In a state neighboring North Carolina, a “pain” doctor who prescribed a patient 1,600 pills a day, was sentenced to 25 years for drug trafficking. He served 2½ years in prison and might face a reduced term, he soon could once again be diagnosing patients and prescribing addictive pain medication.
"Pain" Doctor's Patients Sold Their Prescriptions
William Hurwitz, whose story was featured on CBS’ “60 Minutes,” was granted a second chance after the Fourth Circuit Court of Appeals court overturned his 25-year prison sentence in 2006. Assistant U.S. Attorney Gene Rossi said of Hurwitz, “He crossed the line from a healer to a dealer."
From trial court records in 2004, prosecutors alleged Hurwitz profited by charging a $1,000 initiation fee per each patient and a $250 monthly maintenance fee. Records revealed Hurwitz treated 470 patients over the last five years, resulting in millions of dollars in profit. Prosecutors told the jury several of Hurwitz’s patients died and others overdosed; those incidents were linked to Hurwitz's “overzealous” dosages.
Court records showed Hurwitz’s patients illegally sold drugs he prescribed to them. More than 15 of those drug dealers testified against Hurwitz. But the prosecution could produce no evidence Hurwitz profited from those drug sales.
At the doctor’s re-sentencing in July 2007, U.S. District Judge Leonie M. Brinkema concluded Hurwitz helped more patients than he hurt. She sentenced the doctor to 57 months in prison on federal drug charges with “time already served” taken into account. This leaves Hurwitz with just 27 months to sit in lock-up. Brinkema was the judge who presided over the case of alleged conspirator Zacarias Moussaoui in the September 11, 2001 terrorist attacks against the United States. Brinkema sentenced Moussaoui to life in prison.
The Hurwitz decision disappointed federal prosecutors, who wanted a life sentence for the 61-year-old doctor. The physician from McLean, Virginia had been the target of an investigation by the Organized Crime and Drug Enforcement Task Force (OCDETF), which focused on illegal distribution of pain medication by 60-80 doctors, pharmacists, and patients. Those medications included Oxycodone (OxyContin), a heavily abused, addictive narcotic.
In District Court, Hurwitz admitted he deceived himself into believing in some patients who in retrospect were clearly criminals. “My gullibility morphed into lack of judgment," he said.
The OCDETF secured over 50 convictions, pleas, or commitment to guilty pleas under oath from drug dealers, many of whom were patients of Hurwitz. Court testimony showed Hurwitz's patients would schedule monthly meetings with the defendant. Hurwitz would regularly perform perfunctory exams -- if at all -- and facilitate patients' demand for excessive amounts of medication.
At Hurwitz’s initial sentencing in 2004, DEA Administrator Karen P. Tandy said, "DEA remains committed to striking a balance between promoting pain relief for patients in need and preventing abuse of pain medications. There has been no change in our enforcement strategy, and doctors should remain confident in their ability to treat patients in pain. On the other hand, for doctors like Dr. Hurwitz, DEA will not shy away from its enforcement policies. Dr. Hurwitz was one of a very small number of doctors who grossly abused his authority, recklessly exploiting the term ‘pain treatment' to deal street narcotics like a common drug dealer.”
Bench Believed Doctor’s Prescriptions Valid
When she first took the case in 2007, Brinkema thought the dosages that Hurwitz prescribed were "absolutely crazy." But she said defense witnesses changed her mind. "An increasing body of respectable, medical literature and expertise supports those types of high-dosage, opioid medications," the judge said.
The first court convicted Hurwitz on 50 counts, including trafficking that caused the death of one patient and seriously injured two others. Jurors acquitted him of nine counts and deadlocked on three.
But in 2006, an appeals court threw out that verdict, saying despite prosecutors presenting "powerful evidence," U.S. District Judge Leonard D. Wexler improperly told jurors they could not consider whether Hurwitz acted in "good faith" when he prescribed large doses of medicine.
Defining Pain Medication Therapy
Hurwitz’s case became the impetus for discussion on whether licensed doctors prescribing legal medication to patients in chronic pain should be subjected to prosecution if those patients abused or sold the drugs. Patient advocates portrayed Hurwitz as heroic, saying he helped the suffering. Hurwitz’s brother, Ken, said, “I think the judge did her God-awful best to be fair. It's a harsh sentence, but vastly more reasonable than the previous one.”
Before the re-trial in April 2007, Brinkema dismissed the counts involving the patient who died and the two who were seriously injured. The U.S. District Court in Alexandria, Va. found Hurwitz guilty on 16 counts and acquitted him on 17 trafficking counts. Brinkema dismissed the remaining 12 counts. The judge accepted the defense's argument that Hurwitz was not completely at fault because his patients had duped him.
Rennie Buras II of Belle Chasse, La., whose father died in 1999 of a drug overdose months after being treated by Hurwitz's, said Brinkema's ruling punished Hurwitz for treating drug dealers, but offered no justice for patients like his father who died after following Hurwitz's prescriptions.
New York Times science reporter John Tierney, who covered the second trial, spoke with jurors. “They said that the jury considered Dr. Hurwitz dedicated to treating pain who didn't intentionally prescribe drugs to be resold or abused,” Tierney reported. “They (the jurors) said he didn't appear to benefit financially from his patients' drug dealing and he wasn't what they considered a conventional drug trafficker."