, 80 times the amount she said she got from other
doctors.
"After I got off the pills, I felt like I was 18 again," said Horn, 43, of
Manassas, who testified on the second day of the trial, Friday, Nov. 3, that she
called Dr. Hurwitz from jail a few weeks after her arrest. "I told him he needed
to stop giving OxyContin to people," said Horn, dressed in a black-and-white
striped prison outfit. "It was destroying their lives."
THE TRIAL of Dr. William E. Hurwitz of McLean began in Alexandria last
Thursday, Nov. 4, at the U.S. District Court for the Eastern District of
Virginia
before Senior Judge Leonard D. Wexler.
The 62-count indictment against Hurwitz, who closed his practice in 2002,
includes charges of conspiracy to distribute controlled substances, drug
trafficking resulting in death, drug trafficking resulting in serious bodily
injury,
engaging in continuing criminal enterprise, and health-care fraud.
"A self-proclaimed healer, he crossed the line to a drug dealer," said Mark
D. Lytle, assistant U.S. attorney, in the prosecution's one-hour opening
statement last Thursday. "He thought he could hide behind the pain he treated."
BUT HURWITZ'S ATTORNEYS contend that he is a nationally known doctor who
provided needed care for patients suffering from chronic, intractable pain. "The
undertreatment of pain is a serious and widespread health issue," according to
documents filed on Nov. 1 by Hurwitz's attorneys Patrick S. Hallinan, Kenneth
H. Wine and Marvin D. Miller.
From July 1998 to December 2002, Hurwitz treated more than 400 patients for
chronic pain. "Chronic pain is with you all day long, all night long, and makes
you suffer every day. It destroys your life," Hallinan said, in opening
statements for the defense last Thursday.
Dr. Hurwitz treated patients who ranged from 18 to 74, and included patients
with “phantom limb” pain, patients who had undergone multiple
surgeries,
injury victims and people with migraine headaches, multiple sclerosis, AIDS
and terminal illnesses. "Given their previous medical histories, these patients
are candidates for the type of medication therapy used by Dr. Hurwitz, which
often involves high dosages of opioid drugs," according to Hallinan, Wine and
Miller. "It is important to understand that chronic pain patients are not those
suffering from transitory or easily treatable causes of pain," they wrote. "A
lack of public understanding about the nature of pain therapy and overbearing
actions of regulatory authorities have combined to impede access to pain
treatment, deter physicians from practicing pain medicine, chill the legitimate
prescription practices of physicians who do treat pain, and thereby deny
patients in this county their constitutionally protected right to relief from
unnecessary suffering."
SIX WITNESSES for the prosecution testified in the first two days of the
trial, which is expected to last up to six weeks. Assistant U.S. Attorney Gene
Rossi introduced Horn and her 18-year-common-law husband Kevin L. Fuller, 42, as
the prosecution's first two witnesses. Fuller, who first started seeing
doctors following three knee surgeries in 1985, 1987 and 1991, sold multitudes
of
the OxyContin pills prescribed by Hurwitz to continue to support their drug
habits. "I had a lot of pain, but I exaggerated it, trying to get the drugs,"
Fuller said.
Fuller, who pled guilty to conspiracy to distribute OxyContin and was
sentenced to 188 months in jail, first went to Hurwitz on Aug. 4, 1998, at
Hurwitz's
home office on Swinks Mill Road. He testified that he paid Hurwitz a $1,000
initiation fee that was required to be paid in cash, plus a monthly fee that
Horn said cost $250. "I heard he was 'The Man,' the doctor who would help you
get
what you need," Fuller said. "When you're a drug addict hooked on OxyContin,
you try to get what you want."
Fuller testified that he made a $229,000 profit in a 50-day period from March
26, 2001, to April 30, 2001, by selling prescribed pills. "I paid my bills,
bought me a nice bike, and bought a whole lot of crack," Fuller said. But when
cross-examined by Hallinan, Fuller admitted he had "played a lot of doctors"
over the years to get OxyContin. Fuller called Hurwitz naive, but he also said
the doctor was “his friend.” "He was concerned about me and my
wife,"
Fuller said. "Dr. Hurwitz is always concerned."
PAULA JANE FARMER, the prosecution's fifth witness, who testified Friday,
said prescriptions for OxyContin and Dilaudid from Dr. Hurwitz to her husband,
John Farmer, cost $40,000 a month to fill."We had to have more and more and
more," said Farmer, 40, of Centreville, who was granted immunity for assisting
the
prosecution in its case. Her husband died in 2004 of an overdose; he was not
under Hurwitz's care at the time.
During his opening statement, Hallinan called some of Hurwitz's patients
"professional predators" who took advantage of Hurwitz's trust. "It is the
patient
that hurts, the patient that suffers," Hallinan said, "and protocols of
medicine say listen to your patient.”
Hurwitz kept detailed records regarding all his patients, including Horn,
Fuller and Farmer, which his lawyer said points to his innocence. "These medical
records are in stone," Hallinan said. "You think someone involved in a scam of
selling pills will document this?"







