PAIN DOCTOR'S TRIAL BEGINS

Was Mclean Doctor a Criminal Drug Dealer, Or a Compassionate Doctor
Victimized By a Few Patients?

Detox from oxycontin for Cynthia Denise Horn, the U.S. government's second
witness in its case against McLean doctor William Eliot Hurwitz, took place
in an Alexandria jail. At the time of her July 8, 2002, arrest for
conspiracy to distribute OxyContin, Hurwitz was writing prescriptions to
Horn for thirty 160-milligram OxyContin pills per day, 80 times the amount
she said she got from other doctors. "After I got off the pills, I felt
like I was 18 again," said Horn, 43, of Manassas, who testified on the
second day of the trial, Friday, Nov. 3, that she called Dr. Hurwitz from
jail a few weeks after her arrest. "I told him he needed to stop giving
OxyContin to people," said Horn, dressed in a black-and-white striped
prison outfit. "It was destroying their lives."

The trial of Dr. William E. Hurwitz of McLean began in Alexandria last
Thursday, Nov. 4, at the U.S. District Court for the Eastern District of
Virginia before Senior Judge Leonard D. Wexler. The 62-count indictment
against Hurwitz, who closed his practice in 2002, includes charges of
conspiracy to distribute controlled substances, drug trafficking resulting
in death, drug trafficking resulting in serious bodily injury, engaging in
continuing criminal enterprise, and health-care fraud. "A self-proclaimed
healer, he crossed the line to a drug dealer," said Mark D. Lytle,
assistant U.S. attorney, in the prosecution's one-hour opening statement
last Thursday. "He thought he could hide behind the pain he treated."

But Hurwitz's attorneys contend that he is a nationally known doctor who
provided needed care for patients suffering from chronic, intractable pain.
"The undertreatment of pain is a serious and widespread health issue,"
according to documents filed on Nov. 1 by Hurwitz's attorneys Patrick S.
Hallinan, Kenneth H. Wine and Marvin D. Miller. From July 1998 to December
2002, Hurwitz treated more than 400 patients for chronic pain. "Chronic
pain is with you all day long, all night long, and makes you suffer every
day. It destroys your life," Hallinan said, in opening statements for the
defense last Thursday. Dr. Hurwitz treated patients who ranged from 18 to
74, and included patients with "phantom limb" pain, patients who had
undergone multiple surgeries, injury victims and people with migraine
headaches, multiple sclerosis, AIDS and terminal illnesses. "Given their
previous medical histories, these patients are candidates for the type of
medication therapy used by Dr. Hurwitz, which often involves high dosages
of opioid drugs," according to Hallinan, Wine and Miller. "It is important
to understand that chronic pain patients are not those suffering from
transitory or easily treatable causes of pain," they wrote. "A lack of
public understanding about the nature of pain therapy and overbearing
actions of regulatory authorities have combined to impede access to pain
treatment, deter physicians from practicing pain medicine, chill the
legitimate prescription practices of physicians who do treat pain, and
thereby deny patients in this county their constitutionally protected right
to relief from unnecessary suffering."

Six witnesses for the prosecution testified in the first two days of the
trial, which is expected to last up to six weeks. Assistant U.S. Attorney
Gene Rossi introduced Horn and her 18-year-common-law husband Kevin L.
Fuller, 42, as the prosecution's first two witnesses. Fuller, who first
started seeing doctors following three knee surgeries in 1985, 1987 and
1991, sold multitudes of the OxyContin pills prescribed by Hurwitz to
continue to support their drug habits. "I had a lot of pain, but I
exaggerated it, trying to get the drugs," Fuller said. Fuller, who pled
guilty to conspiracy to distribute OxyContin and was sentenced to 188
months in jail, first went to Hurwitz on Aug. 4, 1998, at Hurwitz's home
office on Swinks Mill Road. He testified that he paid Hurwitz a $1,000
initiation fee that was required to be paid in cash, plus a monthly fee
that Horn said cost $250. "I heard he was 'The Man,' the doctor who would
help you get what you need," Fuller said. "When you're a drug addict hooked
on OxyContin, you try to get what you want." Fuller testified that he made
a $229,000 profit in a 50-day period from March 26, 2001, to April 30,
2001, by selling prescribed pills. "I paid my bills, bought me a nice bike,
and bought a whole lot of crack," Fuller said. But when cross-examined by
Hallinan, Fuller admitted he had "played a lot of doctors" over the years
to get OxyContin. Fuller called Hurwitz naive, but he also said the doctor
was "his friend." "He was concerned about me and my wife," Fuller said.
"Dr. Hurwitz is always concerned."

