Pubdate: Tue, 12 Feb 2002
Source: Portland Press Herald (ME)
Copyright: 2002 Blethen Maine Newspapers Inc.
Author: Bart Jansen


WASHINGTON - Nancy Green, a nurse midwife in Calais, will tell a Senate 
panel today how abuse of the prescription pain reliever OxyContin has 
devastated rural Maine. According to Green:

Ten of the 40 births she attended last year involved mothers who abused 
opiates like OxyContin, and babies suffered narcotic withdrawal.

One of the clients Green counsels for drug abuse was desperate enough that 
she asked her for money to feed her habit. The client then turned to 
another health-care professional and asked again.

One mother of four got a prescription for legitimate pain relief. But she 
became addicted and lost her home and her children before going to prison 
for two years for supplying a habit that costs up to $500 per day.

"Believe me when I tell you that since the legal introduction and illegal 
diversion of OxyContin, a dark cloud hangs over Down East Maine and I don't 
see it clearing for a long, long time," said Green, who co-founded the 
group Neighbors Against Drug Abuse.

She will tell her story to the Senate Health, Education, Labor and Pensions 
Committee as part of the search for ways to fight drug abuse.

Sen. Susan Collins, R-Maine, a member of the committee, said she hopes to 
strike a balance between discouraging abuse and keeping the supply open to 
patients who need it.

In particular, she expressed concerns about "disturbing evidence" that 
manufacturer Purdue Pharma LP marketed the drug to family physicians 
without explaining the risks, which are familiar to pain specialists and 
oncologists who deal with such drugs routinely.

"Access to it is far easier than to drugs that we consider serious targets 
of abuse, such as heroin," Collins said.

Purdue Pharma has distributed 500,000 educational brochures to doctors and 
50,000 to pharmacists, a spokesman said. Any effort to limit distribution 
to certain doctors might also limit access to patients in rural areas, the 
spokesman said.

"In my view, no other company has done so much so quickly to respond to 
abuse as we have," said Tim Bannon, a Purdue spokesman.

Nobody disputes that the drug - an opiate like heroin - is effective. The 
12-hour time-release formula made the drug attractive to doctors and 
legitimate patients.

But if the pills are ground up, the effect is immediate. Addicts snort the 
powder or mix it with water to inject it like heroin.

Addicts have turned to falsifying prescriptions, crossing into Canada or 
robbing pharmacies, demanding the drug by name. The pills sold in 10 
milligram to 80 milligram doses are worth as much as $1 per milligram on 
the black market.

One of the country's hardest hit areas for abuse is Maine's Washington 
County, a rural area the size of Rhode Island with only 35,000 residents. 
High unemployment and poverty, coupled with easy border crossings to 
Canada, made the county one of the first places in the country where 
illegal abuse surfaced.

The number of Mainers admitted to drug treatment for opiates including 
OxyContin rose from 232 in 1995 to 1,299 last year, according to the 
Substance Abuse Services Commission and Maine Office of Substance Abuse.

Washington County saw the steepest rise, from nine cases to 144. But 
Cumberland County also rose sharply, from 103 to 386.

At the same time, arrests for synthetic narcotics climbed from 115 in 1995 
to 239 in 2000, the last year for which statistics were available. 
Washington County's cases again jumped the most, from seven to 58. The 
number of cases in Cumberland County rose from 16 to 50.

The state commission, Purdue and Green urged more treatment and education 
programs for addicts as well as increased law enforcement to deter abuse 
and prescription tracking to detect abuse.

Bannon, the company spokesman, said the problem with addicts chopping up 
the pills wasn't obvious at first. The company has spent $100 million 
developing new forms of abuse-resistant pain relievers, he said.

"If you make a legitimate product, there will be people who find a way to 
misuse it," Bannon said. "It's a constant chess game."
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MAP posted-by: Jay Bergstrom