HTTP/1.0 200 OK Content-Type: text/html Pain Doctor Accused Of Drug Trafficking Testifies
Pubdate: Tue, 07 Dec 2004
Source: Richmond Times-Dispatch (VA)
Copyright: 2004 Richmond Newspapers Inc.
Author: Matthew Barakat, Associated Press


He Says Abruptly Ending Treatment Would Be 'Tantamount To Torture'

ALEXANDRIA - A prominent pain-management doctor accused of using his office 
as a front for drug trafficking took the stand in his defense yesterday.

William E. Hurwitz, on trial in U.S. District Court, acknowledged that he 
prescribed massive amounts of opiates for some of his patients but said he 
always had a medical reason for doing so.

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 such as 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 

Hurwitz frequently prescribed 100 tablets or more of OxyContin 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 one of the world's leading experts on pain management.

Hurwitz treated nearly 500 patients from 39 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 today with Hurwitz's cross-examination and is 
expected to go to the jury this week after more than a month of testimony.

He faces up to life in prison if convicted on the most serious charges.
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