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From: dazzle_4U@excite.com
Date: 02 Sep 2002
Time: 22:16:25 -0400
Remote Name: 170.215.6.160
I HAVE COMPLETE PERMISSION TO POST THIS PLEASE READ - VERY LONG - BUT WHEN YOU ARE DONE PLEASE WRITE Virginia Governor Senator, and Congressmen.. then write your state also in protest. HURWITZ PATIENT FALL-OUT Message: 2 Date: Mon, 02 Sep 2002 01:46:30 -0000 From: "kaldrogo2000" <kaldrogo2000@yahoo.com> Subject: Soon To Be Former Dr. Hurwitz Patient - Help!! Posted by: Andrew Conley Location: Sanford, Florida (407) 650-2795 Greetings all, my name is Andy. I can currently a patient under the care of Dr. William Hurwitz. I wanted to let all potential readers of this post know at the outset that is a LONG post because I have a lot to share especially about Dr. Hurwitz' decision to end his practice in December. As are most of Dr. Hurwitz current patients, even though I hope against hope that enough of a positive change can occur before December so that Dr. Hurwitz might feel that he could delay even postpone his decision to end his practice as a person who suffers from intractable pain, I am currently seeking to consult with a pain doctor, preferably in Florida, but I can travel. I've put my details below and now On with my post! Three years ago suffering from intractable back pain resultant from a car vs. pedestrian accident, in which I was pedestrian I began a desperate search online for a pain physician who understood intractable pain and who could properly treat same. After several years since the accident, bouncing from one doctor to the next, being turned away, lectured about not knowing anything about my own pain and the best modalities for its treatment and worse, something most all of us intractable pain patients have experience being characterized as a "druggie" an "addict" and an "abuser" my medical history was clear, there was no ambivalence on my x-rays the damage was clear and yet in the face of pain that was so horrible at times that I'd begin to seriously question if I could even go on with life I had doctors tsk tsking me in their offices, writing prescriptions for 500mg of Ibuprofen, Ultram Flexerill everything ANYTHING but the medication necessary to adequately control my pain. I finally found, after years of searching - a "pain" doctor who was willing to prescribe 90 5mg tablets of methadone per month which provided me with exactly 3 ½ days of relief and was again contemplating either "unconventional" (read: street) options or just not continuing at all when I exchanged emails with a person who sent me to action on pain where I read about a doctor in Mclean Virginia, Dr. William Hurwitz, who understood and could treat intractable pain the way it really must be treated aggressively, professionally and comprehensively. I spent some time talking online and on the phone with some of his patients, and as I listened and read their comments about his treatment modalities, I must admit that I really didn't believe that such a physician really could exist, or that a life in which my pain could be truly adequately controlled could be a reality. Yet, I contacted Dr. Hurwitz office, scheduled my first appointment, and spent several days with Dr. Hurwitz undergoing extensive medical testing, medical history review, and finally education and titration. I sat in my hotel room on the third day of my visit not in complete AGONY for the first time in my recent remembrance, and I cried. I cried for the years of pain that I'd gone through. I cried for the glares and accusations I'd gone through. I cried for the other intractable pain sufferer's who I knew were even then suffering through what I'd suffered and who hadn't yet found a doctor like Dr. Hurwitz. I cried, for this country that I love and that has been so good to me so be so backward when it comes to aggressively and comprehensively treated patients with intractable pain instead of treating us with compassion we are lumped in the "addict" or "junkie" or "druggie" or "abuser" category and shunned, harassed and denied the help we desperately need when we deserved compassion, treatment and the RIGHT not the privilege to live a life as free from pain as current medical progress allows. I sat through, of all things, an episode of "Roseanne" while sitting there in my hotel room near Mclean Virginia and cried through the whole show because it occurred to me that I was actually performing an activity without having my pain ALWAYS on my mind agonizing and tormenting me destroying my ability to focus, or be productive I cried because I could watch a television show and for ONCE actually follow the show instead of using it as a desperate attempt to draw my attention away from my pain. And so, for this, and so much more I cried. There was one thing however that brought tears to my eyes that stand out in my mind above all else. I realized sitting there listening the Dan and Roseanne Connor banter back and forth that I had just met a hero. An honest to God, true blue real McCoy hero. Who, instead of following the rest of the establishment and caring less about their patient's pain than they did about their license, or even making the SLIGHTEST attempt to change overall policy., decided to take a stand, and really treat intractable pain the way it should