VA. DOCTOR DEFENDS PRESCRIBING PAIN PILLS

A prominent former pain doctor on trial for alleged drug trafficking
defended his treatment methods yesterday, saying he prescribed large
dosages of narcotics to patients who had been arrested or failed drug
screenings because he believed they were in chronic pain.

In one instance, William E. Hurwitz testified, he refilled a Dilaudid
prescription for a woman who said her dog had eaten the original one.
"The issue of whether the excuse was believable or credible or
truthful is hard to assess," said Hurwitz, who practiced in McLean
until 2002. "I think it is possible that someone's dog may have
mangled a prescription."

Another time, Hurwitz acknowledged, he prescribed 200 OxyContin pills
for a man with severe neck and back pain who had been arrested on drug
charges and failed a urine screening. "He told me he had been framed,"
Hurwitz said on the stand in U.S. District Court in Alexandria. "He'd
had dirty urine in the past, but he'd also had clean urine in the past."

Asked by his own attorney why he continued to treat patients who
displayed so many "problem signs," Hurwitz said he "was wrestling with
these issues and trying to reconcile how to deal with problematic
patients. . . . I believe all the patients had pain."

Hurwitz, 59, is charged in a 62-count indictment with leading a broad
conspiracy to traffic in prescription narcotics that prosecutors say
led to the deaths of three patients. Prosecutors say that he
prescribed excessive quantities of dangerous narcotics, sometimes as
much as 600 pills a day, and that some patients then sold the drugs on
the lucrative black market.

The case has attracted national attention from advocates for patients
with chronic pain who criticize the government for what they consider
an effort to criminalize good medicine. Government officials counter
that the prosecutions of Hurwitz and other doctors have helped stem
growing abuse of potent painkillers.

The trial culminates a two-year federal investigation into doctors,
pharmacists and patients suspected of selling potent and addictive
painkillers. Hurwitz was one of the ultimate targets of the probe, in
which about 50 people have been convicted.

More than 25 supporters crowded the courtroom yesterday for the
testimony of Hurwitz, who was considered a major figure in national
pain management circles.

"The stakes are cosmic," said Mary Baluss, director of the Pain Law
Initiative, a District-based corporation that advocates for people
with chronic pain. "If Hurwitz is convicted, it will show that a
doctor who is very widely respected in the pain management community .
. . cannot be safe."

Baluss said she thought Hurwitz's testimony was effective and
"conveyed a respected line of thought that says it's okay to treat
addicts who have pain."

Hurwitz's testimony came in the sixth week of the trial before U.S.
District Judge Leonard D. Wexler. If convicted, Hurwitz could face up
to life in prison.

In his cross-examination of Hurwitz, begun late yesterday, Assistant
U.S. Attorney Gene Rossi pointed out that while getting his law degree
in 1996, Hurwitz took a class about recognizing aberrant behavior
called "Red Flags & Loud Gongs."

Under questioning from defense attorney Marvin D. Miller, Hurwitz said
he had dropped 17 patients, some for abusing or selling medication.
But he said he would still treat patients with addictions or other
warning signs if he felt he could have a "morally persuasive"
relationship with them.