1st Day of Trial


11/05/04 - Federal prosecutors yesterday portrayed prominent pain doctor
William E. Hurwitz as a man who used his white coat and prescription pad to
traffic in narcotics, spreading the abuse of addictive painkillers nationwide
and
ultimately leading to the deaths of several patients.
During the opening day of his trial in U.S. District Court in Alexandria,
prosecutors outlined a 62-count indictment against the McLean doctor that
includes charges of drug trafficking resulting in death and serious bodily
injury,
conspiracy to traffic in controlled substances and health care fraud.
During the trial, which is expected to last as long as eight weeks and has
drawn national attention from advocates for patients with chronic pain,
prosecutors intend to prove that Hurwitz, 59, was "a drug dealer in his own
right,"
entering into sketchy financial agreements with patients whom he provided with
countless prescriptions for painkillers such as OxyContin -- sometimes up to
600 pills per day.
Prosecutors said those patients used the drugs both to fuel their own
addictions and to make huge profits on the black market.
"The indictment tells the story of someone who crossed over from a
self-proclaimed healer to a drug dealer," Assistant U.S. Attorney Mark Lytle
told the
jury during opening statements. "Dr. Hurwitz was playing the role of an illegal
drug supplier."
Hurwitz's attorneys have denounced the charges against their client as an
attempt by the government to criminalize good medical practice. They say Hurwitz
was providing needed pain management to a class of patients whose chronic
suffering "destroys your body . . . your soul."
"This case is not about drug dealing," said defense attorney Patrick S.
Hallinan, who is based in San Francisco. "This is a case about new science: the
treatment of chronic pain with high opioid doses to ameliorate that pain."
The trial is the culmination of a two-year federal investigation into
doctors, pharmacists and patients suspected of selling potent and addictive
painkillers. About 50 people have been convicted. Law enforcement sources said
the
probe is ongoing, though Hurwitz was one of the ultimate targets.
Before he closed his practice in 2002, Hurwitz was considered a major figure
in pain management. If convicted of the most serious counts, Hurwitz, who has
been free on $2 million bond, faces up to life in prison.
During the government's presentation yesterday, prosecutors showed the jury
enlarged photographs of medical records allegedly written by Hurwitz that
mention a patient's arrest for selling drugs. Although prosecutors said evidence
--
including a recording of a conversation between Hurwitz and one of his
patients -- will show that the doctor knew his patients were abusing drugs and
in
some cases selling them, Hallinan said the opposite is true.
"For goodness sake," Hallinan said, "these medical records are in stone. You
think someone involved in a scam selling pills would put it down in the
records?"
Hallinan told the jury that his client would "never tolerate the
dissemination of medications into the community" and denied prosecutors' claims
that
patients told Hurwitz they were actively selling the drugs.
Rather, he said his client was the victim of "professional predators" who
took advantage of his medical practice in order to obtain drugs and sell them
for
a profit.
If Hurwitz worked in Beverly Hills or healed only "the upper middle class,"
Hallinan said, he would not be in this predicament.
"These were poor people who couldn't resist . . . the temptation to get more
pills than they need and sell them," said Hallinan, describing one of
Hurwitz's patients who later agreed to cooperate with investigators and wore a
wire to
tape their conversations.
Prosecutors contend that a conversation includes Hurwitz suggesting that his
patient get an unnecessary MRI to falsely support his heavy prescriptions.
Prosecutors say the patient also discloses his arrest for possession of cocaine.
Still, they said, Hurwitz prescribed the patient 300 tablets of OxyContin.
"That tape recording provides a window into the real Dr. Hurwitz," Lytle told
the jury. "As a doctor, he thought he could hide behind the pain he treated."
Prosecutors allege that Hurwitz made large profits by charging an initiation
fee of $1,000 for each patient and then $250 a month for maintenance. They
said Hurwitz had about 470 patients in his clinic over the last five years,
resulting in millions of dollars in profit.
Several of those patients died and others overdosed, prosecutors said
yesterday, telling the jury they can link the incidents to Hurwitz's overzealous
dosages.
Several of Hurwitz's friends and former patients were in the courtroom
yesterday to lend support.
Siobhan Reynolds is executive director of the Pain Relief Network. Her former
husband suffers from a congenital tissue disorder that she said has left him
with intractable pain. He was a patient of Hurwitz's until the practice was
closed.
"He saved my husband's life for sure," said Reynolds, adding that Hurwitz was
"brave enough" to give her husband the care and the medication he needed --
extraordinarily high doses of OxyContin, Dilaudid and Fentanyl -- when other
doctors were afraid to act.
"Other doctors who might have been persuaded to get involved see this as a
precautionary tale," she said, referring to the trial. "Who wants this?"
Newshawk: chip
Pubdate: 5 Nov 2004
Source: Washington Post (DC)
Author: Leef Smith
Webpage: http://www.washingtonpost.com/wp-dyn/articles/A26799-2004Nov4.html
U.S. Calls Doctor Dealer, Not Healer
Trial on Drug Charges Begins in Va.
By Leef Smith
Washington Post Staff Writer
Friday, November 5, 2004; Page B07


Karen Hallenbeck~Sikorsky~George BS,RN,UM,QC
Owner-Moderator
"AnGeLsInPain"
"OneVoiceInPain"

http://health.groups.yahoo.com/group/AnGeLsInPain

Interqual Certified
Published Psychiatric Researcher
Advocate for those in CIP, HIV, Psychologic Pain
"A Higher Power is necessary to find the ability to withstand self
destruction.."


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