be treated. You see, it's so much easier to close your mind to someone's pain. To tell yourself that they are an addict. To deny the visual proof sitting right in front of you on an x-ray and other medical reports. It's easier to do all this, than to risk losing your license. So I cried, because, hey it's not every day that one meets a real hero. Now, those of you who know Dr. Hurwitz, and his sense of humor, his intellectual wit, his self-deprecation can tell you that he is far too modest to allow himself to be called a hero or to be overly praised. He will spend hours on the phone with you discussing your pain control, or a myriad of other issues, but if you try to articulate how grateful you are how much his treatment, his professionalism, his courage means to you it's a fair bet he'll need to pick up another line! He is just too modest to want to deal with overmuch praise. This was about three years ago. I have long accepted that I will never be able to live a life completely free of pain. I hurt, even under Dr. Hurwitz' excellent care and I always will hurt but for the past three years, my pain has been under control to the extent that I can actually live a moderately productive life I can work, and write and live! However, I made a terrible mistake, one for which I must apologize to God, to the pain community, and most of all to Dr. Hurwitz himself. For about three years now, I have been following Dr. Hurwitz' instructions, and controlling my pain and little by little, the dark days the "before" days began to fade from my memory. The glares, and accusatory lectures and denials all became things of the past for I had entered a glorious new era one where the world had righted itself where my pain while never fully gone was under control, and I could live a relatively normal life, I'd seen television news reports on Oxycontin, attacking the medication for those who abuse it characterizing Oxycontin itself as the root of all evil instead of those who abused it as law- breaking criminals. No, if someone illegally obtained OxyContin and then fatally abused it they were "victims" of the EVIL OxyContin. Their innocent smiling pictures, full of hope, were framed on the television screen, while somber voiced reporters intoned behind them, warning the world that a pestilence a plague an indescribable horror had been unleashed on the world and that evil's name was Oxycontin. I saw the reports and heard stories in the media about the ongoing issues with patients diverting their medications, young people becoming hooked, and instead of reporting on the abuser's culpability the reports almost always placed the blame squarely on the shoulder's of the doctor's who these reports accused of irresponsible prescribing, etc I saw the initial spate of lawsuits regarding Oxycontin, where tearful mother's, holding the hands of their attorney's told the camera about how OxyContin had stolen from them, and had destroyed their lives. Did she, or anyone mention the fact that little Jimmy had to have actively attempted and succeeded in obtaining the OxyContin? That had the substance been discovered on his person, his mother's attorney would be defending Jimmy in a criminal court of law instead of suing Purdue who offense as I see it, is that they've developed a pain medication that works well, and that DOES NOT BELONG in the hands of persons who are not suffering from severe or intractable pain. I saw the continued chilling effect of policy on the pain treatment community, but I felt that I didn't really have to worry because I was under the care of a doctor who knew how to help me control my pain for whom all of those reports of abusing patients and doctors didn't apply because I KNOW Dr. Hurwitz' and the concept of that man EVER knowingly prescribing ANY opioid medication to an undeserving or unqualified individual is about as likely as George W. Bush sitting down for Tea and Crumpets with Osama Bin Laden! I didn't worry because I KNEW that Dr. Hurwitz was "above the fray" and that since he'd already been the target of exhaustive scrutiny and had emerged vindicated and able to resume his practice I actually thought that his days of being harassed because it was simply KNOWN that he DOES NOT NEVER HAS WOULD NOT COULD NOT and NEVER WILL knowingly allow a single tablet of medication to fall into the hands of the wrong type of person. I honestly believed that since he IS a great man, a hero, and honest doctor with complete integrity which the authorities KNOW that his practice was for all intents and purposes immune from the ruckus that I saw and heard happening with other pain treatment doctor's dealing with. Instead of making time every day every week, every month to keep politically active to make sure that from a grassroots standpoint and from every other angle or modicum of my ability to be working every single day to bring the woeful state of pain treatment in the United States to the attention of the general public to try to mobilize people to demand that their elected representatives add the RIGHT to adequate and comprehensive pain control be added and included on the Patient's Bill of Rights'. To work in every way possible espousing concepts such as patient licensing. Having elected officials hold hearings to ask the DEA why their articulated policy