OPIOID PRESCRIPTIONS LEAD TO PRISON SENTENCE The DEA head says doctors who legitimately prescribe painkillers have nothing to fear. It was not the life sentence prosecutors sought, but for 59-year-old William Hurwitz, MD, the 25-year sentence he received April 14 may be just that. Some fear the federal prison time and $1 million fine may have a chilling effect on pain prescriptions. A jury in December 2004 convicted the McLean, Va.,-based pain specialist, who gained fame when "60 Minutes" told his story, of 50 of the 62 counts related to prescribing large amounts of opioids and other narcotics. Because of the high-profile nature of the case, some physicians said Dr. Hurwitz's imprisonment would result in them being too afraid to prescribe opioids to patients who need them. "He's the poster boy," said C. Stratton Hill Jr., MD, professor emeritus of medicine at the University of Texas and founder of the M.D. Anderson Cancer Center's pain clinic in Houston. "You're going to see more physicians abandoning the treatment of pain because they don't want to worry about getting into trouble." Dr. Hill, who served as a witness for Dr. Hurwitz's defense, said he was troubled that law enforcement officials were deciding what constitutes legitimate medical practice. But at a news conference after the sentencing, U.S. Drug Enforcement Administration Administrator Karen Tandy emphasized that doctors who "legitimately" prescribe narcotics to treat pain have nothing to fear. AMA Trustee Rebecca J. Patchin, MD, said Tandy's statement reflects the message of balance that AMA representatives tried to convey when they met with the DEA chief in March. An anesthesiologist and pain-management specialist in Riverside, Calif., Dr. Patchin said physicians need to be aware of diversion issues, but still need to adequately treat pain. She said that while it's inappropriate for a doctor to prescribe drugs he or she knows are being diverted, it is appropriate to treat a patient simultaneously for pain and substance abuse. "Substance abuse is a disease that you treat like diabetes or any other illness," Dr. Patchin said. "If a physician is concerned about what they're doing, I ... recommend that they consult with a colleague or either a pain or substance abuse specialist."