A TANGLED STORY OF ADDICTION

Consequences of Cindy McCain's Drug Abuse Were More Complex Than She
Has Portrayed

When Cindy McCain is asked what issues she would champion as first
lady, she often cites one of the most difficult periods of her life:
her battle with -- and ultimate victory over -- prescription
painkillers. Her struggle, she has said repeatedly, taught her
valuable lessons about drug abuse that she would pass on to the nation.

"I think it made me a better person as well as a better parent, so I
think it would be very important to talk about it and be very upfront
about it," McCain said in an interview with "Access Hollywood." In an
appearance on the "Tonight Show With Jay Leno," she said she tries
"to talk about it as much as possible because I don't want anyone to
wind up in the shoes that I did at the time."

In describing her struggle with drugs, McCain has said that she
became addicted to Vicodin and Percocet in early 1989 after rupturing
two disks and having back surgery. She has said she hid her addiction
from her husband, Sen. John McCain, and stopped taking the
painkillers in 1992 after her parents confronted her. She has not
discussed what kind of treatment she received for her addiction, but
she has made clear that she believes she has put her problems behind her.

While McCain's accounts have captured the pain of her addiction, her
journey through this personal crisis is a more complicated story than
she has described, and it had more consequences for her and those
around her than she has acknowledged.

Her misuse of painkillers prompted an investigation by the Drug
Enforcement Administration and local prosecutors that put her in
legal jeopardy. A doctor with McCain's medical charity who supplied
her with prescriptions for the drugs lost his license and never
practiced again. The charity, the American Voluntary Medical Team,
eventually had to be closed in the wake of the controversy. Her
husband was forced to admit publicly that he was absent much of the
time she was having problems and was not aware of them.

"So many lives were damaged by this," said Jeanette Johnson, whose
husband, John Max Johnson, surrendered his medical license. "A lot of
good people. Doctors who volunteered their time. My husband. I cannot
begin to tell you how painful it was. We moved far away to start over."

McCain's addiction also embroiled her with one of her charity's
former employees, Tom Gosinski, who reported her drug use to the DEA
and provided prosecutors with a contemporaneous journal that detailed
the effects of her drug problems. He was later accused by a lawyer
for McCain of trying to extort money from the McCain family.

"It's not just about her addiction, it's what she did to cover up her
addiction and the lives of other people that she ruined, or put at
jeopardy at least," Gosinski said in an interview this week.

Cindy and John McCain declined repeated requests to be interviewed
for this article. The McCain campaign also declined to comment.

Based on the limited details they have provided in earlier
interviews, it is impossible to tell the full story of a difficult
period in their lives. The following account of Cindy McCain's
prescription drug abuse and her and her husband's efforts to deal
with it is based on official records, including a report by the
county attorney's office in Phoenix, and on interviews with local and
federal officials involved in the probe.

Politics and Philanthropy

In 1988, during her husband's first Senate term, Cindy McCain founded
the American Voluntary Medical Team, a nonprofit that sent volunteer
doctors and nurses to provide free medical care in Third World
countries and U.S. disaster zones. Cindy McCain served as president,
operating out of her family's business, a giant Anheuser-Busch beer
distributorship in Phoenix owned by her father.

The McCains had married in 1980. They moved to Washington after he
was first elected to the House of Representatives in 1982. But she
later returned to Phoenix, her home town, believing it was a better
place to raise a family. Sen. McCain commuted home on weekends.

Even far from Washington, politics took a toll on Cindy McCain. In
1989, she was pulled into a Senate investigation that focused on her
husband and four other senators who had intervened with regulators on
behalf of savings-and-loan owner Charles Keating.

When questions arose about a vacation the McCains took to Keating's
home in the Bahamas, Cindy McCain, as family bookkeeper, was asked to
document that they had reimbursed the Keatings, but she could not.
She has repeatedly cited the stress of the Keating Five scandal and
pain from two back surgeries that same year as reasons for her
dependence on painkillers.

Her charity, AVMT, kept a ready supply of antibiotics and
over-the-counter pain medications needed to fulfill its medical
mission. It also secured prescriptions for the narcotic painkillers
Vicodin, Percocet and Tylenol 3 in quantities of 100 to 400 pills,
the county report shows.

McCain started taking narcotics for herself, the report shows. To get
them, she asked the charity's medical director, John Max Johnson, to
make out prescriptions for the charity in the names of three AVMT employees.

