PILL PROBE FOCUSES ON N.VA. DOCTORS

U.S. Agents Target OxyContin Sources

A nationwide drug investigation is substantially focused on two
Northern Virginia doctors who have written prescriptions for
OxyContin, a powerful painkiller that has killed nearly 450 people,
for patients from as far away as Oregon, California, Maine and Louisiana.

More than a dozen federal agencies and scores of local and state law
enforcement officials have been working for more than a year to build
cases against doctors, pharmacies and patients who have been
prescribing or selling OxyContin and other potent painkillers that are
abused as recreational drugs. They are pursuing investigations in
Kentucky, Tennessee, the Carolinas and Maine, in addition to Virginia,
as an epidemic of prescription drug abuse continues to grow.

The Virginia doctors acknowledge they are the focus of a criminal
probe but say they have done nothing illegal and are providing a
valuable service to chronic pain sufferers who need the drugs.
OxyContin is a mainstream pain remedy approved by the Food and Drug
Administration and prescribed more than 6 million times last year, but
it has come under intense scrutiny recently as its abuse has become
widely documented.

The investigation shows the government's concern about the surge of
OxyContin overdoses, but it also highlights the complexities of
finding -- and proving -- criminal culpability in cases of licensed
and reputable physicians prescribing a painkiller that's completely
legal.

"The problem with the prosecution is demonstrating that the doctors
knew or should have known that these were not bona fide patients,"
said Robert Dupont, who was director of the National Institute on Drug
Abuse under Presidents Richard M. Nixon and Gerald R. Ford.

But the federal authorities insist that, just as in any drug
investigation, the only way to stop the problem is to go after the
source, which in this case happens to be doctors. Several U.S.
officials said the government has devoted more resources in more
locations to this probe than to any other drug investigation in recent
memory because of its complexity.

"We're moving up the food chain right now," said Gregg Wood, a health
care fraud investigator with the U.S. attorney's office in Roanoke.
Investigators have started with the drug abusers and are working
backward. "Most OxyContin gets written at the end of a doctor's pen,"
Wood said. "Some of these doctors are nothing more than
clearinghouses."

A federal grand jury in Alexandria has been investigating William E.
Hurwitz and Joseph K. Statkus, sole practitioners who run pain clinics
in Fairfax County, and some pharmacies since last year to determine
whether they have been conspiring to distribute controlled substances
and whether their actions have led to overdose deaths, sources said.

"I will neither confirm, deny nor comment except to say that the
growing national plague of Oxy addictions, overdoses and deaths caused
by the illegal activity of some doctors, pharmacists and patients has
been focused on like a laser beam by this office and other U.S.
attorneys' offices," said Gene Rossi, a federal prosecutor in
Alexandria. "If any person falls into one of those three categories,
our office will try our best to root that person out like the Taliban.
Stay tuned."

Law enforcement officials have arrested dozens of suspected
prescription drug dealers throughout Virginia in the past month. Some
are being held by federal authorities in the Alexandria jail under
U.S. racketeering statutes; others are in custody elsewhere on drug
and other charges, facing intense pressure from investigators to offer
anything they know about the doctors, according to defense attorneys.

Both Hurwitz and Statkus deny wrongdoing. They said separately in
interviews that the government is making them scapegoats for a wave of
abuse touched off by what they say is a small percentage of
unscrupulous pain patients who sell their medication.

"This is a symbolic investigation with a political agenda to squelch
OxyContin and other pain medications," Hurwitz said. "It's easy to put
fear in the mom-and-pop pharmacies and into the doctors because we are
easy to scare to death. They're looking at us as Mafia dons and the
heads of drug cartels, while we're just trying to help patients who
are in serious pain and are in dire need of help."

Statkus, whose offices were raided by the FBI in January, said he
knows federal agents are talking to his patients, but he said they
won't find anything. "I really haven't done anything wrong," he said.
"It seems like they're just waiting for something bad to happen.
They're looking to find something where there may be nothing."

OxyContin abuse has proved a difficult problem for the government. The
drug is a synthetic morphine pill that has eased the pain of the
chronically ill. But it also has been transformed into a terrifying
street drug. Rural Appalachian communities have been ravaged by
OxyContin abuse, suburban teenagers have experienced its powerful
euphoric rush, and urban street dealers have come to recognize it as
one of the best moneymakers around.

But unlike crack cocaine or heroin, which are necessarily obtained
illegally, OxyContin almost always wends its way through a legitimate
pipeline, with doctors and pharmacies controlling its output.

Because painkillers are legal drugs, prosecutors must show that the
doctors are prescribing them to patients who don't need them, largely
for financial gain. Investigators say the doctors enter into
agreements with independent pharmacies so no one asks questions when
they prescribe thousands of pills worth tens of thousands of dollars.

"When you've got 400 patients and you're charging $250 each month to
see them, sometimes for only 15 minutes or not at all, it's a lot of
money. You do the math," one federal investigator said. "And you're
creating drug addicts who have to come back to you, each month,
forever, until they die."

