Doctor convicted for narcotic prescriptions

June 2001 - A Southwest Virginia physician described as "a drug dealer in a suit" was convicted Tuesday of supplying narcotic painkillers to addicts posing as patients.

A jury found there was no legitimate medical purpose for 266 prescriptions written by Dr. Freeman Lowell Clark. About a third of the charges involved OxyContin, a potent painkiller that has been linked to fatal overdoses and soaring crime rates in the western tip of the state.

Clark's three-week trial in U.S. District Court in Abingdon pitted a doctor who said he was only trying to help patients in pain against the government's contention that he was no different from a street corner drug peddler.

"In essence he's just a drug dealer in a suit," Assistant U.S. Attorney Randy Ramseyer said.

Ramseyer said Clark know his prescriptions were being abused, but continued to dispense medication from offices in Wytheville, Bluefield and Bland. Witnesses testified that Clark kept his office open past midnight to accommodate a steady flow of patients who knew their next fix was just a feigned symptom away.

With OxyContin abuse being called an epidemic in the coalfields, federal authorities are cracking down on physicians who illegally prescribe the drug. Clark, 43, is the fifth Southwest Virginia doctor convicted of writing illegal prescriptions in the past two years.

Even as the jury was deliberating Clark's fate, authorities executed a second search warrant Monday against a Roanoke doctor suspected of over-prescribing the drug. Medical records, computer disks and credit card statements were seized from the home of Dr. Cecil Knox, according to court records. Knox has not been charged.

Some say that prosecutions like Clark's will discourage well-meaning doctors from prescribing OxyContin, even when they believe the drug could help patients with severe chronic pain.

"The potential for a chilling effect is huge," said Dr. Mitchell Max, medical director of the Pain Research Clinic at the National Institutes for Health in Bethesda, Md. "This is bad news for anybody who has bad back pain and goes to the doctor for relief."

Max, who testified as an expert witness for Clark, said he saw no indication of wrongdoing - except by some patients who managed to fool the doctor into prescribing their drug of choice.

"He seemed like an earnest guy who was eager to help his patients in his first practice," Max said. "It seemed to me his only possible sin was being a little too trusting."

However, a second expert opinion went against Clark. Dr. Adam Steinberg of Abingdon testified for the prosecution that Clark should not have continued to prescribe powerful narcotics to people who were clearly addicted.

In addition to OxyContin, Clark was charged with illegally prescribing Percocet, Percodan, Lortab, Lorcet, Tylox and Florinal, all Schedule II or III controlled substances. Prosecutors said the prescriptions, which involved 19 patients, began in late 1998 and continued through last year as Clark moved his practice from Bluefield to Wytheville to Bland.

Although Clark was acquitted of 30 counts, his defense attorney said the volume of charges brought made it a tough case - especially in front of a jury in an area that has been inundated by negative publicity about OxyContin.

"It's hard to battle a case when the government brings 300 counts that come clothed in public opinion," said Robert Rider of Roanoke.

"It's always hard to fight the twin sisters of fear and ignorance."

Ramseyer disputed the notion that prosecuting doctors will discourage effective pain management. He said that 99 percent of doctors prescribe drugs properly and will continue to do so. "There are exceptions in every profession, and they're the ones we're prosecuting," he said.

OxyContin has also begun to show up on civil court dockets. Last month, a $5.2 billion lawsuit filed in Lee County Circuit Court claimed that the drug's manufacturer, Purdue Pharma of Connecticut, marketed the drug excessively, making millions of dollars while failing to disclose OxyContin's highly addictive side.

The company says the lawsuit is baseless.

Since 1998, at least 43 people in Western Virginia have died of fatal overdoses from oxycodone, the active ingredient in OxyContin. Police say the drug's addictive grip has led to a dramatic increase in robberies of pharmacies, property thefts and prescription frauds.

Clark, who was taken into custody Tuesday afternoon following the jury's verdict, will likely face a sentence of between five and 15 years when he is sentenced Oct. 16, Ramseyer said.

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