Paula Jane Farmer, the prosecution's fifth witness, who testified Friday,
said prescriptions for OxyContin and Dilaudid from Dr. Hurwitz to her
husband, John Farmer, cost $40,000 a month to fill. "We had to have more
and more and more," said Farmer, 40, of Centreville, who was granted
immunity for assisting the prosecution in its case. Her husband died in
2004 of an overdose; he was not under Hurwitz's care at the time. During
his opening statement, Hallinan called some of Hurwitz's patients
"professional predators" who took advantage of Hurwitz's trust. "It is the
patient that hurts, the patient that suffers," Hallinan said, "and
protocols of medicine say listen to your patient." Hurwitz kept detailed
records regarding all his patients, including Horn, Fuller and Farmer,
which his lawyer said points to his innocence. "These medical records are
in stone," Hallinan said. "You think someone involved in a scam of selling
pills will document this?"

SIDEBAR

Prosecution and Defense

THE PROSECUTION

Mark D. Lytle, assistant U.S. attorney, made the prosecution's opening
statement before the jury on Thursday, Nov. 4. Excerpts are included here.

"On Wednesday, May 29, 2002, Robert Woodson, a drug dealer, headed to
McLean, Va., to meet his supplier. "On that day, he wore a wire. You will
hear Mr. Woodson and his supplier talk about the street value of drugs.
"This was no ordinary drug supplier. He wore a white coat. "Behind every
count [of the 62-count indictment against Dr. William E. Hurwitz] are the
individual stories of lives that were systematically ruined. . They tell
the stories of drug dealers and drug addicts who had unlimited access to
drugs. "It tells the stories of parents . who watched loved ones destroy
themselves. "A self-proclaimed healer, he crossed the line to a drug dealer.

"This was no typical doctor's office. "OxyContin hit the market in the mid
1990s and hit America by storm. It is highly addictive, very susceptible to
abuse. "We will prove that he prescribed incredibly large amounts of
narcotics well outside the boundaries of proper medicine. "Linda Lalmond,
51, suffered a back injury. She longed for the day she could get back on a
horse and ride with her daughter. Linda and her husband put their hope into
Dr. Hurwitz. "You will read her e-mails and her optimism for life. At that
time, she told Dr. Hurwitz she was experiencing great pain relief. "Within
36 hours of seeing Dr. Hurwitz, Linda Lalmond was dead. "We ask you to find
the defendant guilty and be held responsible for the lives he has ruined
through his criminal conduct."

THE DEFENSE

Patrick S. Hallinan, defense attorney, gave the defense's opening statement
immediately following the prosecution's opening statement on Thursday, Nov.
4. Excerpts are included here.

"This is a case about new science, and about the treatment of chronic pain.
"Chronic pain is not the kind of pain where you stub your toe, or break
your leg. Chronic pain is with you all day long, all night, and makes you
suffer every day. . It destroys your life. "It is a science still
struggling with its own protocols. "It's not a question about whether [Dr.
William E. Hurwitz] was the best doctor. The question is, 'Was he trying
his best to practice pain medicine?' "Pain is a very relative thing. Each
one of us experiences it very differently. "There is a formula by which you
increase the amount of opiates, and you increase and you increase and
increase until the patient says, 'You've done it.' "Our experts will show
that [the patients] did not die because of pain treatment by Dr. Hurwitz. .
They all had chronic pain, they all had failed operations, screws in their
legs and backs. "Instead of targeting doctors, they should make doctors
part of the solution. None of this would have happened if the agents came
to Dr. Hurwitz and said, 'Let's take care of this.' "We will [introduce]
the finest experts in the field. "These doctors will say that Dr. Hurwitz
was practicing good pain medicine. "When we get all the evidence in, after
the government has a month of witnesses after witnesses, then we'll ask you
to bring an acquittal back in this case." - Ken Moore

Controlled Substance "OxyContin, which is also known as 'Oxy,' 'Hillbilly
Heroin,' 'Killer,' and 'Coffin,' is a Schedule II controlled substance
whose active ingredient is oxycodone. Demand for OxyContin has grown in
epidemic proportions in parts of Kentucky, Tennessee and southwest
Virginia, and other parts of the United States, where drug dealers can sell
an 80-milligram OxyContin pill on the street for $80 to $100 or more.
"OxyContin is a pill that gradually releases steady amounts of narcotics
for 12 hours. "OxyContin and other Schedule II drugs have a high potential
for abuse and can be crushed and snorted or dissolved and injected to get
an immediate high. The abuse can lead to addiction and overdose, and,
sometimes death. "Many of those who misuse or are addicted to OxyContin
frequently abuse cocaine and crack cocaine to offset the sometimes numbing
effects of OxyContin." - From indictment against Dr. William E. Hurwitz