DOCTORS CAUGHT IN PAINKILLER BATTLE

STAMFORD - Dr. David Walshin does not want to bring his work home with him.

Walshin, a doctor of physical medicine and rehabilitation whose practice is
in Stamford, has become more wary of prescribing narcotics for pain since
Purdue Pharma L.P.'s drug OxyContin exploded on the scene.

"It started with this drug, but I now apply the same caution to all
narcotics," he said. "If I have a doubt with a patient now, I just don't
take a chance. I'll either prescribe them another product, or I'll let them
get the drug from someone else if there's a chance they'll abuse it.

"I don't want to second-guess myself when I go home to have dinner with my
family."

Walshin knows some of the signs. A patient insists on paying cash rather
than going through insurance. A patient refuses to provide addresses or
telephone numbers. They show up minutes before the office closes for the
day or arrive an hour early for their regular appointment.

In those cases, which he sees about twice a month, Walshin sends patients
elsewhere for care.

In many ways, Walshin represents the battle at the center of the OxyContin
story. He knows how effective the drug can be for many of his patients who
suffer chronic or severe pain. But he is mindful of the drug's powerful
addictive quality if used improperly.

Stamford-based Purdue Pharma and medical professionals fear that because
the drug is becoming known for its illegal uses, doctors will shy away from
prescribing the landmark time-release medication.

Pamela Bennett, Purdue Pharma's director of advocacy, uses numbers to make
her point. She says 75 million Americans will seek help for pain this year,
of which 50 million will suffer daily pain.

"Take those numbers and compare them with the 4 million people who suffer
from addiction," she said. "In this story, we're hearing from the addicts.
We're hearing from the criminals. When will we hear the voice of the patient?"

Bennett and other Purdue Pharma officials say their goals are identical to
those of law enforcement and government agencies: to prevent illegal use of
prescription drugs and to ensure patients in legitimate need of the
medication are not denied access to it.

But, Purdue fears, proposed methods of limiting distribution of the drug
will not impact the ability of abusers to get the pill. They also might
make patients in pain less likely to fill their prescriptions.

The doctors are the group in the middle.