News on the Drug War: DEA, not Docs, to Determine What Prescriptions are Appropriate

[why_me]

Damm 53 pills a day!!

Thats almost as much as Rush Limbaugh was taking!!

 

[alan]

A recent issue of the CATO Daily Dispatch (www.cato.org) included a discussion of the Hurwitz case. Sounded like a great deal of the "evidence" involved the testimony of drug dealers, seeking a deal from the feds, as well as other felons.

One wonders as to when we will see some DEA bureaucrat, hauled off in chains, having been arrested for practicing medicine without a license. I'm not going to hold my breath, it gets uncomfortable and besides, blue is not my best color, however one does get curious.

 

[AZRickD]

The jury was supposed to determine whether Hurwitz intentionally fed the black market in opioids.

Sounds remarkably similar to the Brady Bunch and their attempt to sue gun manufacturers, distributors and dealers.

I did a google search using the terms "pills per day" +"pain treatment" and found this:

http://www.paincare.org/pain_management/perspectives/government/restrictions.html

To average citizens, these amounts may seem like a lot; but for intractable pain patients, most dosage unit limitations add up to only a fraction of what they need to relieve their pain. For example, one pain patient featured on 60 Minutes in 1997 said that he takes 60 pills per day—400 pills per week—to relieve his pain. If this pain patient lived in one of the above states, he wouldn’t receive the amount of medication necessary to relieve his pain. Also, pain patients who need to prescribe medication on mail order may be restricted by dosage unit limitations from a state in which they don’t live.

Dr. William Hurwitz, a pain specialist, said, "If it takes 100 pills a day or 200 pills a day to relieve the pain, that’s what it takes. There’s just no way for me to say, ‘Let’s undertreat them. Let’s make them suffer.’ "

Also, compare that with an AIDS patient on HAART (highly active anti-retroviral therapy). Fifty pills a day would be a blessing to some.

Rick

 

[bobby68]

i suffer from a spine injury i got five years ago. I have a prescription for pain medication which i refrain from taking for long periods of time... so i know what it is like to live with and without the medications.

I doubt most people would choose to live with the pain and refuse the medications. I have been unable to work since i was hurt. With pain meds i can at least sit at the computer and have even begun college classes.

I appreciate the help that i get from my doctor, the medical profession is pretty awful. No one would want to go through this if they could avoid it.

 

[bobby68]

and the number of pills depends on the concentration in each pill... it's easy to take a lot of pills if they are light.

 

[c_yeager]

The prosecutors did not dispute that Hurwitz had helped hundreds of patients recover their lives by prescribing the high doses of narcotics they needed to control their chronic pain. Instead they pointed to the small minority of his patients—5 to 10 percent, by his attorneys' estimate—who were misusing the painkillers he prescribed, selling them on the black market, or both.

According to his OWN ATTORNY as many as ONE IN TEN of his patients were either abusing or dealing drugs that HE PROVIDED. That sounds pretty damn irresponsible to me. Sure he built up a reputation for providing lots of meds to people who needed them. But, it looks to me like he built that reputation based on being a "Doctor Feelgood" who perscribes narcs based on the flimsiest of pretext. Guys like this are the reason that the DEA is watching physicians so closely in the first place.

He didnt get busted for perscribing drugs to cancer patients. he got busted for being so recklessly negligent that he was an unwitting wholesaler to drug dealers. Think about it. If this guy was so oblivious to his clientell how well do you think he was serving his LEGITIMATE patients?

 

[Azrael256]

If this guy was so oblivious to his clientell how well do you think he was serving his LEGITIMATE patients?

A very valid point, and one that should have been a major issue in an investigation by his licensing board. That's why boards exist.

he got busted for being so recklessly negligent that he was an unwitting wholesaler to drug dealers.

That's it right there: "unwitting." Unless he had some kind of intent, which would invariably involve some kind of money trail, he didn't commit a crime.

He's a negligent jackass who deserves to have his license revoked. I don't see anything more in this case.

 

[c_yeager]

That's it right there: "unwitting." Unless he had some kind of intent, which would invariably involve some kind of money trail, he didn't commit a crime.

Actually negligence can, depending on the charge replace intent. The applicable phrase would be "criminal negligence". For example, if I elect to drive on the wrong side of the road with my eyes closed and end up running over an old lady i didnt INTEND to kill her but, I was negligent to the point of commiting a criminal act.

