MB CLINIC AT CENTER OF DRUG CASE

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, 55, police chief of
Clinton, 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.

S.C. responds in MB

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

But what terrified Julia Lorenz were 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 area.

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

Today, distribution of OxyContin on the Grand Strand 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 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 Department.

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 where Lorenz worked.

Long after dark, patients would mill around the parking lot of the
Comprehensive Care and Pain Management Center. 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 learned 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
seeing a doctor and leave with a 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, N.C., 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 arrested. But
Lorenz and her colleagues still saw signs of addiction, abuse and desperation.

Groups of customers, carpooling from communities such as Lancaster,
Georgetown and Darlington, would regularly come to the pharmacy to fill
large OxyContin prescriptions from the 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 maker for
promoting the drug despite reports of 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 mostly for cancer patients or people
in severe pain. OxyContin was promoted for a broader range of pain
patients, arguing that since the medicine is released slowly, there's a
lower addiction risk.

Purdue says it marketed the product conservatively and ethically and that
the company cannot regulate health care 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. We did respond. But we don't have
regulatory or law enforcement authority."

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

In the U.S. Attorney's Office in Florence, 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, pyramid schemes
and IRS records.

Day started spending 50 percent of 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 operation of the
pain 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 to investigators.

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

Day so far has 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 the distribution 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.

INFO: Law enforcement and addiction experts say dozens of people in
neighborhoods across Lancaster County took part in the OxyContin drug trade
beginning in early 2000 | 5A