Pubdate: Thu, 20 Jun 2002
Source: Inquirer (PA)
Contact:  2002 Philadelphia Newspapers Inc
Author: Larry King, Inquirer Staff Writer
Bookmark: (Oxycontin/Oxycodone)


Richard Paolino, once considered the area's top illicit supplier of the
narcotic painkiller OxyContin, has been jailed since his arrest in March
2001. The former Bensalem doctor is set to be sentenced today, and he could
spend the rest of his life behind bars.

But sidelining Paolino apparently has done little to slow the abuse of
oxycodone - the active ingredient in OxyContin and similar drugs - which can
give a heroin-like high if taken incorrectly.

"I don't want to underestimate the impact of his arrest," said Philadelphia
Police Inspector Jeremiah Daley, until recently in charge of the city's
narcotics division. Paolino "was a huge purveyor, but I also don't want to
say that his arrest and conviction ended the problem."

According to a survey of coroners and medical examiners, the drug caused or
contributed to at least 92 deaths last year in the eight-county Philadelphia
region, up slightly from 2000.

>From a bustling family practice on Hulmeville Road, the physician wrote
hundreds of unnecessary prescriptions for OxyContin, a potent, time-release
form of oxycodone. Much of it turned up in blue-collar city neighborhoods
along the Delaware River, until conscientious pharmacists called federal
drug agents.

Paolino, 59, never was charged with any deaths, but "there will be some
lives saved as a result of his arrest," Bucks County District Attorney Diane
E. Gibbons predicted last year.

While that may be, police say other illicit sources have taken his place.

In 2000, the Philadelphia Medical Examiner's Office found oxycodone in 41
cases. How many of those deaths were brought on by the drug is not known; no
such breakdown was done then.

But by any measure, the toll rose last year, when 47 city deaths were
blamed, at least in part, on oxycodone, an ingredient used in a number of
other prescription painkillers, including Percocet.

This year is looking even darker, with 22 oxycodone-related deaths in
Philadelphia through March.

Things were better in the Pennsylvania suburbs. Last year's 21
oxycodone-related deaths across Bucks, Chester, Delaware and Montgomery
Counties marked a 40 percent drop from 2000.

"I think [drug abusers] got a little scared," said Halbert E. Fillinger Jr.,
medical examiner in Montgomery County, which, after eight oxycodone deaths
in 2000, had none last year.

In South Jersey, fatalities increased from 15 in 2000 to 24 last year across
Burlington, Camden and Gloucester Counties, led by Camden's 11 deaths.

"There's a surprising amount of oxycodone on the street," said George Mosee,
the Philadelphia deputy district attorney who supervises narcotics
prosecutions. "I say surprising because it shouldn't be that easy to get."

In fact, the supply is soaring. Sales of OxyContin, first marketed in 1996,
hit $1.2 billion last year.

OxyContin is especially prized by abusers for its heroin-like euphoria. The
pills contain large doses of pure oxycodone, but with a time-release coating
for meting out 12-hour pain relief.

Abusers break the coating to get the hit of a full dose at once, sometimes
with fatal results.

The federal Drug Enforcement Administration announced in April that
OxyContin may have played a role in 464 deaths across the country in

For the first time, the DEA specifically tied OxyContin to 146 of those
deaths, meaning oxycodone helped cause the death and that some evidence of
the product - a tablet in the body, a prescription, a witness's account -
verified its use.

An additional 318 deaths were labeled "OxyContin likely," meaning oxycodone
was found in the body but that aspirin or acetaminophen were not. Those
substances are found in other oxycodone-based drugs, such as Percocet, but
not in OxyContin.

"The recent media reports of 'hundreds of deaths' attributed to OxyContin
can now be substantiated by credible scientific evidence," the DEA report

The statistics were culled from a voluntary survey of medical examiners in
32 states, but DEA officials could not say how much of the populace it took

OxyContin's manufacturer, Purdue Pharma Inc., has assailed the study as
flawed. It hired a private-investigation firm to collect similar data from
medical examiners, but has not completed its analysis, spokesman Timothy
Bannon said.

"We have been frustrated, having asked DEA to share their data, and they
have refused," Bannon said.

Purdue Pharma, he said, backs several initiatives to restrict oxycodone
abuse, such as electronic registration of patients' prescriptions. The
company also is trying to make an abuse-resistant OxyContin pill that would
disable its active ingredients if it were crushed.

Relatively few deaths result from oxycodone abuse alone, local statistics
show. More often it is found comingled with alcohol or other drugs in an
overdose victim's body.

The Food and Drug Administration has said it sees no reason for people using
OxyContin as prescribed to worry.

For those who abuse it, police say, the publicity given the Paolino case has
at least provided a cautionary tale.

"The word got out that this is not small-time pill-popping, but that it can
be deadly," Daley, the Philadelphia police inspector, said.

Paolino, convicted of trafficking in OxyContin and other prescription drugs,
could be given so many years in prison today that he would effectively be
given a life sentence.
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