CRIME FOLLOWS DRUG'S TRAIL

OxyContin abuse struck swiftly in the Carolinas and hasn't let up.

The powerful painkiller has become the most heavily abused prescription
drug in some Carolina communities, forcing agents with the Drug Enforcement
Administration to spend as much as 80 percent of their time investigating
OxyContin-related crimes.

Their work started in 2000, after distribution of OxyContin in North
Carolina had doubled in one year. In South Carolina, it increased even more.

Much of the increase can be attributed to OxyContin's growing popularity
among pain patients. But as use of the drug spread, so did abuse, addiction
and crime.

"I've never seen anything like it," says Carroll Baker, police chief of
Clinton, S.C, where addicts in the community south of Spartanburg were
gaining entry into homes of elderly residents and stealing OxyContin. "They
don't want to take money. They don't want to take the gold bracelet. They
want the OxyContin."

Which is why, in the early months of 2000, law enforcement began to fight back.

She could see the man's eyes through his ski mask.

But what terrified Julia Lorenz was his hands. They were shaking -- and
pressing a pistol against her temple.

Lorenz thought about her husband and mother and the friends she would leave
behind if she died behind the pharmacy counter in Myrtle Beach this
Saturday afternoon in late 1999.

"Don't faint," Lorenz, a pharmacy technician, remembers thinking as she
watched the pharmacist nearby turn pale. "Just give him what he wants."

He wanted the store's supply of OxyContin, a powerful painkiller that by
2000 largely dominated the illicit prescription drug trade in the Myrtle
Beach region.

Distribution of the painkiller nearly tripled in Myrtle Beach from 1999 to
2000, the largest increase in the Carolinas.

Today, distribution of OxyContin in the Grand Strand region is still among
the heaviest in the nation, and police fear young people may now be abusing
it. Last year, OxyContin was found at a popular nightclub; those arrested
ranged in age from 17 to 25.

"Kids think that because OxyContin is a prescription, they're OK. They
think the government regulates those so they're not going to get hurt,"
says Detective Amy Stanley with the Myrtle Beach Police.

In early 2000, agents with the Drug Enforcement Administration suspected
the single-largest source of OxyContin in Myrtle Beach was a nondescript
pain clinic tucked into a strip shopping center near the drug store where
Lorenz worked.

Long after dark, patients would mill around the Comprehensive Care and Pain
Management Center parking lot. Employees at nearby businesses compared the
clinic to a crack house. At a hot dog restaurant next store, groggy
patients would sometimes fall to the floor as they tried to hoist
themselves onto stools at the counter.

Investigators say that some doctors and staff were inappropriately
prescribing OxyContin and other narcotics to patients without legitimate
pain, then billing private insurance and Medicaid for office visits and
unnecessary medical tests -- or tests that were never conducted.

Patients told law enforcement the clinic would at times use a fast-tracking
system: Patients in the lobby would raise their hands if they needed a
prescription refilled. Then they would pay for an office visit without ever
seeing a doctor, and leave with a new prescription.

Patients from across the Southeast came to the clinic, and investigators
believe the clinic helped fuel the OxyContin black market as far away as
Charlotte and Columbia.

Lorenz later learned the man who robbed the pharmacy was a clinic patient.
No one was hurt, and the man and his accomplice were later caught and
arrested. But Lorenz and her colleagues continued to see signs of
addiction, abuse and desperation.

Groups of out-of-town customers, carpooling from S.C. communities such as
Lancaster, Georgetown and Darlington, would regularly come to the pharmacy
to fill large OxyContin prescriptions from the pain clinic.

"It's the drug," Lorenz says. "Once you start on that stuff, there's no way
to get off of it."

As law enforcement pushed to clip the OxyContin drug trade, some
pharmacists in the Myrtle Beach area criticized OxyContin's manufacturer
for promoting the drug despite repeated reports about crime and addiction.

"(Purdue Pharma) said this drug is the next best thing since sliced bread,"
say Ron Mason, a pharmacist in the store where Lorenz works. "They haven't
given up. They're still trying to convince people of that."

In the past, narcotic painkillers were prescribed mostly for cancer
patients or people in severe pain. Purdue promoted OxyContin for a broader
range of pain patients, arguing that since the medicine is released slowly,
there's a lower risk of addiction.

Purdue says it marketed the product conservatively and ethically, and that
the company does not have authority to regulate healthcare professionals.
When sales representatives learned about problems in Myrtle Beach, the DEA
was already investigating, says Purdue spokesman Jim Heins.

"What could we do about it?" he says. "All we can do is talk to these
doctors about proper pain management and the proper way to do it. If they
were bad, they may not listen to us. If they were good and just not doing
it right, then we would educate them."

In June 2000, the DEA seized the pain clinic's records.

In the U.S. Attorney's Office in Florence, 70 miles west of Myrtle Beach,
Bill Day began to build his case.

Day is soft-spoken and unassuming, but he's a hard-nosed prosecutor when it
comes to fraud, easily deciphering off-shore bank accounts and the densest
of IRS records.

Day started spending half his time working on the Myrtle Beach case.

"The people get addicted to OxyContin, so you've got very loyal patients
who kept coming back, and they'll wait for hours," Day says. "They'll take
whatever tests you want them to take and they're going to do whatever you
want them to do, and that generates a lot of money."

Day says the doctors made at least $5 million through the clinic.

According to indictments, the clinic sought payments for unnecessary
medical tests or tests that were never conducted -- the staff threatened to
withhold prescriptions to patients if they objected. And to increase the
likelihood that insurance plans would pay, patients' symptoms and test
results were often faked.

The clinic employed 13 doctors, but Day says several left when they
suspected problems; others reported their concerns.

The clinic closed in June 2001, days after the DEA suspended the
physicians' registrations to prescribe narcotics and other controlled
substances.

Day has so far charged eight doctors. One pleaded guilty earlier this year
to unlawful distribution of controlled substances, health-care fraud and
money-laundering.

Seven were indicted last month and charged with, among other things,
conspiracy to distribute controlled substances and money-laundering. Day
says distribution of OxyContin resulted in serious injuries and at least
one death.

If convicted, the doctors face 20 years to life in prison.

Besides the doctors, the clinic's psychologist, nerve conduction technician
and office manager were also charged. Two have pleaded guilty. Day has also
convicted eight patients, charged with, among other things, distributing
controlled substances.

While drug enforcement agents in South Carolina worked on the problems in
Myrtle Beach, law enforcement in North Carolina focused on an obscure
medical clinic in rural Cleveland County prescribing unusually high
quantities of OxyContin and other narcotics.

Patients came by the hundreds, from across the region and out-of-state, to
see a small-town doctor named Joseph Talley.

His case would pit pain patients against law enforcement, a doctor against
government regulators. And it would raise vexing questions. Chief among
them: Should doctors be punished when their patients abuse drugs?