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2 North Virginia Doctors [Hurwitz and Statkus] Linked to Deluge Of Illegal Drugs;
Patients Resold Painkillers; Half-Dozen Deaths Probed

Josh White; Washington Post; Monday, December 23, 2002; Final Edition; Originally posted: 2003-01-25

[Related resources:]
See also:
[Response to this article by Dr. Joel Hochman]
[War on Pain Sufferers #4 - The Dr. William Hurwitz Collection]
[Index and Introduction to the War on Pain Sufferers Special Collections]

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Eighteen people who illegally sold large amounts of OxyContin and other powerful prescription painkillers have pleaded guilty to drug charges in federal court over the past two months and for the first time have openly implicated two Northern Virginia doctors in widespread conspiracies to put the drugs on the black market.

In court proceedings and documents filed in U.S. District Court in Alexandria, federal prosecutors and investigators have publicly identified the doctors as the sources of hundreds of thousands of pills later sold throughout the region and deep into Appalachia. Prosecutors in court have called the doctors conspirators who acted as hubs of two separate sales schemes.

The pleas have come from patients of William E.
Hurwitz, who recently closed his McLean practice after learning that he was a target of the investigation, and Joseph K. Statkus, also a target and operator of a pain clinic in Centreville. Information and grand jury testimony from the patients have allowed investigators to get closer to the doctors, who authorities say prescribed thousands of OxyContin pills a month each, in some cases without performing medical examinations. The pills then wended their way to abusers in Virginia, Kentucky, Tennessee and West Virginia, where an epidemic of abuse has ravaged small towns. OxyContin, a mainstream pain remedy approved by the Food and Drug Administration, was prescribed more than 6 million times last year, but it has come under intense scrutiny recently as its abuse has become widely documented. The Drug Enforcement Administration cites 146 cases in which OxyContin was verified as the direct cause of death or a contributing factor and 318 deaths in which OxyContin was most likely involved -- a total of 464 deaths linked by investigators to the drug.

Hurwitz and Statkus acknowledge that they are targets of the investigation but say that they have done nothing wrong, that they were duped by phony patients and that they have provided valuable services to chronic pain sufferers through their clinics.

The nationwide investigation, which involves more than a dozen federal agencies and scores of local and state law enforcement officials, is also focusing on more than a half-dozen deaths believed to be connected to prescriptions written by the doctors, including a woman who died in Fairfax County in 2000 and another -- Mary Ruth Nye, 45 -- who died of a suspected overdose in Prince William County six weeks ago.

Federal law enforcement sources said prosecutors will try to use those deaths to trigger death penalty statutes under drug kingpin laws if they are able to obtain indictments against the doctors.

"Through willful blindness, deliberate ignorance, if not intent, the pain-management physicians in McLean and Centreville would give obscene amounts of pills to the spokes of the wheel, if you will," Assistant U.S. Attorney Gene Rossi said Dec. 13 during plea hearings for three patients. Rossi alleged that the patients received drugs from the doctors with little or no medical treatment, filled the prescriptions at local pharmacies and sold them at enormous profit.

Law enforcement sources say investigators have found no evidence of any kickbacks, and both doctors say they have received no such incentives.

It is a complex and intricate probe that officials say is breaking ground because it centers on licensed and reputable doctors prescribing legal drugs. Prosecutors must show that the doctors are prescribing OxyContin to patients who do not need it, largely for financial gain. Investigators say the doctors charge their patients monthly maintenance fees as high as $ 250 and enter into agreements with independent pharmacies to avoid questions about why they prescribe thousands of pills.

Hurwitz called the investigation a political one that veers away from law enforcement and into how doctors do their jobs. "The ethical dilemma is: What can you do? You don't ask a patient if they've committed adultery or cheated on their taxes," Hurwitz said. "But in this particular area, doctors are expected to have perfect knowledge of everything a patient does. That presumption is invalid. Nobody could treat pain if they're going to hold doctors to that standard."

