PAINKILLER PROBE SNARES APPALACHIAN DOCTORS

Some physicians recruited to poor region allegedly supplied addicts with
medications

Pikeville, Ky -- More than a dozen Appalachian doctors, many of them
recruited to work in the medically underserved region, have been taken away
from their patients in handcuffs for allegedly supplying drug addicts with
powerful narcotics.

In eastern Kentucky alone, seven small-town doctors are in prison or on
their way for illegally prescribing such drugs as the painkiller OxyContin.
At least six others have been arrested in the hills of West Virginia,
Virginia and southern Ohio.

Advocates for the mountain region say that while the loss of so many doctors
leaves a void, in these circumstances the departures only can improve
medical care.

"As badly as we need more physicians, we certainly don't need the type that
will violate their oaths and do much more harm than good," said Ewell
Balltrip, executive director of the Kentucky Appalachian Commission.

Federal and state law enforcement agencies began cracking down on wayward
physicians in Appalachia in 2000, after OxyContin -- intended for cancer
patients and others suffering from severe pain -- began showing up in large
quantities on the black market.

The first eastern Kentucky physician snared in the crackdown -- Dr. Ali
Sawaf, 61, of Harlan -- had turned to illegally prescribing OxyContin and
other painkillers after he lost his $250,000-a-year job at a regional
clinic.

Assistant U.S. Attorney Roger West has said Sawaf handed out prescriptions
almost as quickly as he could write them.

The latest physician to plead guilty, Dr. David Procter, 52, of South Shore,
Ky., traded pain killers for sex. He admitted to a federal judge he had
sexual relations with two female patients after they became hooked on the
drugs.

Most of the doctors caught in the past two years had been recruited to the
region to help care for rural residents, said Assistant U.S. Attorney Pat
Molloy.

"They may not have stepped over the line before they got here, but clearly
they were corruptible," Molloy said.

Legitimate doctors have nothing to fear when they appropriately prescribe
medications, Molloy said. The doctors who have been prosecuted, he said,
were flagrant violators.

The problem is not confined to Appalachia. A Florida doctor was convicted of
manslaughter in the OxyContin overdose deaths of four patients. A
Connecticut physician, nicknamed "Dr. Feelgood" by police for the
prescriptions he wrote for OxyContin and other pain killers, was convicted
last year on multiple counts.

Authorities blame the abuse of OxyContin for scores of overdose deaths in
the Appalachian region and beyond.

Larry Bailey of Grayson, Ky., said he believes his son still would be alive
if unscrupulous doctors had not been so willing to feed his addiction.

At first, Paul Bailey, 35, had a legitimate need for medication to ease
severe back pain. But the last time he visited Dr. Rodolfo Santos of South
Shore, he left with prescriptions for painkillers, tranquilizers and muscle
relaxants. It was a combination of those pills that claimed his life.

Santos was convicted last month of overprescribing drugs. Larry Bailey had
been in the courtroom during Santos' trial.

"Being angry doesn't solve anything," Larry Bailey said. "But I was thrilled
to see him being put out of business.'

The jury recommended Santos, who was recruited to work in eastern Kentucky,
serve 16 years in prison. He could be eligible for parole in a little more
than three years.

Procter, the physician who owned the clinic where Santos worked, pleaded
guilty in April to one count of conspiracy and two counts of illegally
prescribing controlled substances. He faces 10 to 12 years in prison.

In an effort to attract more doctors to rural Appalachia, area leaders got a
medical school established in 1997. As of this month, the Pikeville (Ky.)
College School of Osteopathic Medicine will have graduated 168 doctors.

The new doctors immediately will begin to narrow the physician-to-patient
ratio, easily replacing the physicians who have been sent to prison, said
Dr. John Strosnider, dean of the college.

Strosnider said he has no doubt that, as a result of the crackdown,
legitimate physicians are more careful about prescribing OxyContin and other
potent pain killers.

"They're leery that patients may be trying to fool them," Strosnider said.