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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
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
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
"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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