Pubdate: Tue, 20 Nov 2001 Source: Orlando Sentinel (FL) Copyright: 2001 Orlando Sentinel Contact: http://www.orlandosentinel.com/ Details: http://www.mapinc.org/media/325 Author: Doris Bloodsworth 2 LEGAL DRUGS KILL MORE Deaths from abusing legal prescription drugs in Florida surged during the first half of the year, while fatalities from illegal drugs held steady or declined. And although drug experts are concerned about the deadly persistence of heroin -- blamed for killing 19 people in the Orlando area -- they are especially troubled by the dramatic rise in deaths from lethal doses of the painkiller oxycodone and its cousin hydrocodone. These findings, part of an assessment by state medical examiners of drug-related deaths during the first half of 2001, show that in Central Florida, at least 56 people died from January to June from fatal doses of the two painkillers. That was up from 46 deaths from the prescription drugs during the final six months of 2000. Across Florida, 165 people died from oxycodone and another 75 from hydrocodone during the first six months of the year. The two drugs killed 152 people across the state during the last six months of 2000. The powerful drugs -- sold under brand names such as OxyContin, Percocet, Lortab and Vicodin -- were not even tracked by the state until July 2000. That's when Purdue Pharma of Stamford, Conn., started manufacturing its 160-milligram version of OxyContin -- and when law- enforcement officials saw a surge in abuse and illegal trafficking of the drug. Relief for extreme pain The synthetic narcotic, the nation's top seller, became immediately popular with patients because of the relief it afforded people with cancer and others with extreme, chronic pain. But the pills also became the drug du jour among addicts who liked the euphoric high OxyContin produced. That surge is prompting Florida's attorney general to launch an investigation into how OxyContin's manufacturer markets the drug and the incentives it offers doctors to write prescriptions. "We're trying to reduce the illegal diversion of the drug OxyContin to unauthorized persons," said David Aronberg, assistant attorney general for economic crimes. Legal painkillers have long been a drug of choice among addicts, but the trend has surged with the emergence of OxyContin, officials say. Drug agents describe prescription-drug abuse as "very underrated" and say a soaring appetite for oxycodone and hydrocodone on the street has put a new face on drug addiction. "Executives, cops, doctors, pharmacists, lawyers -- I've arrested them all," said Orlando police Detective Lloyd Randolph, who arrested a 29- year-old Orlando woman Tuesday for trafficking hydrocodone. Drug maker cooperates So far, Purdue Pharma has cooperated with Florida authorities. "The abuse of prescription drugs and OxyContin is a problem that we take seriously, especially since kids make up almost half of the first-time prescription drug abusers," said Purdue executive vice president Dr. Paul Goldenheim. To demonstrate its concern, since Nov. 12, Purdue Pharma has run radio advertisements in Palm Beach County and three other areas in the country to discourage teenagers from illegally using prescription drugs. Palm Beach County, where 54 people died from overdoses of oxycodone during the first six months of the year, leads the state in painkiller abuse. For recovering addicts, the investigation is welcomed. A Lake Mary man, who is drug-free after getting hooked on oxycodone and hydrocodone six years ago when he took Vicodin for pain after a back injury, said those making a profit should help curb the illegal use of prescription drugs. "As far as I am concerned, they are the supplier," said Philip, 30, about drug stores and pharmaceutical companies. He asked that his last name not be used to protect his family and livelihood. "And like drug dealers on the street, they should be held accountable," he said. The state report shows that illegal street drugs remain a problem in Central Florida, especially the flourishing heroin trade in Orange County. Cocaine deaths drop Cocaine deaths, however, dropped from 34 to 24 in the region. Ecstasy deaths were cut in half, from 10 to five.But it is prescription drugs that are the target of a host of lawsuits around the country. And drug agents have become increasingly aggressive, as reflected in the first- degree murder charges filed against a West Palm Beach doctor who was accused this summer of improperly prescribing OxyContin. Counselors at The Center for Drug-Free Living in Orlando said that although many of the addicts it treats start with legitimate prescriptions, they eventually turn to the black market on the streets to purchase prescription drugs illegally. Orlando drug agents said a 40-milligram dose of OxyContin in Orlando costs about $40, and 80-milligram pills can go for up to about $160 apiece or $16,000 for a bottle of 100 doses on the black market. At the drug store, a prescription for the same item would be about $900. When the state first started counting deaths attributed to the painkillers last year, many experts thought deaths were caused by users' crushing the tablets and snorting them in order to get an intense and sometimes deadly euphoria. Federal study But in recent weeks, a federal review of autopsy reports around the country showed that almost all the deaths attributed to OxyContin were of people who swallowed the pill whole or crushed it into powder and mixed it with food or drink. The federal study was the first to look into links between overdose deaths and a brand-name drug. Of the 282 people whose deaths were associated with OxyContin, fewer than 10 were intravenous drug abusers and only one likely snorted the drug. The negative attention surrounding OxyContin has caused alarm in pain- management circles, where people suffering chronic pain say they depend upon OxyContin and similar drugs in order to function. They fear the autopsy reports and other negative publicity will make it impossible to get drugs that deliver relief from disabling pain. Those fears aren't completely misplaced. A growing number of doctors, such as orthopedist Dr. Tom Winters in Orlando, do not prescribe OxyContin because of its addictive history. And Florida along with a handful of other states restricts the amount of OxyContin that Medicaid patients can receive in a month without approval. Last Friday, a national task force on prescription-drug abuse began looking into problems with OxyContin. "The goal is not to shut down the company or ban the drug," Aronberg said about the investigation he's leading. "We want to protect the patients who need the drug while restricting access to abusers." - --- MAP posted-by: Keith Brilhart