Prosecutors are using the same racketeering and drug kingpin statutes
before the grand jury in Alexandria that have brought down Mafia capos
and high-level drug dealers, sources close to the investigation said.

So far, the federal investigation has resulted in a number of arrests
and convictions in Florida, Connecticut, Kentucky, Pennsylvania,
Tennessee, Ohio and the Carolinas. A Maryland doctor was charged in
June with distribution of OxyContin, and a Roanoke doctor was charged
in a 60-count indictment in May with drug trafficking violations and
operating an enterprise that engaged in a pattern of fraud.

A South Carolina neurologist pleaded guilty in April to federal
charges of illegally distributing OxyContin and conspiracy to commit
fraud. Facing up to 45 years in prison, the doctor, Benjamin Moore,
killed himself last month.

Authorities have secured indictments by alleging conspiracies with
pharmacists and patients. They also have charged doctors with Medicare
fraud and money laundering.

"The statutes used to be reserved for kingpin drug lords and Mafia
bosses," Wood said. "But they also work on these doctors. . . . These
are very involved investigations because we're looking for a very
small percentage of the doctors out there."

Investigators are largely working with the doctors' own records that
they are required to submit to the government. They're also talking to
the people they find on the streets and learning where the drugs are
coming from.

Documents that Hurwitz has filed with the Drug Enforcement
Administration over the past two years show that some patients have
received as many as 1,200 40-milligram OxyContin pills each month. In
some cases, the documents show, they received that many in three weeks
even though the patients were on a monthly regimen.

With OxyContin worth about $1 per milligram on the street, such a
prescription would be worth about $48,000. A number of those patients
are now in federal custody, sources said.

Hurwitz defends the practice, saying patients become tolerant to the
drugs and need more and more to get the same relief. Besides, he said,
it's impossible for doctors to weed out patients who might defraud
them.

"Assuming that . . . there will be diversion and abuse, it may be that
we need to administer [the drugs] in a more controlled setting,"
Hurwitz said. "Blaming me for taking care of patients according to an
approved protocol as if it were criminally negligent is a solution,
but it's not a solution that will allow pain management to continue as
we know it."

Hurwitz said he's telling his patients to stock up on their drugs or
find other doctors willing to take them on. He also is teaching them
how to safely withdraw because he believes his practice might be in
jeopardy.

Federal investigators also are tracking deaths associated with
OxyContin. Sources said one case they are looking at is that of Rennie
Scott Buras, a New Orleans oysterman who died in October 1999. Buras
became a Hurwitz patient in 1999 after seeing him on "60 Minutes,"
following Hurwitz's unrelated license suspension.

M. Suzanne Montero, an attorney for Buras's son, said Buras was a
successful businessman who lost everything when he got hooked on
OxyContin after a back injury. She said he was looking for someone who
could give him drugs and found Hurwitz.

According to depositions taken in 2000 in a civil lawsuit Buras's son
filed against Hurwitz, Buras got his drugs by sending e-mails to
Hurwitz and telling him how much he wanted. Prescriptions for
OxyContin, methadone, Dilaudid and other medications were sent to a
Fairfax pharmacy, and the drugs were mailed to Buras. Buras had three
appointments with Hurwitz in Virginia in the nine months he was a
patient until his death. The civil suit was settled with a
confidentiality agreement.

Hurwitz acknowledged in the depositions that in the months before he
reopened his practice, he coordinated with some pharmacists to handle
his prescriptions.

"I don't think the doctors want to kill anyone, and I don't think that
Dr. Hurwitz wanted Rennie Buras dead," Montero said. "But did he stand
by and give a clearly impaired human being an arsenal of ways to kill
himself? Yeah."

Federal authorities also point to the case of Cindy Jean Harris as an
example of why they are trying to prosecute doctors and pharmacies.

Harris, 40, of Dale City said she went to Statkus when she was in
pain. She knew it could be treated with ibuprofen, but she wanted the
highs of Demerol, methadone and OxyContin. She faked more severe pain
and got the drugs, she said.

"It was almost like a game to play," Harris said in an interview from
the Virginia Correctional Center for Women in Goochland, where she is
serving a 3 1/2-year term for selling drugs and neglecting her
children. "Going to Statkus was like going to a candy store."

Statkus called Harris a "very talented liar" who duped him into giving
her drugs. Both he and Hurwitz said it's inevitable that some clever
criminals will sneak into their practices.

After Harris's husband, David, died in August 2000, Harris went
downhill. By October 2000, she was crushing and injecting OxyContin
along with other drugs and had track marks on each arm, from wrist to
elbow.

"I gave him some lame excuse that even I wouldn't have believed,"
Harris said. "A blind man couldn't have missed it. But still, he gave
me more. It was entirely too easy. . . . It's kind of frightening to
know that when I walk out of these gates I could find another doctor
and start doing this all over again."