Roanoke, Virginia, pain specialist Dr. Cecil Knox walked out of a federal courthouse a free man October 31. Despite a high-powered and highly-publicized prosecution of Knox as a murderous, profit-driven Dr. Feelgood, federal prosecutors failed to convict him on any of the 69 counts of illegal prescribing and associated Medicare fraud with which they had charged him. After seven weeks of testimony and more than a week of deliberations, jurors acquitted Knox of all 30 of the drug charges and were unable to reach a verdict on the remaining, mostly fraud counts.
Also walking away free were Knox's nurse, Beverly Boone, who was acquitted on 60 charges (the jury hung on one count) and counselor Willard James, who faced five fraud counts. The jury failed to reach a verdict on any of the counts against James.
Prosecutors have announced that they will retry Knox on the remaining counts in a matter of weeks, but Knox, his supporters, and the growing movement to rein in the Justice Department's aggressive stance toward pain management specialists are elated. "Right now, there is no anxiety," Knox told the Knight-Ridder newspaper syndicate. "I feel very good and very positive about the future. I think I'm going to be back, my practice will be back."
"Cecil Knox, Beverly Boone, and Willard James are real American heroes," said Siobhan Reynolds, director of the Pain Relief Network (http://www.painreliefnetwork.org), who witnessed the trial and whose organization emerged to fight just such unwarranted prosecutions. "They stood up to an overwhelming power and bet on truth and justice," she told DRCNet. "And these days, that takes a lot of courage."
The prosecution of Dr. Knox is only the latest of a string of prosecutions of pain management specialists across the country. But its outcome so far is a blow to the Justice Department's already staggering campaign against what it views as doctors running "pill mills" but what patients' and doctors' advocates see as physicians applying the latest and most effective techniques of pain management. In recent years, federal or state prosecutors have brought charges against dozens of doctors for their opiate prescription practices, while hundreds have been disciplined by state medical boards. Despite some successes, such as the murder conviction of Florida Dr. James Graves, more convictions have been overturned on appeal, and now the Justice Department has lost outright in the Knox case. Still pending is the prosecution of nationally known Virginia pain specialist Dr. William Hurwitz.
"These people should never have been prosecuted," said Reynolds, who is preparing a documentary on the plight of pain patients and doctors. "Cecil was prescribing medications in combinations and in dosages that the Justice Department doesn't agree with. Justice isn't supposed to have an opinion on medical practices, but it does. Then they bring a drug dealing case to stop this practice with which they don't agree. It's a shameful manipulation of the law," she said.
While federal prosecutors portrayed Knox as a money-hungry, conscienceless fraud, patients and other witnesses disagreed. "Over the past seven weeks, there's been a complete and total character assassination of Dr. Knox," argued Knox's attorney, Toby Anderson said during closing arguments. And from the verdicts, it appears the jury agreed.
For Reynolds, the Knox trial is just one more battle, but the war may be turning in the direction of patients and doctors. "We're making real progress now," she said. "A year ago, the DEA was running its Oxycontin campaign full-tilt and trying to evolve it into a full-blown prescription drug abuse crisis, but now they are running into significant opposition. The war on prescription drug abuse kills pain patients and is an invasion of privacy on an unprecedented level, but the pain patients are organizing now and they'll be addressing these issues more forcefully in the future."