ROANOKE DOCTOR'S OFFICE IS DRUG RAID TARGET

Officials Say Dr. Cecil Knox's Oxycontin Prescriptions Are Suspicious

Just this month, a detective told the doctor that one of his patients had
been charged with distributing OxyContin, records say.

Federal authorities searched the office of a Roanoke physician Wednesday
for evidence to support their suspicion that he prescribed OxyContin and
other drugs to addicts, drug dealers and at least two people who later died
of overdoses.

Although Dr. Cecil Knox was not charged immediately after the raid, a
search warrant affidavit stated that he is under investigation for making
false claims to medical insurance programs and prescribing drugs for no
legitimate medical purpose.

Until now, abuse of OxyContin has been most prevalent in far Southwest
Virginia. But according to the affidavit, Knox was dispensing large amounts
of the prescription painkiller from Southwest Virginia Physical Medicine
and Rehabilitation, which he runs from a converted home on Second Street
Southwest.

One witness told authorities that Knox was prescribing drugs "to anyone who
asked for them," the affidavit stated.

According to records from Trigon Blue Cross Blue Shield, the largest
managed health care company in Virginia, Knox is the state's second-largest
provider of OxyContin under its program.

U.S. Attorney Ruth Plagenhoef declined to comment on Knox's case. But she
did say her office, which has brought charges against five Southwest
Virginia doctors in the past two years, is committed to fighting
prescription drug abuse.

Knox could not be reached for comment.

A witness who was not identified in the affidavit told a Drug Enforcement
Administration agent that his brother, who died of a drug overdose, once
confided to him that he was giving marijuana to Knox in exchange for
OxyContin and methadone.

An autopsy determined the man died from an overdose of methadone, which
Knox had been prescribing to him along with OxyContin and four other
prescription medications, according to the affidavit.

A second fatal overdose linked to Knox happened in Salem in 1999. "Acting
very nervous," Knox showed up at a motel where one of his patients was
found dead, the affidavit states. He left after being questioned about
medications found at the scene.

An autopsy later found that the man overdosed on cocaine, benzoylecgonine
and diazepam, also known as Valium. Just three days before the death, Knox
prescribed Valium to the man, according to the affidavit.

Based on accounts from other witnesses, authorities believe Knox prescribed
drugs to people he knew were addicts. In one case, Knox never responded to
a probation officer's letter and repeated phone calls expressing concern
that a drug abuser was receiving OxyContin from him, according to the
affidavit.

That was not the only time law enforcement officials tried to warn Knox,
the affidavit states. Earlier this month, a detective with the Pulaski
County Sheriff's office called the doctor to tell him that one of his
patients had been charged with distributing OxyContin.

"Even though he was aware of the arrest, Dr. Knox continued to prescribe
the patient OxyContin," the affidavit states.

Agents from the FBI, DEA, state police and U.S. Department of Health and
Human Services provided details for the search warrant, which authorized
them to remove patient files and other records from Knox's office. Several
agents on the scene declined to comment Wednesday afternoon as empty
cardboard boxes were carried into the building.

Since 1998, at least 43 fatal overdoses in the western half of the state
have been attributed to oxycodone, the active ingredient in OxyContin. Most
of the overdoses have occurred in far Southwest Virginia.

Citing investigations like the one Wednesday, authorities now say the
problem is spreading to larger cities.