Pubdate: Sat, 18 Dec 2004
Source: Roanoke Times (VA)
Copyright: 2004 Roanoke Times
Contact:  http://www.roanoke.com/
Details: http://www.mapinc.org/media/368
Author: Laurence Hammack
Bookmark: http://www.mapinc.org/meth.htm (Methamphetamine)
Bookmark: http://www.mapinc.org/oxycontin.htm (Oxycontin/Oxycodone)
Bookmark: http://www.mapinc.org/find?136 (Methadone)

ARE DRUG DEATHS DECREASING?

Through mid-August, 136 people in Western Virginia had died  of
overdoses, according to the state medical examiner's office.

The number of fatal drug overdoses in Western Virginia, which has
increased precipitously in recent years to surpass those in the more
populous areas of the state, appears to be leveling off this year.

Through mid-August, 136 people in the region had died of overdoses,
mostly from prescription drugs such as methadone, hydrocodone and
oxycodone, according to Dr. William Massello of the state medical
examiner's office.

Last year's total was 223.

Because it takes three to four months for laboratory tests to confirm
a drug overdose, this year's total will not be known for some time.
But based on the numbers through August, and the autopsies done since
then that indicate probable overdoses, Massello said he does not
expect an increase in 2004.

"I think for the first time in about seven years we're actually going
to have a small drop in the numbers," he said.

But it will take more than a small drop to ease what Massello has
called an epidemic of prescription drug abuse. Fatal overdoses have
claimed more victims per capita in the mountains and valleys of
Western Virginia than on the streets of urban areas such as Richmond
and Norfolk.

With just 20 percent of the state's population, Western Virginia last
year accounted for 41 percent of the fatal overdoses statewide.

"Overdose drug deaths are a big problem in Southwest Virginia. Why, we
don't know, but it's got to be related to addiction," said Dr. Molly
O'Dell, director of the Alleghany Health District.

With residents of rural areas seemingly more inclined to abuse
prescription drugs, addicts have found an increased supply as the
medical community has begun to treat pain more aggressively with
opioids and other painkillers.

Continuing a trend that began several years ago, methadone is the
region's deadliest drug. The synthetic narcotic - prescribed by
doctors as a painkiller and also used to treat drug addicts at
methadone clinics - was involved in 50 overdoses through the first
eight months of 2004, Massello said.

Hydrocodone, a category of prescription painkillers that includes
Vicodin and Lortab, ranked second. It accounted for 38 fatalities.

Oxycodone, an opium-based drug that is the active ingredient in
OxyContin and Percocet, was involved in 19 fatalities.

Five years ago, oxycodone was the top killer in the region. But with
rampant abuse of OxyContin receiving attention from both the news
media and law enforcement, other drugs such as methadone have seen
wider use.

Some say a crackdown by law enforcement is one reason why drug deaths
are leveling off.

More than 20 people have been charged in recent years with
distributing drugs that led to fatal overdoses in the region. About a
half-dozen doctors have also been charged with overprescribing
medications to their drug-abusing patients.

"The more exposure it gets in the media and the news, it sends a
signal that these people will be prosecuted," said Raymond Melick,
resident agent in charge of the Drug Enforcement Administration office
in Roanoke.

While problems with OxyContin and other prescription drugs seem to
have peaked, authorities have been busy dealing with the emergence of
methamphetamine abuse in far Southwest Virginia.

Also known as meth and crank, methamphetamine is a powerful, addictive
drug that is concocted from cold medicine and household chemicals at a
growing number of makeshift labs.

But while authorities have reported a twofold increase in the number
of meth labs busted in far Southwest Virginia, the region has not seen
any fatal overdoses from the drug this year, Massello said.

Unlike prescription drug abusers, who often take increasingly large
doses as they develop a tolerance for their drug of choice,
methamphetamine users are able to sustain a high on a relatively small
amount, according to Melick.

"I don't think with methamphetamine you see the doses increasing from
a small amount to a much larger amount," the DEA agent said.

Most of the prescription drug overdoses are accidental, with users
inadvertently crossing the line between a better high and a lethal
level of consumption, Massello said.

As methamphetamine abuse grows, there is increasing evidence that
prescription drug abusers in Western Virginia are switching to the
newer drug. U.S. Attorney John Brownlee said recently that a rumor
spreading in the coalfields is that methamphetamine can cure an
OxyContin addiction.

Yet another reason for the decrease in prescription drug abuse could
be the implementation of a monitoring program designed to cut down on
doctor-shopping, in which abusers feign ailments to multiple doctors
to obtain large amounts of pills, which are then sold on the black
market.

Under the prescription monitoring program, which began in September
2003, doctors and police can obtain someone's medication records from
a computerized database compiled by the Department of Health
Professions in Richmond.

But there are limitations to the pilot program. For one thing, it
covers only the western part of the state. And the approximately 300
pharmacies in the pilot area are required to submit only prescriptions
they fill for Schedule II drugs, which include oxycodone and methadone.

Through Dec. 1, there had been 1,125 inquiries for records from the
database, which now contains nearly 500,000 prescriptions. That means
that only 1 percent to 2 percent of the doctors in the area have used
the system.

Other states with prescription monitoring programs receive many more
inquiries, and the operators of Virginia's system say expansion is the
only way to increase its use.

At a meeting last week in Roanoke, an advisory committee that has been
monitoring the system reviewed several proposed changes.

Under legislation that will be considered at the upcoming General
Assembly session, the coverage area would be expanded to include the
entire state. The system would also be broadened to include Schedule
III and IV drugs, which include the widely abused hydrocodone-based
painkillers.

Some fear that the close monitoring of doctors - and with it the
possibility of criminal prosecution - will have a chilling effect on
physicians who have only recently begun to recognize that pain is
undertreated.

According to a survey conducted by Virginia Commonwealth University,
36 percent of the doctors questioned said they have prescribed fewer
Schedule II drugs over the past three years, either because of intense
media coverage or increased criminal prosecutions.

However, other data presented to the advisory committee show that the
volume of hydrocodone and methadone in the region has increased
steadily over the past five years. After increasing by 210 percent
between 1998 and 2000, oxycodone prescriptions have since leveled off
at about 140,000 grams a year.

The dramatic increase in methadone deaths has been raised as a
criticism by opponents of the Roanoke Treatment Center, which plans to
dispense the drug at a Hershberger Road clinic to addicts of
opium-based drugs. But Massello has said that virtually all of the
methadone overdoses seen by his office involve the pill form of the
drug prescribed by doctors as a painkiller, not the liquid version
dispensed by methadone clinics.
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MAP posted-by: Larry Seguin