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News (Media Awareness Project) - US FL: Panhandle Doctor's OxyContin Conviction To Send Message
Title:US FL: Panhandle Doctor's OxyContin Conviction To Send Message
Published On:2002-02-20
Source:Denver Rocky Mountain News (CO)
Fetched On:2008-01-24 20:20:01
PANHANDLE DOCTOR'S OXYCONTIN CONVICTION TO SEND MESSAGE

A doctor's manslaughter convictions for overdose deaths from the painkiller
OxyContin should make physicians more cautious about their prescribing
practices, a federal drug official said Wednesday.

The prosecution of Dr. James Graves, convicted Tuesday in the deaths of
four patients, was part of a national crackdown on the abuse of
prescription drugs. He was convicted in state court in nearby Milton.

"It's going to send a very strong message to the medical community that
they treat these very potent drugs _ to include OxyContin but there are
others _ with respect," said Laura Nagel, head of diversion control for the
Drug Enforcement Administration.

Graves, 55, of Pace, was the first doctor in the nation convicted of
manslaughter or murder for deaths from OxyContin. He is facing a maximum of
15 years in prison on each of four counts of manslaughter and five counts
of unlawful delivery of controlled substance. He also faces 30 years for
racketeering.

At least two other doctors are facing charges of causing the deaths of
patients who took OxyContin. Dr. Frank Fisher is set for trial next week in
Redding, Calif., on three manslaughter counts, and Dr. Denis Deonarine of
West Palm Beach, Fla., could face a death sentence if convicted of
first-degree murder in an overdose death. No trial date has been set for
Deonarine.

Dr. Theodore Parran, a specialist in internal and addictive medicine who
testified against Graves, expects more manslaughter prosecutions.

"My impression is that prosecutors have generally felt unwilling to push
the manslaughter side of this because of not really having a game plan on
how to make a manslaughter charge stick," he said.

The Graves case gives them a "roadmap," said Parran, who is on the medical
school faculty at Case Western Reserve University in Cleveland.

In most cases doctors accused of overprescribing have been charged with
crimes such as insurance fraud or illegal distribution.

The DEA, working with state law enforcement agencies, in recent years has
focused more attention on prescription drugs partly because of OxyContin.
The agency blames OxyContin alone for 117 deaths in the past two years and
suspects it is the likely cause in 179 others.

"It cannot be ignored," Nagel said. "People are dying."

Nagel said most physicians have nothing to worry about.

"Doctors that are operating and doing everything appropriately, they'll
never see us," she said.

Parran agreed, saying "This isn't going to have a chilling effect on
anybody except for felons." He characterized Graves as a rare "dishonest
doc" out to make money from addicted or dependent patients by keeping them
coming back for more prescriptions.

Dr. William Hurwitz, a pain management physician in McLean, Va., has a
different view and is worried that legitimate doctors also have reason to
worry because of the verdict.

"There's almost a standard of strict liability for any mistakes that are
made or deviations in proper behavior by patients," Hurwitz said. "That has
a chilling effect and should have a chilling effect on primary care
physicians to sort of venture tentatively into managing pain."

Graves, a Kentucky native, was a general practitioner but began
specializing in pain management a couple years before he was arrested in 2000.

Hurwitz said pain management doctors should protect themselves by keeping
meticulous records and closely monitoring patients. Some may avoid young
and lower-class patients because they are more prone to being drug abusers,
he said.

Timothy Bannon, a spokesman for Purdue Pharma, which makes OxyContin,
declined comment on the Graves case but said the Stamford, Conn.-based
company, is vigorously defending itself against lawsuits prompted by
overdoses and deaths.

"We believe them to be baseless and motivated in many cases by money,"
Bannon said. "We also feel that these cases can threaten the appropriate
care given to patients by their physicians."

The company has cited the voluntary withdrawal of three suits in
Mississippi, Maine and North Carolina over the past couple months.

Bannon said Purdue Pharma also is committed to spending $100 million by the
end of the year on developing an abuse-resistant alternative to OxyContin.

Addicts defeat OxyContin's 12-hour time release mechanism and get a
heroin-like high by chewing the tablets or crushing them and then snorting
or injecting the drug.
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