PROFESSIONAL ISSUES

Pain specialists fear chilling effect after arrest

The action came within weeks of an FDA panel's ruling against new limits on OxyContin prescribing.

By Andis Robeznieks, AMNews staff. Oct. 27, 2003.

Pain management physicians celebrated a victory recently when a federal advisory panel ruled against a proposal to place more restrictions on how they treat patients.

But their celebration was short-lived when an outspoken member of their specialty was arrested on drug trafficking charges weeks later.

The good news came Sept. 10 when a U.S. Food and Drug Administration advisory panel voted 13-5 against new restrictions on OxyContin prescribing that were suggested by the U.S. Drug Enforcement Administration and members of Congress.

Two weeks later, pain management specialist William E. Hurwitz, MD, of McClean, Va., was arrested and indicted on 49 counts of drug trafficking in 39 states. Authorities also linked him to the deaths of three patients.

"I was very heartened by the action of the FDA advisory panel," said Joel Hochman, MD, a Houston psychiatrist and executive director of the National Foundation for the Treatment of Pain. "There is no rational basis for restricting the availability of OxyContin for pain patients or their prescribing physicians."

While the decision against further restrictions made sense to him, he said the arrest of Dr. Hurwitz outraged him and could lead to self-imposed restrictions.

"You talk about a chilling effect," Dr. Hochman said. "I waited all last night for them to kick my door down."

At the FDA hearing, Terrance Woodworth, deputy director of the DEA office of diversion control, said more limits are needed on OxyContin promotion and distribution, and that prescriptions should be limited to patients with certain disease states or only given to those with severe pain.

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