Feb. 12, 2007 — A local doctor charged with illegally prescribing pain medications took the stand in District Court Monday, telling the jury that he is not "a drug dealer," but rather "just a trusting physician" trying to help his patients.
But the prosecutor said Dr. Paul Maynard was "motivated by greed" when he prescribed Schedule II drugs — including OxyContin (a narcotic), Vicodin and Percocet — to individuals without examining their medical records, conducting followup examinations or consulting with other professionals.
A federal grand jury indicted Maynard in 2003 on 170 counts of illegal distribution of controlled substances or derivatives — OxyContin in particular. The prosecutor, U.S. Attorney Kim Chisholm, said OxyContin caused the death of 26-year-old Aaron Houle in May 2001. (See "Indictment Can't Heal a Mother's 'Broken Heart.'")
While Houle came to the territory in part to buy the OxyContin with a prescription obtained from Maynard, Chisholm said, defense attorney Gordon Rhea described Houle as a "drug addict" who attempted to trick the doctor into giving him pain medication.
On the witness stand, Maynard said that on May 23, 2001, Houle came to his office complaining of back pain. "He said he had sustained a sporting injury," Maynard said. "I asked him what he had been taking for it, and he said OxyContin. So I examined him, and saw that his lower spine was tender. All I did was refill his medication. It was the same prescription given to him before — 40 milligrams, or 60 OxyContin tablets."
Under questioning from Rhea, Maynard said "there was no indication" that Houle was not "being truthful."
"I would not have given them to him if I knew he was going to party the next day," Maynard said.
Some published news reports said Houle died after mixing the pills with alcohol.
Maynard testified that he first learned of the drug while watching a forum on television in 1999, and "didn't know until late 2001" how "dangerous and addictive" OxyContin could be.
"In the program, it was hailed as a great drug," he said. "The best of its time. I read up a little about it and got a flier from the pharmacy about its characteristics. But because the knowledge of the drug was still evolving, I didn't know everything, including how addictive it could be."
Later in the day, however, Maynard testified that as he kept prescribing the drug, he did notice other patients — treated for ailments ranging from back pain to migraines — getting addicted to the medicine. While he encouraged those patients to enroll "in a program" to treat the addiction, Maynard said, he still continued to prescribe the OxyContin because he did not want his patients to "suffer from withdrawal."
For some patients, who testified when the trial began last week, Maynard added that he prescribed a "cocktail" of drugs, mixing OxyContin with "weaker" substances such as Vicodin or Percocet. Maynard maintained that he wrote the prescriptions to alleviate the pain of his patients, whom he said were sometimes immobilized by their conditions.
When Chisholm asked why he did not consult the medical records of his patients before prescribing the medications, Maynard said that it was "not standard practice at the time" for doctors to do so. He also said that patients "with established medical histories" were not referred to other medical professionals for further study.
Chisholm also asked how Maynard could prescribe the medications without having undergone the requisite "pain-management training."
"Most other doctors here in the V.I. haven't had that kind of training," Maynard responded, adding that he always conducts a general examination of the patient before prescribing a medication.
"We depend on our patients to be truthful and honest," he said. "I can't say that someone doesn't have pain. Once they say they do, it's my job as a physician to help them."
The trial continues at 9 a.m. Tuesday with closing arguments from the defense.
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