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.
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MAP posted-by: Jay Bergstrom