Supporters of Hurwitz believe he is the scapegoat in a larger federal crackdown on physicians who treat pain. But Karen Tandy, who heads the DEA, said it only targets the most egregious abusers of the law.
"The number of doctors that have been arrested by DEA or the number of cases that DEA's participated in is less than one-hundredth of 1 percent of all the registered doctors," Tandy said. "It was 42 this year. It was 50, a little over 50, last year. So it's a very small number of doctors."
But Dr. Russell Portenoy, a pain specialist at New York's Beth Israel Hospital, said he and his colleagues increasingly are concerned about the criminal prosecution of doctors who prescribe pain medication.
"Physicians, in the last year, have begun to view the DEA as an adversary or have begun to feel increasingly suspicious that the DEA is so focused on prescription drug abuse that they're willing to sacrifice appropriate medical care, at least in certain circumstances, in order to reduce prescription drug abuse," Portenoy said.
For Cynthia Hildt, 70, chronic pain began after seven surgeries on her spine. For years, she said, it went largely untreated because doctors were so wary of prescribing all of the painkillers she needed.
"It was all concern about addiction, addiction, addiction," Hildt said. "I got so tired of hearing that word. I constantly said to these people, 'If you felt what I feel in my body right now, you would do anything to fix it.' "
But now, Portenoy is treating her and she is taking daily doses of morphine and methadone that are 20 to 40 times higher than a typical trauma or surgical patient would receive.
"In the chronic pain setting, what often happens is that doses may rise over time, and patients end up taking quite large doses," Portenoy said.
For Hildt, it's made a world of difference. "It's enabled me to do things that I couldn't do before," she said. "It's made me able to be more active."
Such high-dose therapy using narcotics -- known as opioids -- now fairly common among physicians who treat chronic pain, has put those specialists on a collision course with federal regulators. The crux of the issue is whether the DEA is now unfairly targeting doctors merely for doing their jobs.
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