DOCTOR AT CENTER OF N.C. INQUIRY

Just after 7 a.m. in a medical clinic packed with patients, Dr. Joseph
Talley steps outside an exam room and into a semicircle of flashing badges.

For years, he figured this day might come. Now, standing before drug
enforcement agents with the power not just to disable his medical practice
but to help put him in jail, Talley says he's furious.

His Grover clinic, in southeastern Cleveland County, N.C., is teeming with
some 20 law enforcement agents. They seal off the driveway and send
patients away. They confiscate the clinic's prescription narcotics and haul
off almost 40 years of medical files.

It's Dec. 19, 2001, and the Carolinas are two years into a fierce battle
against the abuse of a painkiller sweeping the illicit prescription drug
market.

OxyContin, a government-approved narcotic, has eased the chronic and
sometimes debilitating pain of thousands of people nationwide. But abusers
discovered that using a crushed pill produces a heroinlike high.

Abuse struck regions of Appalachia, Alaska and Maine before moving into the
Carolinas in 1999.

Talley's case brings the struggle to a controversial new level.

About 65 doctors and 35 pharmacies have been investigated by the Drug
Enforcement Administration for diverting OxyContin, many for financial gain.

But Talley's case is different. He's one of a handful of doctors accused of
inappropriately prescribing massive, unconventional doses of OxyContin and
other narcotics, not for personal gain, but because he believes drugs work
best to ease pain.

He has become a central figure in a growing national debate about how far
doctors should go, and what standards should be followed, when treating
pain with narcotics.

In a clinic where chairs are held together with duct tape, Talley spends
hours counseling patients who are often uneducated, disabled, poor or
without access to medical care. He considers himself a victim of his own
beliefs, another in a growing list of physicians the DEA has investigated
mainly, Talley believes, to prove the agency is winning the war on drugs.

Law enforcement and the N.C. Medical Board disagree.

They say Talley is not a pioneer of pain management - he is, quite simply,
a reckless physician.

After months of investigation, they say Talley almost exclusively relies on
drugs when pain specialists combine drugs with treatment such as physical
therapy. They charge he fails to perform physicals and diagnostic tests or
run drug screens to make sure patients are taking the pills he prescribes -
not selling them for profit.

Worst of all, investigators say, 23 of Talley's patients died in recent
years at least in part by overdosing on the drugs he prescribed. If he's
charged criminally in connection with those deaths, Talley's case would
likely be the largest of its kind in the nation.

"It's like they've said that every single thing that I've done, all the
papers I've written, all the patients I've seen, everything that I've done
has been wrong," says Talley, 65, shortly after agents came to his office.

In Washington, meanwhile, the DEA prepares to suspend Talley's registration
to prescribe narcotics. And in Raleigh, N.C., the medical board is
considering revoking Talley's license to practice medicine - which would
end his medical career in North Carolina.

Pain Patients Turn To Talley

In a one-room apartment in Kings Mountain, N.C., David McCurry tries to
fight the pain.

It courses from his neck to his back to his legs. An amputee with medical
conditions that include a bulging disc in his back, McCurry was a patient
of Talley's for 12 years.

OxyContin helped McCurry walk, clean, even go fishing.

But one month after drug enforcement agents came to Talley's clinic, the
DEA pulled the doctor's registration to prescribe narcotics.

The suspension order called Talley "an imminent danger to the public health
and safety."

Now, McCurry can't find another doctor willing to prescribe such liberal
doses of OxyContin.

He's confined to his wheelchair again. He can't sleep. A former truck
driver who inscribed his dead wife's name, Verleen, on the knuckles of his
hand, McCury cries several times a day.

"If it wasn't for Dr. Talley, I would not be living," he says.

Seizing Talley's narcotics' registration is in many ways like taking away
another doctor's stethoscope.

When other physicians run tests, perform surgeries, order physical therapy
and still can't ease chronic pain, patients come to Talley for narcotic
painkillers. New research has shown that narcotics such as OxyContin can be
used successfully to treat pain.

Talley admits he pushes that theory to the limit. While some doctors might
prescribe 30 to 60 milligrams of morphine, Talley might prescribe 300.

Some doctors say they fear Talley's patients are addicts. Talley suspects
that others are hesitant to prescribe high doses of narcotics because of
the possibility of government scrutiny.

Meanwhile, Talley knows his patients will lose access to medical care and
medication if they can't find another doctor. In a similar Virginia case,
at least one chronic pain patient committed suicide after his doctor lost
his registration to prescribe narcotics.

"I feel useless," Talley says. "The practice and my career is in shambles,
but these patients are more than customers to me. And now I have to tell
them goodbye."

Doctors Or Addicts To Blame?

DEA officials say doctors who prescribe narcotics responsibly have nothing
to fear.

But some doctors, they say, defend reckless behavior by arguing they are
aggressively treating pain.

"The DEA isn't unreasonable," says Bob Williamson, former drug diversion
chief for the DEA-Atlanta division, which oversees the Carolinas. "This is
a very dangerous substance with a well-known abuse potential. If you're
going to be involved in this business, you really have a lot of homework to
do ... to make sure that patients are not trafficking drugs, and that
you're not becoming just a source of drugs."

Doctors from California to Virginia have had their prescribing privileges
suspended after being accused of dispensing OxyContin and other narcotics
inappropriately, and at least a half-dozen have been charged.

Charlotte, N.C., attorney Lyle Yurko, who is representing Talley, says
what's happening to the doctor sets a frightening precedent.

"The primary responsibility for someone who is abusing drugs needs to be
put on the person abusing the drugs," he says.

Others, however, say doctors must share in that responsibility by taking
steps, such as random drug testing, to ensure patients are taking pills as
prescribed. Talley argues the tests aren't always accurate because people
who sell their pills know to take them in the days before a doctor visit.