DRUG DEALER OR DOCTOR? PROPER CASE FOR COURTS

Deciding when a physician should face criminal charges rather than a
malpractice lawsuit is not easy. In the case of Dr. Denis Deonarine,
however, a Palm Beach County grand jury made the decision to indict him for
first-degree murder.

Michael Labzda, 21, died Feb. 8 after overdosing on a lethal mix of
tranquilizers, alcohol and, most relevant, OxyContin. Dr. Deonarine
prescribed the powerful painkiller for Mr. Labzda and is charged with 78
counts, dating to 1999, of drug dealing involving OxyContin.

Dr. Deonarine is the first doctor in Florida and only the second in the
country to face a murder charge for prescribing OxyContin. The indictment
comes amid growing concern about widespread abuse of the drug. The county
medical examiner's office is investigating two other deaths to determine
whether they resulted from OxyContin overdoses.

The Food and Drug Administration approved OxyContin in 1995. The FDA and
the Drug Enforcement Administration regulate its manufacture and
distribution. The drug has been a blessing for people with terminal cancer
or other intractable pain, but it can be a killer for those who abuse it.
Oxycodone, the synthetic opiate that is the drug's active ingredient, is a
relative of opiates such as heroin. The difference is that heroin is
illegal. OxyContin is legal and available from any physician who can
prescribe controlled substances.

OxyContin's reputation has spread quickly among physicians and abusers.
Last year, it was the leading opioid painkiller in the country, generating
$1.14 billion in sales for manufacturer Purdue Pharma. Initially,
oncologists prescribed it for cancer patients. Today, family physicians,
who may be less skilled in pain relief, are the largest group prescribing
it. Scientists believed that the drug's timed-release function would reduce
the risk of addiction, but abusers found that crushing and ingesting the
drug produced a heroinlike high and rapid addiction.

It may be difficult to convict Dr. Deonarine on the murder charge, but
prosecutors did not act in haste. During a five-month investigation,
undercover agents from the state attorney's office and the Florida attorney
general's Medicaid fraud unit visited his office and obtained prescriptions
without the doctor taking even a medical history. Dr. Deonarine also is
accused of defrauding Medicaid by writing illegitimate prescriptions. At
Wednesday's bond hearing for Dr. Deonarine, Palm Beach County Circuit Judge
Kenneth Marra set bail at $250,000.

State Attorney Barry Krischer says the first-degree murder charge is
"absolutely not" intended to send a message. "This isn't a shot across
anybody's bow," he says. "It's not about medical practice or this
particular drug. This is about a man using his medical license to sell drugs."

Any doctor who writes OxyContin prescriptions for the money alone is little
more than a drug dealer. If Dr. Deonarine did that, prosecution is
necessary. If it sends a shot across somebody's bow, so much the better.