that those in need of intractable pain treatment should have access to adequate medications is belied by their continued actions of jackbooted bully tactics, and oppression. To work every day towards the day when the DEA and other enforcement agencies work closely WITH doctors to help weed out "bad apple" patients who actions adversely affect the ability of the rest of us to access adequate pain control medications. To work every day to remove the FEAR the doctors from Alaska to Florida feel when the subject of pain medication is even mentioned in their offices. To work every day to CHANGE U.S. PAIN POLICY. Instead, I accepted that the dark days where I was in constant pain were over, that I'd found a physician whose competence, and professionalism and transparent dedication to the proper treatment of intractable pain would protect him from any further harassment What I didn't realize is that DEA and Federal authorities in Alexandria Virginia probably KNOW that Dr. Hurwitz' is the consummate professional, compassionate, dedicated and caring doctor that I and so many other patients, friends, and colleagues know him to be THEY JUST DON'T CARE. He is their target. Never mind that he's never broken the law. Never mind that NO physician could EVER possibly weed out every "bad apple" patient with 100% percent efficacy Never mind the fact that the onus to weed out such patients should not reside with JUST the physicians who treat pain, but ALSO with the agencies charged with the duty of enforcing access to these substances, who should be working in tandem with pain specialists, as opposed to working against them, attempting to drive them from practice, or worse, imprison them. They believe, probably correctly, that by eliminating all pain treatment specialists who treat pain as it SHOULD be treated that they will eliminate those "bad apple" patients who divert or abuse their medications. They are probably right. However, by driving competent pain treatment specialists from practice, they are also creating new criminals out of patients who feel they have no other choice but to obtain pain control substances illegally. They are causing untold amounts of death as patients, abruptly withdrawn from medications they desperately need, and who are then faced with the triple threat of the instant return of their pain, the immediate onset of horrible withdrawal symptoms, and the expensive, tiring, and lengthy process of once again seeking a doctor courageous and professional enough to treat their pain who then decide that they simply cannot face that situation and opt out of life altogether. They are causing all manner of mistrust and fear amongst members of the medical community who are trained, and swear a solemn oath to "First Do No Harm" but are then faced with the untenable choice of either "doing harm" by withholding desperately needed pain medication, or facing the potential loss of their license to practice and 8 years of intense medical training down the drain. Had I been working EVERY DAY to change the current U.S. pain policy would I have been able to make a difference? I don't know. I DO know however that the pain situation especially the lack of access to adequate treatment for patients with intractable pain in the United States is a problem that is not going to go away or disappear despite the best efforts of those who would attempt to "solve" the problem by crushing doctor's who properly and professionally treat patients with intractable pain. THE PROBLEM IS HERE TO STAY. The QUESTIONS are: How many unnecessary arrests and prosecutions, how many millions of wasted tax dollars on these arrests and prosecutions and the subsequent costs of incarcerating these medical patients? How many unnecessary deaths, by suicide, by the use of illicit pain control substances, by the misuse or over use of pain medications containing Tylenol destroying the livers of intractable pain patients who take enough of them to control their pain for 4 -6 hours, not counting on the fact that that much Tylenol is antithetical to continued liver function? How many families will have to be destroyed by desperate patients with intractable pain being impossible to live with, too expensive to live with, as they seek and pay for one ineffective treatment after the next? How many intractable pain patient will be exploited by unscrupulous physicians and laypersons who KNOW that they cannot obtain adequate medication to control their pain and who will then subsequently try just about ANYTHING to get their pain under control? How many "revolutionary" pain treatments will be bought and paid for, and then almost instantly discarded as useless? How many lives will be lost or destroyed? How many families will be lost or destroyed? How many marriages will be lost or destroyed? UNTIL - the problem has become so overwhelmingly, horribly evident that the public will demand change? Why should it take that long, why should so many lives and families and marriages and freedoms go up on the chopping block? The authorities and pain doctors COULD work together to ensure that "bad apples" are weeded from practices and aggressively prosecuted and THEN the problems of diversion and abuse would be HUGELY REDUCED WITHOUT THE NEED FOR THOUSANDS OF LIVES TO BE DESTROYED WAITING FOR THE PROBLEM TO