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Pubdate: Tue, 07 Dec 2004 Source: Richmond Times-Dispatch (VA) Copyright: 2004 Richmond Newspapers Inc. Contact: http://www.timesdispatch.com/ Details: http://www.mapinc.org/media/365 Author: Matthew Barakat, Associated Press PAIN DOCTOR ACCUSED OF DRUG TRAFFICKING TESTIFIES He Says Abruptly Ending Treatment Would Be 'Tantamount To Torture' ALEXANDRIA - A prominent pain-management doctor accused of using his office as a front for drug trafficking took the stand in his defense yesterday. William E. Hurwitz, on trial in U.S. District Court, acknowledged that he prescribed massive amounts of opiates for some of his patients but said he always had a medical reason for doing so. Hurwitz testified that he knew some of his patients were drug abusers who were illegally taking cocaine or abusing his prescriptions. But he said he felt compelled to continue treating them with drugs such as OxyContin - or at the very least to refrain from abruptly canceling their prescriptions - because of the withdrawal they would suffer after taking such high doses. "Abrupt termination of these medicines is tantamount to torture," Hurwitz testified. Hurwitz frequently prescribed 100 tablets or more of OxyContin for his patients as they developed tolerance to lesser doses. Court testimony during the trial indicated that at least one patient received a prescription for 1,600 pills a day. Hurwitz, who has had frequent run-ins with state medical boards, testified that the body quickly develops a tolerance for opiates such as morphine and OxyContin. The best way to combat that, Hurwitz said, is to rotate the drugs used and to increase the dosage when needed, often by doubling it. He said the human body can tolerate massive amounts of opiates without physical damage and that the risk of addiction is overstated. He also said that the physiology of such drugs leaves a user with an increased sensitivity to pain if they are abruptly taken off a drug. One of Hurwitz's patients, according to testimony, obtained an early refill of an OxyContin prescription by telling Hurwitz that the dog had eaten the initial prescription. Hurwitz had also seen what appeared to be track marks on the woman's arms, which she said she had received by hauling some wood. Hurwitz said he didn't necessarily believe her excuses but continued her treatment because "if the treatment was going to be terminated, it should be done in a tapered, rational way." Some of Hurwitz's patients were using the prescriptions they received to deal drugs; many have struck plea bargains and testified against him at trial. Prosecutors have played audiotapes to the jury that they say are proof that Hurwitz knew these patients were dealing drugs and that he turned a blind eye. Hurwitz testified that he did not know any of his patients were dealing drugs. Expert witnesses have testified for both prosecutors and the defense, differing on whether Hurwitz's prescriptions were medically justified. Among the doctors to testify on Hurwitz's behalf was Russell Portenoy, chairman of the pain management department at Beth Israel Medical Center in New York and considered one of the world's leading experts on pain management. Hurwitz treated nearly 500 patients from 39 states in the late 1990s through 2002, receiving a $1,000 initiation fee and monthly fees of up to $250 for each patient in the practice. The trial was to resume today with Hurwitz's cross-examination and is expected to go to the jury this week after more than a month of testimony. He faces up to life in prison if convicted on the most serious charges. - --- MAP posted-by: Beth