DOZENS DENIED PAIN DRUGS AFTER DEA RAID

Dr. Richard A. Nelson called about 50 patients to his office last
Thursday to deliver the news: federal officers had raided his office,
seized records and told him to stop prescribing certain narcotic
painkillers.

The patients, whom Nelson treated for chronic pain from injuries,
cancer and other ailments, were shocked.

"We were angry and I guess a bit frightened about what we're going do,
who's going to treat us," said Mike Bledsoe, 52, who has been seeing
Nelson for about two years to ease the agony of a work-related injury
and other problems. "It's a bad situation."

Some patients have contacted the office of Sen. Conrad Burns, R-Mont.,
asking about the April 20 visit by the Drug Enforcement Administration
to Nelson's office.

"Something needs to be done," Bledsoe said. "This is not, as the DEA
might put it, a drug-dealing doctor treating a bunch of junkies.
That's not what's going on here."

DEA officials won't offer specifics about the case except that agents
served an "administrative inspection warrant" at Nelson's office and
seized records and some pharmaceuticals. The raid was low-key - no
drawn guns or SWAT gear.

No one has been arrested and no criminal charges have been
filed.

"This is an ongoing investigation," said Karen Flowers, a DEA
spokeswoman in Denver.

The DEA in recent years has been cracking down on the illegal sale of
pharmaceuticals, including the painkiller OxyContin. Flowers said an
estimated 15 percent of all controlled substances make it to the
illegal market - a process called "diversion" when a patient resells
medication - accounting for about $25 million in sales each year.

"Somebody can make a lot of money in diversion," Flowers
said.

Nelson, who said he has done nothing wrong, said the DEA never told
him what the case is about.

"They just came in and grabbed the charts," said Nelson, a neurologist
who has been practicing medicine in Montana since the 1970s and has an
unblemished record with state medical officials.

Nelson has been in contact with lawyers and said he plans on speaking
with a lawyer in San Francisco who has dealt with other pain-relief
doctors who have had run-ins with the DEA.

Meanwhile, Nelson has stopped prescribing narcotic drugs that his
patients have come to rely on, he said. Instead, he's referring them
to alternatives that "muffle" the pain but may not be as effective.

Nelson started treating patients with chronic pain about three years
ago. His office on South Frontage Road serves a wide range of
patients, including some dealing with severe pain who need strong
narcotic medications.

"A lot of people come in because they didn't have any place to go,"
Nelson said, adding that the situation emphasizes the need for a
comprehensive pain management center in each city.

Bledsoe, one of Nelson's patients, hurt his back in January 2001 while
working as a union electrician in Gillette, Wyo. Years of heavy
industrial work also had taken a toll and, he later found out, his
body was suffering arthritis, degenerative conditions and other problems.

Lifting a cup of coffee or climbing a set of stairs could be
debilitating.

"The pain transforms your life," he said.

Bledsoe spent 18 months working with a doctor in Sheridan, Wyo.,
trying to find suitable medication. Finally, a little reluctantly, he
tried OxyContin, a time-release narcotic that Bledsoe said provides
some relief.

When he moved to Billings, Bledsoe checked in with several doctors and
was eventually referred to Nelson. Bledsoe said the doctor was
professional, cautious and thorough and helped find the right
combination of medications "so I could be operational."

His heart sank at the meeting last week when Nelson told his patients
that he'd been told by DEA not to prescribe certain medications.
Bledsoe, who said he needs Roxicodone and Dilaudid, isn't sure whether
he and other patients will be able to get the medication they need.

"It's going to put a lot of people back to a world of pain," he
said.

Five of Nelson's patients contacted Burns' office concerned about what
do, said Grant Toomey, a Burns spokesman. The patients were told to
seek another doctor or go to a hospital emergency room.

"We'll certainly keep tabs on it, but as an ongoing (DEA)
investigation, it really falls above our heads," Toomey said.

Similar situations have occurred elsewhere in recent years, according
to Siobhan Reynolds, president of Pain Relief Network, a New
York-based group that says it advocates for patients with chronic pain
and the doctors who treat them.

"The DEA has been going after doctors en masse," Reynolds said. "It's
mostly in out-of-the-way places like Erie (Pa.), Billings, Iowa and
Indiana."

Last month, a nationally known pain specialist in Virginia was
sentenced to 25 years in federal prison in a case where prosecutors
said he was willfully ignorant that some of his patients were selling
their prescription drugs or using them recreationally. A few of his
patients also overdosed, prosecutors said.

Reynolds said the recent activity may have a "chilling effect" on
other physicians who deal with management of severe and chronic pain,
especially when they are targeted for the behavior of drug-selling
patients.

"In any practice, a certain percentage of the patients are going to do
that," she said. "It's an impossible situation for the
physicians."

The American Medical Association in 2003 adopted a policy statement
opposing "the harassment of physicians by DEA agents in response to
the appropriate prescribing of controlled substances for pain
management."

"The AMA is committed to the goal of protecting the legitimate use of
prescription drugs for patients in pain," the AMA said on its Web site.

With his medications expired for the month, Bledsoe went to the
emergency room on Tuesday afternoon. He was told that he can't get a
scheduled appointment until next week and can't get a prescription for
the medications he used to get through Nelson.

"I don't know what to do right now," he said.