BECOME SO HORRIBLE THAT THE PUBLIC IS FORCED TO TAKE NOTICE! I thought my days of desperately seeking control for my pain, of seeing multiple doctors on the same day of suffering with both pain and withdrawal were behind me, I believed this because I believed that no right thinking person would ever look at the practice of Dr. William Hurwitz, M.D. and infer ANYTHING but the TRUTH which is that he is a caring, professional, dedicated to the proper,:LEGAL treatment of patients suffering from intractable pain. How utterly, and completely wrong I was how I abrogated my responsibility to fight every day for a national change in the way patients are able to access adequate medications to control severe/intractable pain. I was blind but now I see and I shall now be calling in EVERY favor, working every day to hasten the day when these changes ESPECIALLY the dialogue between pain physicians and enforcement authorities and the two working in tandem take effect. So, I apologize from the bottom of my heart. First, to Dr. Hurwitz, who deserved better and far more than just my blind faith in his ability to keep his practice doors open. I apologize to every patient who may now be unable to find Dr. Hurwitz and become a patient, and whose suffering may continue because I and others like me may have failed to mobilize soon enough. I apologize to the current, dedicated members of the action on pain community for not joining your active, working every day towards change ranks until now. I am so very sorry. I continue to hope that my efforts and the efforts of the rest of the pain community calling in every favor, getting the word to our representatives, doing everything from grass-roots to national levels will somehow allow Dr. Hurwitz to keep his doors open. He has laid out the criteria as to what will need to happen in order for him to remain in practice and the criteria are neither easy, nor under the current political conditions and leadership do they look very likely. I do continue to hope and pray and above WORK for these changes to occur and for these criteria to met before December. If the public were aware of what their chances of receiving adequate treatment for their pain if they were to be in a car accident or otherwise injured, or if they were contract cancer or other painful disease, if the public were truly aware of what their realistic chances of obtaining control for intractable pain if they were to develop such then I believe that the horror of loss of lives, families, marriages, and the rest could be avoided but it will take education getting the word out and every educated and concerned voice rising in thunderous tandem that a change is needed! A change is needed! A change is needed. So, in conclusion, after three years it looks very much like I am a soon to be former patient of Dr. William Hurwitz. Perhaps the most courageous and dedicated man I've ever been privileged to know. So, instead of crying this time, I lament. Not just for myself, and the return of "dark days" but for those persons who are now suffering, or who will soon suffer intractable pain who will no longer have the option to be treated by Dr. Hurwitz, who's pain and desperation will continue until some hopefully find treatment and help others and this is sadly inevitable will simply give up and take themselves out of the equation altogether and for any of you who may be reading this I tell you now please try not give up! I am facing the exact same situation once again and while I do not know if there are any physicians out there who even come close to Dr. Hurwitz' professionalism and dedicated care - I am going to try to find one and share the information from my efforts with all persons who are truly and honestly suffering from intractable pain. To those of you who may be reading this who are abusers of pain medication or who divert pain medication you cannot comprehend the damage your actions cause, the horror and pain, the harassment and terror suffered by honest people in pain, the lives families and careers torn apart because of your choice to abuse the trust your doctor has placed in you. To abusers I say only this: I know my words won't make you stop doing what you are doing but you'll one day have a reckoning, if not here, than certainly with God. You abusers should think of the countless others who are in AGONY because of what you do and STOP NOW. I wonder if the people who have targeted Dr. Hurwitz, know the overwhelmingly negative effect their actions are having? I wonder if they know that they are unleashing an evil far more insidious than the "evil" they are "attempting" to address? I wonder why they refuse to even consider opening a dialogue? To even consider the obvious solution of working WITH pain doctors to identify and weed out the patients who do not qualify for or who abuse their treatment? It is the STATED POLICY of the DEA at least, that patients who are proved to suffer from intractable pain should be able to have access to adequate pain control medications. Why do their actions contraindicate their stated policy? Why is that necessary? Why isn't Purdue standing behind Doctor Hurwitz, who, I'm sure they know, is a courageous pioneer in the field of intractable pain? They have an effective, truly wonderful product if used properly to treat intractable