DEA and FBI agents along with a regional drug task force raided both doctors' offices Nov. 6, when agents also raided Hurwitz's home and a pharmacy in The Plains for files and financial records.

"We've done nothing wrong," Statkus said shortly after the raid. "I think this is just another attempt to rattle me. This is a fishing expedition hoping that they find something, and there's nothing to find. I'm just trying to help people."

But sources say prosecutors are homing in on the deaths of several of the doctors' patients. Nye's death Nov. 4, in particular, has caught their attention because she went to both doctors and was given large doses of OxyContin and morphine for back pain that other doctors had suggested could be relieved with surgery, according to her family.

Within 18 months, the drugs had Nye bedridden, and she resorted to forging checks and pawning household items to buy OxyContin, said her husband, Paul. She ultimately depleted her family's savings after her health insurer found the drug doses to be suspiciously high and scaled back its coverage.

"Her body was beaten up by all of the drugs, and there was nothing left of her to fight it," Paul Nye said. Her dosage of the drug increased more than 1,200 percent over a year of treatment. This summer, she was issued prescriptions for 2,100 80-milligram OxyContin pills a month, according to medical records provided by Nye's attorney.

"There was no doubt that she was addicted to the drug, and it was the doctors who set her on that path," her husband said. "They didn't force her or stuff the pills down her throat, but they gave her what they gave her, and she took it. She thought it had to be okay because it was coming from a doctor."

Local officials have turned the case over to federal authorities, who are waiting for a toxicology report.

Mary Nye, who originally went to a local doctor for a broken wrist, needed to boost her pain medication when she slipped and fell in a Manassas grocery store in 1999. She first went to Statkus, who prescribed hundreds of OxyContin pills, the medical records show. He stopped seeing her in summer 2000, when she allegedly tested positive for another drug. She then went to Hurwitz.

In her initial questionnaire at Hurwitz's office June 27, 2000, Nye wrote that she was taking two 40-mg and two 80-mg OxyContin pills -- or 240 mg -- each day. Hurwitz sent her home with a monthly prescription for 200 80-mg pills -- an average of more than 530 mg a day, more than double her previous dose, the medical records show.

"That was just the tip of the iceberg," Paul Nye said. "I didn't know what OxyContin was, and I had no idea what was to come."

Ten months later, his wife was taking the equivalent of 1,800 80-mg pills every three to four weeks -- almost 7,000 mg a day -- and was zombielike, unable to perform basic functions. Her husband said she was high all the time, stumbling, unwilling to consider alternatives to the drug. When Nye no longer could afford the pills, Hurwitz gave her 21 prescriptions for 100 80-mg pills each month, to allow her to buy them as she could.

"The 100-pill lots were to facilitate her purchasing limits," Hurwitz said. "We knew she was in a squeeze."

Hurwitz said he had no reason to believe that Nye was not using the drugs responsibly.

When Nye's medication got low, it appears she abused the pills she had. Her family found straws in the house that they believe were used to snort crushed pills.

"I told her that I thought this would kill her," Paul Nye said. "She didn't care about anything -- she just wanted her drugs. If she had been able to see what she was doing to the family, it would have hurt her terribly. She was blind to it. We sat down and begged her because it had gone far enough. She was so hooked, she didn't know how to get off."

Other patients have told authorities that they went to Hurwitz and Statkus without any need for medication and left with large prescriptions, court records show. Every few weeks, they went back for more, in some cases getting tens of thousands of pills in just a few months. OxyContin sells on the street for about $ 1 a milligram, making an 80-mg pill worth $ 80. Federal authorities estimate that the conspiracy netted millions of dollars.

Patients would "obtain obscene amounts of pills, and the doctor would act, at best, willfully blind to [a] request for more and more 'Oxy' pills," Rossi, the federal prosecutor, said in court Dec. 13. The patients "would fill those prescriptions at a pharmacy and then would distribute them to other people. That's the conspiracy."

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Dr. DeLuca's Addiction, Pain, and Public Health Website

Alexander DeLuca, M.D., MPH

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Originally posted: 2003-01-24

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