The employees did not know their names were being used. And under DEA
regulations, Johnson was supposed to use a form to notify federal
officials that he was ordering the narcotics for the charity. It is
illegal for an organization to use personal prescriptions to fill its
drug needs.

"The DEA told me it was okay to do it that way," Johnson told The
Washington Post recently, in his first media interview about the
case. "Otherwise, I never would have done it."

The county report showed that Johnson told officials he knew it was
wrong, but he wrote prescriptions at McCain's request at least twice.

After Johnson wrote the prescriptions, McCain, and sometimes her
secretary, picked them up from his home. Once they were filled,
Johnson was supposed to maintain custody of the narcotics, but he
said he let McCain control them and carry the medications in her
luggage on charity trips.

No one tracked the narcotics in between the charity's missions, the
county report shows.

When the county investigator asked Johnson where the charity stored
its narcotics, he said they were in a safe. When asked where the safe
was located, Johnson said he had never seen it.

Officials with other medical charities contacted by The Post said it
is unusual to distribute narcotics overseas, particularly in Third
World countries where medical teams treat disease and infection
rather than performing painful surgeries.

Some of the doctors and nurses who went on McCain's missions said
they never saw narcotics on AVMT trips and would have discouraged
carrying such medications. "You don't bring narcotics into a foreign
country, especially with people who have machine guns around," said
Michele Stillinger, a nurse during a 1991 AVMT mission to Bangladesh.

'I Noticed the Mood Swings'

Tom Gosinski, then 32, met Cindy McCain while working for America
West Airlines and coordinating an AVMT flight to Kuwait. She hired him in 1991.

He grew close to the McCain family. He knew the domestic staff, as
well as Cindy's father, James, and mother, Marguerite.

Thinking he might one day write a book, Gosinski kept a journal that
he later turned over to investigators. His entries about AVMT suggest
that McCain's behavior led employees to believe she was using drugs.

"Right away, I noticed the mood swings," Gosinski told The Post in
June. "She wouldn't show up at the office, and we'd call her home.
Her house staff would say she hadn't come out of her room yet. It
would be 11 a.m. or noon."

As time wore on, his diary chronicled office concerns that McCain was
taking pills from the charity's inventory. Gosinski developed a code
for her behavior, the county report shows. On days when his boss
appeared to be in a good mood, he wrote "OP," for "on Percocet." Bad
days were called "NOP," for "not on Percocet."

On July 20, 1992, he wrote, "I really don't know what is going on but
I certainly hope that Cindy does not get herself of [sic] AVMT in trouble."

A relative of McCain's told charity staff members that McCain's
parents planned to confront her about her behavior, according to the
journal. McCain has said they did so in late 1992, asking whether
painkillers were causing her "erratic" conduct. Gosinski's journal
indicates he heard about the confrontation the next day, Oct. 2, 1992.

McCain's relationship with Gosinski soon deteriorated. In January
1993, she ordered him to stop gossiping about her, Gosinski said.
Soon after, she fired him but wrote him a glowing termination letter.

Gosinski eventually returned to America West as a travel consultant
and worked part time in a bookstore.

The Investigation Begins

Three weeks after his firing, Gosinski contacted Phoenix DEA agents
and gave them a copy of his journal.

The DEA questioned the charity's doctors, and McCain hired John Dowd,
a powerhouse Washington lawyer, to represent AVMT. Dowd had defended
John McCain in the Keating Five scandal, helping the senator win the
mildest sanction of the five senators involved. Dowd declined to
comment for this article.

Soon, the DEA began looking at Cindy McCain. Dowd informed Johnson,
the physician, that "there's been further investigation and Cindy's
got a drug problem," Johnson told county investigators.

The DEA pursued the matter for 11 months. Dowd kept tabs on the
investigation from Washington, writing letters and making frequent
phone calls to the agency, according to sources close to the investigation.

McCain's conduct left her facing federal charges of obtaining "a
controlled substance by misrepresenting, fraud, forgery, deception or
subterfuge." Experts say she could have faced a 20-year prison sentence.

Dowd negotiated a deal with the U.S. attorney's office allowing
McCain, as a first-time offender, to avoid charges and enter a
diversion program that required community service, drug treatment and
reimbursement to the DEA for investigative costs. Johnson agreed to
surrender his medical license and retire.

With final negotiations between federal prosecutors and Dowd still
underway, Gosinski sued McCain for wrongful termination.