pain, but by not standing behind the doctors who come under fire for prescribing Oxycontin, they will soon not only not be able to find any doctors willing to prescribe it at all, and will also likely be seeing only the tip of the torrent of lawsuits they are likely to face. Why not work to stave off that potential litigation by working with and STANDING BEHIND physicians who properly prescribe, and understand its proper, effective, and legal application in the treatment of intractable pain? In any case thanks to all of you who have taken the time to read this post. God Bless you and may He grant us all the strength we'll need to continue the struggle against current U.S. pain policy. I live in Central Florida just a few miles north of Orlando, and am seeking a pain treatment physician or facility that I can consult with for when December arrives or worse if Dr. Hurwitz should close his practice early for any reason. I'd prefer to be able to see a physician in Florida but will travel if need be. I am currently taking Oxycontin, MSIR, and Methadone as my primary pain control medications and am looking for a physician who will be able to review my medical records, perhaps consult with Dr. Hurwitz prior to the ending of his practice and then potentially become a patient. If anyone knows of a physician they can recommend, I would be extremely grateful. I do want to contemplate returning the days before I became a patient of Dr. Hurwitz, so if anyone knows of a physician taking on new patients, and who is dedicated to treating pain aggressively. Please let me know! I'd be very, very grateful. My email address is corky@cfl.rr.com my telephone number is (407) 650-2795 or (407) 256- 9232. As I stated before, my eyes are now wide open, and while it may well be too late, I am mobilized. I continue to hope against hope that conditions will improve to the extent that Dr. Hurwitz would consider delaying his decision to end his practice, however as a person with intractable pain I must also seek a physician who can help me control my pain else I'll be incapable of anything political action or otherwise. Lastly if you are suffering from intractable pain, and need someone to talk to for any reason any reason at all. Please feel free to either call me, or email me or IM me! My AIM ID's are either AndrewCorky or Loyalcorky. I know what it's like to deal with intractable pain and I know that even when one is getting enough medication to adequately control their pain that there are other issues that can be very important as well. I don't claim to have all the answers, in fact I don't claim to have ANY answers, but I have shared many of the same experiences I am searching for a new pain physician right now and perhaps most importantly (behind my now daily political mobilization work) I KNOW HOW TO LISTEN and will be more than happy to talk and/or listen to anyone who wishes to contact me. Not to mention the fact that I am frightened very, very frightened in fact, at the need to once again seek a professional and comprehensive doctor so I wouldn't mind having someone to speak to myself, if anyone out there is available. Thanks again for reading this! To all Dr. Hurwitz patients: Take heart! I have a firm faith in God and a firm belief that a determined person, or group of people can achieve anything! God Bless You All! Andy Conley Sanford, Florida (407) 650-2795 kaldrogo2000@yahoo.com corky@cfl.rr.com Message: 4 Date: Mon, 02 Sep 2002 06:06:30 -0000 From: "sprucewolf" <sunwolf@together.net> Subject: My Letter in Support of Dr. Hurwitz (Long) This is the first letter I had sent to the people involved in the investigation 8/19/02. The addition at the bottom I put in after hearing of his decision to end his practice (9/1/02). Michele Malone, VT sunwolf@together.net ------------------------------------------------------------- 8/19/02 I am writing this letter in regards to the federal investigation of Dr. William E. Hurwitz. I want to convey my adamant belief in his integrity, professional abilities and conduct?both as a physician and as a human being. Also, I would like to comment on the complex issues surrounding the use of oxycontin and other related pain medications used in pain management today. I have been a patient of Dr. Hurwitz since May of 1999. I made the decision to see a pain management physician who utilized opioid medications after an initial trial of these medications prescribed by my primary care physician basically gave me back a life worth living. Not only was I pain free for the first time in years; but I was able to resume a level of activity and functioning that had been gone for a long time. Overall, Dr. Hurwitz gave me back a quality of life that chronic pain had worn away. One absolute unmitigated truth exists for any person who has ever suffered with chronic unrelenting pain that won?t go away no matter what they try. This truth is that living through years of chronic pain permanently changes things. It changes you as a person and effectively ends the life you were living before it entered your life. There is the life you lived before chronic pain and then there is life you live with chronic pain. This is the hard-earned lesson that a person only knows if they are unfortunate enough to suffer with severe unrelenting pain. Dr. Hurwitz is an excellent physician?being reputable, professional, and conscientious. He is: 1. Very knowledgeable in all aspects of pain medications?from their chemical composition and biochemistry, through their indications and effects, to their dosing and titration through their side effects and management of them. 2. Very thorough in providing both prospective and established patients comprehensive information necessary for them to make informed decisions about opioid therapy. He is just as thorough in obtaining a comprehensive medical history on his patients; and keeping abreast of their current state of health. 