Pubdate: Sun, 11 May 2003
Source: Messenger-Inquirer (KY)
Copyright: 2003 Messenger-Inquirer
Contact:  http://www.messenger-inquirer.com
Details: http://www.mapinc.org/media/1285
Author: Roger Alford  /Associated Press
Bookmark: http://www.mapinc.org/oxycontin.htm (Oxycontin/Oxycodone)

ONCE-HERALDED MEDICAL RECRUITS FALL FROM GRACE

Doctors Face Drug Charges In Appalachia

PIKEVILLE -- A growing list of doctors who were once welcomed with open 
arms into medically underserved Appalachia have been taken away in handcuffs.

In eastern Kentucky alone, seven small-town doctors are in prison or on 
their way there for illegally supplying drug addicts with prescriptions for 
powerful narcotics such as OxyContin. At least six others have been rounded 
up in the hills of West Virginia, Virginia and southern Ohio.

Advocates for the mountain region say the loss of so many doctors 
ordinarily would have left a void. In these cases, they say, the departures 
can only improve medical care.

"As badly as we need more physicians, we certainly don't need the type that 
will violate their oaths and do much more harm than good," said Ewell 
Balltrip, executive director of the Kentucky Appalachian Commission.

Federal and state law enforcement agencies began cracking down on wayward 
physicians in Appalachia in 2000, after OxyContin, a powerful painkiller 
intended for cancer patients and others suffering from severe pain, began 
showing up in large quantities on the black market.

The first eastern Kentucky physician snared in the crackdown -- Dr. Ali 
Sawaf, 61, of Harlan -- turned to illegally prescribing OxyContin and other 
painkillers after he lost his $250,000-a-year job at a regional clinic.

Assistant U.S. Attorney Roger West said at the time that Sawaf was 
desperate for money and opened an office in a Harlan mall where he handed 
out prescriptions almost as quickly as he could write them.

The latest physician to plead guilty, Dr. David Procter, 52, of South 
Shore, traded painkillers for sex. He admitted to a federal judge that he 
had sexual relations with two female patients after he got them hooked.

Assistant U.S. Attorney Pat Molloy said most of the doctors caught in the 
past two years had been recruited to come to the region to help care for 
rural residents.

"They may not have stepped over the line before they got here but clearly 
they were corruptible," Molloy said. "I don't think they were of high moral 
character when they got here."

The problem is not confined to Appalachia.

Dr. Dudley Hall, a Bridgeport, Conn., physician, was nicknamed "Dr. 
Feelgood" by police for writing so many prescriptions for OxyContin and 
other painkillers . Hall was convicted last year on 22 counts of illegally 
prescribing a narcotic substance and 14 counts of illegally prescribing a 
controlled substance.

In Milton, Fla., Dr. James Graves was convicted of manslaughter in the 
OxyContin overdose deaths of four patients. Graves was the first doctor in 
the nation to be convicted of manslaughter or murder for OxyContin deaths. 
He testified that he was unaware patients were abusing the prescriptions.

Authorities blame the abuse of OxyContin for scores of overdose deaths in 
the Appalachian region and beyond.

If taken properly, the drug's ingredients are released slowly into the 
body. But abusers circumvent the time-release by crushing the pills and 
inhaling or injecting the powder to get the same kind of euphoric high that 
heroin brings.

Larry Bailey of Grayson said he believes his son, who became hooked on 
painkillers and died from an overdose, would still be alive if unscrupulous 
doctors had not been so willing to feed his addiction.

At first, his son, Paul Bailey, 35, had a legitimate need for medication to 
ease severe back pain. The last time he visited Dr. Rodolfo Santos of South 
Shore, he left with prescriptions for painkillers, tranquilizers and muscle 
relaxants. It was a combination of those pills that claimed his life.

So when Santos went on trial last month for overprescribing drugs, Larry 
Bailey sat quietly in the courtroom day after day, hoping the doctor would 
be convicted on the charges. The conviction came last month, making Santos 
the seventh doctor in eastern Kentucky to fall.

"Being angry doesn't solve anything," Larry Bailey said. "But I was 
thrilled to see him being put out of business. My son tried to break the 
addiction. He had moved himself into a treatment center at Ashland and did 
well for a few months. The desire came back, and he could get drugs freely 
from Santos."

A jury recommended in April that Santos, who was recruited to work in 
eastern Kentucky, serve 16 years in prison. He could be eligible for parole 
in a little more than three years.

Procter, the physician who owned the clinic where Santos worked, pleaded 
guilty in April to one count of conspiracy and two counts of illegally 
prescribing controlled substances. Procter faces 10 to 12 years in prison.

Others in eastern Kentucky who have either pleaded guilty or been convicted 
of overprescribing drugs include two physicians in Paintsville, one in 
Garrison and another in South Shore. Some of those individuals saw as many 
as 150 patients a day, ushering them into and out of examination rooms in 
as little as three minutes.

Lewis County Sheriff Bill Lewis said no one in Garrison was sorry to see 
the arrest of Dr. Fortune Williams, the only physician in the community of 
800 people, because of the large number of addicts he created and attracted.

In southern Ohio, two doctors have been convicted over the past two years 
for writing unnecessary prescriptions for painkillers, as have two from 
West Virginia and two from southwest Virginia.

In an effort to get more doctors in rural Appalachia, area leaders pushed 
for and got a medical school. The Pikeville College School of Osteopathic 
Medicine will have graduated 168 doctors as of this month.

The idea is to ease the shortage of primary care doctors with homegrown 
physicians.

Dr. John Strosnider, dean of the Pikeville college, said the new doctors 
will immediately begin to narrow the physician-to-patient ratio, easily 
replacing the physicians who have been sent to prison.

"Those numbers I don't even worry about," he said. "If we have physicians 
who are unethically writing prescriptions and selling narcotics, they're 
not practicing medicine anyway."

The first 53 graduates are scheduled to complete residency training in July 
of next year, at which time they'll be opening offices throughout eastern 
Kentucky.

"Five years from now, we should see hundreds of new primary care doctors in 
these communities," Strosnider said.
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MAP posted-by: Terry Liittschwager