To many of his patients, he was the savior who rescued them from the misery of unbearable pain, but to others, he was an amoral drug dealer who played fast and loose with people’s lives.
The story of William Hurwitz’s imprisonment for excessively prescribing painkillers is emblematic of the US’ burgeoning opioid crisis and the dilemma it presents doctors seeking to manage pain responsibly.
Dr Feelgood, which premiered last week at the Los Angeles Film Festival, examines what has been described as the worst drug crisis in US history through the lens of Hurwitz’s trial in 2004 for trafficking.
“He is a demon — what he has done to my family and the other families,” said Paul Nye, whose wife overdosed on the potent opioid OxyContin and died.
“He gave her 200 OxyContin pills the first time she saw him. Two weeks later he doubled that, two weeks later something like four times that,” added Nye, whose his wife had been suffering from back pain.
The documentary follows the physician’s run-ins with the authorities, his conviction in 2004, his appeal and the retrial that saw his 25-year prison sentence reduced to four years.
However, it also lays bare the quandary for doctors duty-bound to relieve pain and yet required by law to take into account the possible ill effects of over-prescribing or supplying drugs to the wrong people. According to the Centers for Disease Control and Prevention, opioids — including prescription pain relievers and heroin — killed more than 28,000 people in the US in 2014, more than in any other year on record.
Death rates are higher than those from road accidents or AIDS at its peak, and the crisis has prompted urgent calls for action.
The epidemic has been growing gradually since the 1990s, but really took a firm foothold in the public consciousness in April when rock musician Prince died of an overdose.
In the late 1990s and early 2000s, Hurwitz was one of the US’ pre-eminent specialists in pain and its treatment with pharmaceuticals. He came to the notice of the Virginia Board of Medicine, who suspended his license on several occasions, and eventually the police, when two patients died and it became clear his pills were reaching the black market. Yet Hurwitz was a polarizing figure who was as much lauded as condemned.
“I was bedridden — I was wearing diapers,” said Molly Shaw, one of the physician’s patients, who was suffering chronic pain due to a condition of the nervous system.
Tears streaming down her cheeks, Shaw described her pain as worse than childbirth, but said Hurwitz “really gave me my life back.”
“The thrust of the film is to say it is not as simple as ‘pharmaceutical companies and doctors created a nation of addicts,’” first-time director Eve Marson said.
The 34-year-old Marson said she was made aware of the US’ opioid problem by friends who were medics and every day saw people addicted to pills.
“If you are a doctor, here are these pills that are incredibly effective at treating pain and people come to you,” Marson said.
“One American in three suffers from chronic pain and you want to help them relieve this pain — that is why you became a doctor. And at the same time, how can you do this while being sensitive to not creating addiction?” she added.
Hurwitz has always maintained he acted in good faith, saying it was not his job to check up on who was using their medication responsibly and who was dealing.
However, he admitted to having possibly solved this dilemma “too easily, choosing to trust the patients” who sometimes abused the medication or sold their pills on the black market. Hurwitz said the crusade against him and other doctors had done nothing to stem the surge of opioid overdoses or the growth of the black market.
Hurwitz believes that while overdoses are given many column inches, suicides linked to untreated chronic severe pain are largely ignored. Other patients are refused painkillers and turn to the black market for drugs sometimes cut with substances like fentanyl, which is up to 50 times more potent than heroin, he said.
In an attempt to curb the epidemic, health authorities have issued guidelines to reduce the duration of prescriptions and try to reduce the number of pills in circulation. However, Marson believes better sharing of patient information is also key, as it would stop some addicts and dealers going “shopping from one doctor to the other” to amass stockpiles of pills.
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