3. He is a doctor who is always willing to listen. This is a very important factor that contributes to my view of what traits a good doctor has. He is always available to his patients?day or night?providing them with the information needed to reach him 24 hours a day-7 days a week. 4. He gives his patients the time that is needed in their appointments?not limiting, rushing through, or cutting short an appointment to keep to any sort of expedient or rigid schedule. His evaluation and monitoring of each patient is comprehensive. It is not simply a "narrow-view" state of body/physical health, pain level, and medication use. It is much more of a "whole-picture" view of a patient?in body, mind, and soul. What I mean by this is that he sees each patient as the person that they are, including the context of their lives?i.e., their day-to-day lives in respect to their functioning, quality of life and well being, family, work, and financial issues. He is a doctor who has a great level of concern, compassion, and empathy for people?this is why he continues to do what he does?why he decided to begin his practice again and why he continues to be an advocate for the adequate treatment of pain. It certainly would have been "easier" to not do so in light of all the stress and difficulties stemming from the controversy surrounding all of this. However, he strongly believes that all people deserve adequate and effective pain relief?a conviction he holds as strongly in his professional life as a physician as it is in his personal life as a human being that none of us should ever have to suffer with agonizing pain. In consideration of this, he decided that continuing his efforts was more important than the numerous drawbacks and repercussions that this has on him both professionally and personally. If these medications work when all else fails, then it would be wrong to not use them. He is an ethical and principled man who believes that people deserve a second chance; and so has not turned away "risky" patients who may have had prior problems with drug addiction or the law. This, however, may be where he has made a "mistake". I can?t state any stronger that I agree with his moral viewpoint in this respect. It would be plain wrong to deny pain relief to any human being?despite their foibles or mistakes. Dr. Hurwitz is not providing his services "for the money". In my opinion, the controversy over all of the issues involved here renders any incentive to provide this treatment (as well as any reward or benefit derived from it) very low?financial incentive or reward included. Not to mention the stressful aspects and negative impacts related to the "controversial" nature of this type of treatment. Dr. Hurwitz bills his patients on a "sliding scale"?seeing many patients who would be otherwise unable to afford treatment. I am one such patient. As of this month, I am several months behind in payment of my medical bills with him to the effect of thousands of dollars. He knows that the difference between my receiving adequate pain relief and not comes down to my financial situation. He is a physician who takes into consideration the whole picture of his patients?both in regards to who they are as individual people and in regards to the circumstances surrounding their lives. Here are some questions I have in regards to this issue: 1. Should a physician (or pharmacies for that matter) be penalized for a patient?s breaking the law?i.e., in forging or altering prescriptions, going to multiple pharmacies for the same prescription, etc.? 2. How can a physician know if his or her patient is lying to them or involved in criminal activity? 3. Should a physician (or pharmacies for that matter) be penalized for a patient?s not following their instructions regarding the safe, prescribed use of a medication? 4. Should all pain patients be penalized if some patients have individual needs of stronger medications, higher dosages, or greater number of pills per month than the average? In a situation as complicated as this one is, there are obviously no "easy" answers or "quick fixes". Sometimes, what seems to get lost in all of the dialog, argument, and debate is the fact that all of this will dictate the fate of human lives. We have to be cognizant of the entirety of this situation and understand it beyond a theoretical, moral, or legal viewpoint. We must take into consideration how any approaches to resolving the problems here apply in context to the real world?in real life. The laws of our society may be "black and white" in regards to a factual determination of whether or not a deed is legal or illegal; but justice is done only after all the shades of gray in between are