http://www.washingtonpost.com/wp-dyn/articles/A20025-2003Sep29.html

Federal prosecutors yesterday likened a Northern Virginia pain doctor who was indicted on drug trafficking charges to a "street-corner crack dealer" as they tried to keep him jailed until his trial.

William E. Hurwitz, a prominent advocate of using potent narcotics to treat intractable pain, was charged last week with distributing drugs that ended up on the black market. Prosecutors allege that Hurwitz's prescribing practices led to the deaths of three patients and fueled the abuse of painkillers such as OxyContin. Hurwitz's attorney has argued that the doctor was practicing good medicine.

Hurwitz's arrest is part of a nationwide effort by the Justice Department to stem prescription drug abuse, and authorities recently have focused on doctors. Hurwitz, 57, of McLean is one of the first doctors nationwide to be accused of widespread illegal distribution.

Hours after Hurwitz's court appearance, a group of advocates for doctors and pain patients decried the government crackdown, saying it is keeping pain sufferers from getting the help they need.

Assistant U.S. Attorney Mark Lytle said in court that Hurwitz should not be treated any better than a crack dealer simply because he has a medical degree. Lytle said there is evidence that Hurwitz was providing dealers with drugs to sell. "This is a case of a defendant who wears a white coat and with the power of a pen" distributes drugs, Lytle said. "This is not a case about malpractice or whether a doctor exercised bad judgment."

Lytle said Hurwitz should be held without bond until his trial on charges that could yield a life sentence. U.S. Magistrate Judge Barry R. Poretz deferred a ruling on bond until a hearing this afternoon.

Wearing black-and-white-striped prison garb to court, Hurwitz blew kisses to family members. He later shook his head as prosecutors said they had taped conversations between him and his patients. On one of the tapes, Lytle said, Hurwitz talked about a co-conspirator's drug dealing in Tennessee and then issued him more prescriptions.

Lytle also alleged that Hurwitz might have tried to hide the assets of his pain practice, saying authorities have not been able to find almost $2 million of his reported earnings for the past five years.

James Hundley, Hurwitz's attorney, said Hurwitz has done nothing wrong, arguing that the doctor followed accepted medical guidelines for the use of opioid therapy.

"There's a world of difference between him and a crack dealer," Hundley said. "He is a licensed doctor. The illegality happened down the road from him. If patients choose to misbehave, he can't control that."

Yesterday, advocacy groups for patients with chronic pain attacked the prosecution of Hurwitz and what they said was a trend by federal officials to target doctors who specialize in pain management.

Speaking at the National Press Club, group representatives said millions of Americans are finding it increasingly difficult to find doctors who will treat chronic pain because doctors don't want to risk their licenses by prescribing controlled drugs. They said the trend is especially disturbing because, in recent years, medical research has supported the long-term use of opioids as the best treatment for many patients with chronic pain.

"We are here to say we support Dr. Hurwitz and others targeted like him," said Kathryn Serkes, spokeswoman for the Association of American Physicians and Surgeons, a nonprofit group that represents doctors. "These prosecutions should not be occurring, and we will help Dr. Hurwitz become a doctor again when this is over. . . . These doctors who treat chronic pain patients are heroes, not criminals."

Siobhan Reynolds of the Pain Relief Network, whose husband has been a patient of Hurwitz's, said the "Justice Department is misidentifying pain doctors all over the country as drug dealers. What they are enforcing is a national public health catastrophe in pain."

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