Pubdate: Tue, 10 Jul 2001 Source: Inquirer (PA) Copyright: 2001 Philadelphia Newspapers Inc Contact: http://inq.philly.com/content/inquirer/home/ Details: http://www.mapinc.org/media/340 Authors: Elisa Ung and Mary Anne Janco OXYCONTIN PUTS REGION IN SPOTLIGHT Deaths Linked To The Narcotic Show Abuse Is On The Rise. A spike in Delaware County deaths linked to abuse of the oxycodone family of prescription painkillers - including the powerful drug OxyContin - indicates that the number of such deaths in the Philadelphia region may be increasing, authorities said yesterday. The number of oxycodone-related deaths reported by medical examiners throughout the eight-county region in 1999 already led the nation, a federal drug-abuse survey showed. Delaware County District Attorney Patrick Meehan, who is expected to be nominated as U.S. attorney in Philadelphia, said most of the county's 22 oxycodone-related deaths in the last 18 months - many involving other drugs as well - were among middle-aged white males. But, he said, recent anecdotal evidence shows OxyContin abuse increasing among the county's teenagers. The youngest Delaware County fatality reported was 19. "It's now moving beyond the scope of the abuser population and into the potential where it's going to become a club drug, something that's going to be available to teens and people in their late 20s . . . operating out there on the club drug circuit where drugs are used for recreation," Meehan said at a news conference held yesterday morning to announce a county educational offensive against the drug. "We don't want the people of Delaware County to belong to a club whose first stop is right here," he said while standing in front of the county morgue. A federal database of reports from medical examiners around the nation for 1999 shows the Philadelphia region reporting more oxycodone-related deaths than any other metropolitan area, with 42 deaths for the two years. OxyContin was introduced by Purdue Pharma of Stamford, Conn., in 1996 as a 12-hour timed-release painkiller for cancer patients and others with moderate to severe pain. Since then, law-enforcement authorities in the Philadelphia area, like their counterparts nationally, have reported heavy abuse of the medication because it gives a heroinlike high. One federal drug-abuse survey in 1999 found that 221,000 people nationwide reported abusing OxyContin, obtained both legally and illegally, at some point. In Washington, the director of the federal Center for Substance Abuse Treatment said yesterday that he was not surprised by the rate of fatalities in Delaware County. "There has been a dramatic increase in oxycodone-related consumption . . . and most people believe it is attributable to OxyContin," said H. Westley Clark. Oxycodone-related deaths have risen in Philadelphia, according to Jeff Moran, a spokesman for the Medical Examiner's Office. This year, he said, the city had logged 40 deaths as of June 27 in which toxicological tests revealed the presence of oxycodone, up from 41 in all of 2000 and 17 in 1999. State drug agents blamed at least six of those deaths this year in the city's Fishtown, Port Richmond and Kensington neighborhoods on OxyContin abuse. And Montgomery County Coroner Halbert Fillinger said yesterday that 10 deaths so far in 2001 have been caused primarily by oxycodone, three of them suicides. Medical examiners say autopsies can measure the presence only of oxycodone, the active ingredient in OxyContin as well as such brands of painkillers as Percocet and Percodan, but cannot identify the particular brand-name drug. While Percocet and Percodan have 4 to 5 milligrams of oxycodone per pill, OxyContin tablets have as much as 10 to 160 milligrams, authorities say. Abusers get the full impact of OxyContin, known as "Oxy" or "OC" on the street, when they chew or crush the drug to snort or inject it. Delaware County officials say they believe OxyContin is to blame for most of the county's oxycodone-related drug deaths. "Percodan and Percocet have been out there for a while, and all of a sudden we have a spike [in deaths] with the availability of OxyContin," said Fredric Hellman, the county's medical examiner. Meehan said that authorities do not know where the county's abusers are getting OxyContin but that he believes there are three sources: legitimate prescriptions diverted for abuse; illegal prescribing or dispensing by doctors or pharmacists; and thefts from drugstores or diversion from drug deliveries. Meehan and Hellman spoke out the same day that a Bucks County pharmacist, Lewis Winokur, was ordered to stand trial on charges that he manufactured bogus prescriptions on his home computer and sold them for $50 to $100 each. Another Bucks County medical professional, Bensalem physician Richard G. Paolino, is accused of dispensing thousands of prescriptions for OxyContin and other drugs to a parade of "patients," many of them from Fishtown, Port Richmond and Kensington. Paolino is in prison awaiting trial on charges that he practiced medicine without a valid license. Meehan said many teenagers have the misconception that because it is a prescription drug, OxyContin is safer than such drugs as cocaine or heroin. But, he said, many OxyContin abusers later turn to heroin. "In the words of one DEA agent, no other drug over the past 20 years has been so rapidly abused in such a short period of time after its release," Meehan said. Purdue Pharma officials have emphasized that many oxycodone-related deaths occur when the drug is mixed with other drugs or with alcohol. The company also insists the medication has great value for cancer patients and other pain sufferers. "All of these deaths are tragic," said James Heins, a spokesman for Purdue Pharma. But, he said, "the unfortunate side effect is that doctors are scared to prescribe it and patients are afraid to take it." In March, Purdue introduced tamper-resistent prescription pads, with special security features that resist photocopying and scanning. As of June 27, 240 doctors in Pennsylvania began using the pads, which are awaiting approval by the state Boards of Pharmacy in New Jersey and Delaware, Heins said. Delaware County's educational offensive, which begins today at a County Council meeting, will include schools, drug-and-alcohol treatment centers, the medical society and pharmaceutical community. Of the county's 17 oxycodone-related deaths in 2000, the drug was listed as a contributing factor in 14. Three more showed the presence of oxycodone, but not as a primary cause. Of the five deaths this year, oxycodone was listed as a contributing factor in four. In contrast to the 22 deaths reported since January 2000, only five oxycodone-related Delaware County deaths were reported in 1999 and two in 1998. Bucks County has reported 12 oxycodone-related deaths in 2000 and two this year. Chester County has seen one oxycodone-related death in 2000 and one so far this year. In 1999, Chester County reported nine fatal overdoses by prescription medication, most of them blamed on oxycodone. In New Jersey, Gloucester and Camden Counties report no such deaths in either 2000 or this year. No figures were available last night for Burlington County. "This is a legitimate pain medication that is suddenly being abused and we need to figure out how to return it to its legitimate use," Clark said. - --- MAP posted-by: Jay Bergstrom