taken into consideration. There must be a balance in enforcing these laws that does not create an injustice to others. If access to pain relief is "penalized" to the degree that it is effectively reduced or even denied as a result or repercussion of resolving drug addiction or drug abuse issues, then a greater wrong is committed than the ones that were at the root of this. In this type of difficult and complicated issue the possibility of viewing certain aspects of it from a place of ignorance (or from narrow-mindedness) exists in respect to how the effects or repercussions of solving a problem can look "easier" theoretically versus how they actually pan out in real life. For example, if the effect of this pans out that it is in effect equal to telling the millions of people with chronic pain that they would just have to find an alternative pain management solution because: Doctors are unable or unwilling to practice medicine as it should be practiced as a result of this kind of situation. Oxycontin or other related medications are overly restricted in prescribed usage?i.e., in the capacity that effective dosages can no longer be prescribed. Oxycontin and other related medications are effectively "banned from use"; leading to their no longer being available from no longer being manufactured. How would this affect the millions of people afflicted with chronic pain in their day-to-day lives? What would the actual consequences be? Not the consequences based upon the theoretical "way it should be" or on the "way it should work"; but on the way it actually is? For one thing, the reality for many chronic pain patients is that their being able to find an alternative pain management solution is not possible because they are already undergoing the treatment of last resort. For millions of people with chronic pain, opioids are the only treatment that adequately manages their pain when nothing else works. Well, what if these medications are still available, but few physicians are willing to put up with all of the controversy and "risk" involved?and many physicians give up their established practices? This would force many chronic pain patients to have to repeat the many steps necessary to find another physician. This is not often as simple as it seems?it can often be an extremely difficult and even near impossible task for some patients. Finding a good doctor that you trust can be a lengthy and difficult process in and of itself. There can be very long waiting times before you can be seen the first time. There can be difficulties finding doctors in the field or specialty that you need; or in becoming their patient even if you do find them based on the size of their practice. Those of us living in a rural area are faced with the challenges of living far away from medical facilities and not having many options or alternatives to choose from. Then of course there are the financial or insurance related constraints. Many patients would have to endure retrying prior ineffective or inadequate treatment protocols. All this, while otherwise having no choice but to "handle" their pain. It is difficult sometimes for relatively healthy people to do this; but for patients with a serious illness, these difficulties can be almost insurmountable. This wouldn?t be right even if done in order to prevent any more oxycontin or other related medication related deaths; or to curb the practice of (and/or prosecute) the people who sell or abuse drugs or commit other illegal acts. It is horrible to see people suffer through addiction. It is extremely complicated to resolve the difficulties that drug abuse and addiction can bring to communities and society as a whole. It is worse of all to see anybody die as a result of this. But it only makes a bad situation worse to contemplate the effects that a lack of adequate (or any) pain relief would have on millions of people?s lives. To not take this into consideration with the importance that it has is not only insensitive to the plight of those of us who suffer with chronic pain; but is an example of what I said before about the law and justice. Update 9/1/02: I have just been notified of Dr. Hurwitz?s decision to end his medical practice and am very distraught and dismayed. I am very upset that the pressure on him became too much for him to deal with. I am dismayed because a good human being was forced to take a course of action that is against his moral viewpoints as well as his professional ethics. He is a very strong person to have handled himself so well through all of this intense negative scrutiny. However, I am also very angry. I am angry with all of the people involved in the investigation for allowing things to go this far. I am angry at a country that allowed things to go this far. I am also very heartsick and tired because I now have to try to find another pain management physician. Dr. Hurwitz said he will do his best to facilitate this for all of his patients (Another example of how much he truly cares for his patient?s welfare), but the fact is that it will not be easy. The idea of my having to go "back to the couch" (or my bed) because of my pain is a despairing one; but it is not a new one. It was my reality before I saw Dr. Hurwitz. Sincerely, Michele Malone
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