On Feb. 4, 1994, Gosinski's attorney, Stanley Lubin, wrote to McCain,
saying his client had omitted certain details in his lawsuit "due to
their sensitive nature." He said that for $250,000, Gosinski would
drop the action. Lubin said in an interview that he met with Dowd,
who said the lawsuit was without merit. "He told me if I thought the
senator was going to cave into this extortion, I was going to learn a
very serious lesson," Lubin recalled.

On April 28, 1994, Dowd wrote to Maricopa County Attorney Richard
Romley, a Republican, asking that Gosinski be investigated for
attempted extortion.

Romley agreed. Dowd and Cindy McCain lined up witnesses and prepared
a brief to support the contention that Gosinski's job performance was
unacceptable and that he was of questionable character, assertions he denied.

In May of that year, county investigator Terry Blake interviewed
McCain at her Phoenix home. He asked questions about Gosinski and
then grilled McCain about prescription painkillers. He later wrote:

"Mrs. McCain was asked if AMVT procured narcotic drugs as a part of
their normal operation. She said they did.

"I asked if she ever obtained narcotic drugs by using her employee's
names. She said she did.

"Mrs. McCain was asked if prescriptions were written in Mr.
Gosinski's name without his knowledge. She said yes."

McCain told Blake she once had a dependence on painkillers, according
to the report, which included the interview summary and copies of her
illegal prescriptions. The probe of possible extortion by Gosinski
was closed without charges.

After the case was closed, prosecutors told McCain's lawyer that they
would make the report public. Before it was released, Sen. McCain
dispatched Jay Smith, then his top strategist, to Phoenix to line up
interviews between Cindy McCain and journalists from four selected
media outlets who were unaware of the report. Smith did not include
two news organizations that had learned about the report, the Arizona
Republic and New Times, an alternative weekly in Phoenix.

McCain told the reporters that she was stepping forward willingly.
"If what I say can help just one person to face the problem, it's
worthwhile," she said.

Two reporters wrote that McCain said she had completed a drug
treatment program at the Meadows, a facility in Wickenberg, Ariz., as
part of the agreement with federal prosecutors. But days later,
federal officials said that no agreement had been reached and that
she had not yet been accepted into a diversion program, which would
include approved treatment. McCain issued a statement saying the
reporters erred, but she did not disclose details of her treatment.

The only public reference to treatment is her mention in the county
investigator's report of a one-week stay at the Meadows.

Once the county report was released, along with Gosinski's journal, a
few reporters challenged McCain's account. Only New Times published
excerpts from Gosinski's diary. Within a few weeks, the story died in
Arizona, without receiving national exposure. Gosinski ultimately ran
out of money and let his lawsuit against McCain die.

Gosinski, who has moved to Nebraska, was initially reluctant to tell
his story when contacted by The Post in May. He is still viewed with
enmity by some in the drug investigation, including the Johnsons, who
hold him responsible for the doctor's troubles.

He eventually gave several lengthy interviews and provided The Post
with a copy of his journal. He subsequently cut off contact and asked
that his name not be printed, saying he became frightened by the
prospect of facing the McCain campaign on his own.

On Wednesday, he said he had changed his mind. He appeared at a news
briefing in Arlington set up by a Democratic Party consultant.
Gosinski, a registered Republican, said that he sought help
orchestrating a single media event because so many reporters wanted
his story, but that he has had no contact with the Obama campaign or
the Democratic National Committee.

He also signed an agreement with the Citizens for Responsibility and
Ethics in Washington, a D.C.-based watchdog group, which will provide
legal representation for him in the event of a lawsuit.

Controversy Fades

McCain's drug use became national news during her husband's first
presidential campaign in 2000. Newsweek published a first-person
account of her struggle, but it included some errors.

"It began with Vicodan [sic]. In 1989, I had ruptured a couple of
disks carrying my 1-year-old, Bridget, in a pack on my back," she wrote.

But Bridget was not born until 1991. In other accounts, McCain said
she hurt her back while picking up her son Jimmy, who was a toddler
at the time of her injuries.

As the McCains traveled in the Straight Talk Express bus in 2000,
interest in Cindy McCain's story faded when it became clear that she
and her husband weren't headed for the White House.

This year, as the McCains campaigned again, Cindy McCain granted
interviews about her past problems to "Access Hollywood" and Jay
Leno. She called her addiction a life-changing crisis.

"Your life experiences make you," she told "Access Hollywood," "and
hopefully you learn from them."