The Fourth Circuit Court of Appeals’ decision in United States v. Hurwitz: An important victory for pain management professionals and those living with pain

The federal court system has a way of leveling the playing field between the government and defendants, and it often does so in ways that benefit nondefendant stakeholders whose interests are affected by the cases processed by the system. On August 22, 2006, the United States Court of Appeals for the Fourth Circuit, at Alexandria, Virginia, leveled the playing field between the government and defendant William Eliot Hurwitz, MD, and in doing so opened the door for pain management professionals to reclaim their right to establish generally accepted standards of care and to grow a body of experts who are willing to monitor the application of these standards, in both civil and criminal cases, by refusing to allow medical practice to be dictated merely by arbitrary numbers and combinations of drugs and by providing accurate and complete testimony in the courtroom. The future of pain management in the courtroom rests, in part, on the shoulders of this body of experts and their willingness to stand up to the government and its so-called experts, who jeopardize the interests of both pain management professionals and the patients they serve by giving testimony that falls short of expert standards. These experts will also have to navigate the final policy statement on dispensing controlled substances to treat pain, recently released by the Drug Enforcement Administration (DEA). You can read a short summary of the recently released DEA materials in Table 1.