With that said I think I agree with you in this case. I don't really think that what he did was CRIMINALY negligent (unless we are talking about malpractice). based on the article (which i suspect of being QUITE biased in favor of the DR btw) he doesnt seem to have commited an act that warrented the charge. But that is an opinion based on common sense rather than the letter of the law. It is pretty hard to get 12 people to agree on anything so I suspect that there may be more to this article.

FWIW this is the "by line" of the article:

Jacob Sullum is a senior editor at Reason and the author of Saying Yes: In Defense of Drug Use (Tarcher/Putnam).

There is an implied bias here so i'm not going to put all that much stock in the article one way or the other without corroboration.

Doctors walk a fine line when it comes to narcotics. There is a delicate balance between perscribing too little (subjecting the patient to unnecesary pain) and perscribing too much (subjecting the patient to severe health risks) this isnt a concern for end-stage terminaly ill patients who don't have to worry about long-term effects or addiction but, it is of grave concern to everyone else. This is ESPECIALLY important when working with opiates such as this guy is using (the family includes morphine, methadone among others).

EDITED TO ADD
On an intersting side-note I found the guy's website http://www.drhurwitz.com/

One thing that i found PARTICULARLY disturbing from that website is this:

The first month's fee for the services described above is $1250. This fee covers all medical visits, patient education about opioid therapy, and telephone support during the first month. This fee does not include the cost of any laboratory tests (which may be obtained through a patient's primary care or local physician). Thereafter, the fee for maintenance services, including visits and telephone support, is $250 monthly. This fee applies to out-of-town patients who require continuing prescriptions, whether or not there is an office visit.
We require payment for the initial evaluation at the time of the first visit and payment for maintenance services on a monthly basis. We are not Medicare or Medicaid providers. We require that Medicare beneficiaries complete a Medicare Beneficiary Contract which acknowledges and promises that bills for services provided by Dr Hurwitz are not to be submitted to Medicare for reimbursement. We do not accept assignment of insurance benefits.

$1250 for the first visit and $250 per month after that and they DO NOT ACCEPT ANY FORM OF INSURANCE. And that money DOES NOT INCLUDE THE PRICE OF THE DRUGS. This guy is handing out morhine and methadone FOR CASH in his clinic and apparently isnt bothering to distinguish between drug-seekers/dealers and legitimate patients. And he by his own admission is totally OK with sending perscriptions to patients that he doesnt even see after their first visit.

I change my mind, this guy is dealing drugs, plain and simple.

This information was obtained from the good doctor's own website. What REALLY pisses me off is that the article that begins this thread includes this statement

The prosecutors did not claim Hurwitz, who faces a possible life sentence, got so much as a dime from illegal drug sales.

I take back what I said about an IMPLIED bias to the article. Technically this isnt an outright lie, but it is certainly a misrepresentation of the facts designed to push the reader into a direction that they may not have otherwise gone.

 

[alan]

longrifleman wrote in part:

I think we need to perhaps relearn how the jury system works....???



Well............... That was kinda my point.

It would be interesting to hear exactly what the jury did have to say. I would also be very interested to hear the instructions to the jury as well.

For the first hundred years or so of the Republic, juries were expected to act as a check on overzealous prosecution. That changed around the turn of the last century when the govt couldn't get convictions, primarily in labor cases. The govt went judge shopping and finally got the precedent they wanted and that was the end of judges informing the juries about their real power. If the truth of juries real power was known the War On (some) Drugs would be in serious jeopardy.

************

It has been claimed by some, perhaps correctly, that only the lame and the infirmed prove unable to display the smarts necessary to avoid jury duty. I cannot say much as to the truth or falsehood of this theory, though looking at the verdicts of some juries, one might be inclined to agree.

Otherwise, even stipulating the "dumbness" of juries, in this day and age, could they really be that dumb, that they are unaware of the real power of trial juries? Also, in-so-far as I'm aware, jury panels are selected from voter rolls, and similar public documents. I therefore assume that the people who sit on juries have not been confined to monestaries, or such places.

I will once again, ask my earlier question. Are juries really composed of people who are that dumb, that unaware?

 

[longrifleman]

I will once again, ask my earlier question. Are juries really composed of people who are that dumb, that unaware?

Well, the first times I was on a jury "ignorant" would have been an accurate description of me. It was setting on one that gave me the interest to check out that there jury nullification hoo haw. When did you learn about the concept? Not in school probably. Also, I expect that the folks on this board are more politically aware than the general population. Ask the next ten strangers you strike up a conversation with about this and see how many have a clue what you are talking about. I'd suggest you not start with Peter Zenger and William Penn or it might be a short conversation. And don't even think about Lysander Spooner.