Pubdate: Mon, 02 May 2005
Source: American Medical News (US)
Copyright: 2005 American Medical Association
Contact: http://www.ama-assn.org/apps/amednews/edlet.pl
Website: http://www.amednews.com/
Details: http://www.mapinc.org/media/1235
Author: Andis Robezniek, AMNews staff
Bookmark: http://www.mapinc.org/find?232 (Chronic Pain)
Bookmark: http://www.mapinc.org/people/william+hurwitz

OPIOID PRESCRIPTIONS LEAD TO PRISON SENTENCE

The DEA head says doctors who legitimately prescribe painkillers have
nothing to fear.

It was not the life sentence prosecutors sought, but for 59-year-old
William Hurwitz, MD, the 25-year sentence he received April 14 may be
just that. Some fear the federal prison time and $1 million fine may
have a chilling effect on pain prescriptions.

A jury in December 2004 convicted the McLean, Va.,-based pain
specialist, who gained fame when "60 Minutes" told his story, of 50 of
the 62 counts related to prescribing large amounts of opioids and
other narcotics.

Because of the high-profile nature of the case, some physicians said
Dr. Hurwitz's imprisonment would result in them being too afraid to
prescribe opioids to patients who need them.

"He's the poster boy," said C. Stratton Hill Jr., MD, professor
emeritus of medicine at the University of Texas and founder of the
M.D. Anderson Cancer Center's pain clinic in Houston. "You're going to
see more physicians abandoning the treatment of pain because they
don't want to worry about getting into trouble."

Dr. Hill, who served as a witness for Dr. Hurwitz's defense, said he
was troubled that law enforcement officials were deciding what
constitutes legitimate medical practice.

But at a news conference after the sentencing, U.S. Drug Enforcement
Administration Administrator Karen Tandy emphasized that doctors who
"legitimately" prescribe narcotics to treat pain have nothing to fear.

AMA Trustee Rebecca J. Patchin, MD, said Tandy's statement reflects
the message of balance that AMA representatives tried to convey when
they met with the DEA chief in March. An anesthesiologist and
pain-management specialist in Riverside, Calif., Dr. Patchin said
physicians need to be aware of diversion issues, but still need to
adequately treat pain. She said that while it's inappropriate for a
doctor to prescribe drugs he or she knows are being diverted, it is
appropriate to treat a patient simultaneously for pain and substance
abuse.

"Substance abuse is a disease that you treat like diabetes or any
other illness," Dr. Patchin said. "If a physician is concerned about
what they're doing, I ... recommend that they consult with a colleague
or either a pain or substance abuse specialist."
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MAP posted-by: Larry Seguin