Pubdate: Sun, 28 Oct 2001 Source: Chicago Tribune (IL) Copyright: 2001 Chicago Tribune Company Contact: http://www.chicagotribune.com/ Details: http://www.mapinc.org/media/82 Author: Barry Meier, New York Times News Service DRUG SUSPECTED IN 282 DEATHS OxyContin Abuse A Rising Concern An extensive federal review of autopsy data has found that the powerful painkiller OxyContin is suspected of playing a role in the overdose deaths of 282 people in the past 19 months, more than twice the number in some previous estimates. The analysis also found that virtually all the deaths were of people who swallowed the pill whole or crushed into powder, further suggesting that OxyContin misuse may be difficult to curb. Previously, the overdose deaths were thought to be people who injected or snorted crushed pills, which offers a quicker, more dangerous delivery of the drug. Asa Hutchinson, the nation's top drug enforcement official, recently called the new finding "startling." The drug manufacturer, Purdue Pharma, acknowledged recently that even after reports that OxyContin had been getting into the wrong hands, the company continued to distribute free seven-day supplies through doctors as part of promotional campaigns. This Drug Enforcement Administration study is first to explore links between overdose deaths and a brand-name drug. Previous reviews had looked only at drugs' active ingredients, used by many manufacturers. Besides the 282 deaths, which often also involved other drugs and alcohol, federal officials said they found that 500 people had died since the start of 2000 from overdoses involving oxycodone, the active narcotic in OxyContin and other popular painkillers. Federal officials could not say whether the oxycodone linked to those deaths was from OxyContin, a drug for the treatment of severe and chronic pain. "This verifies the fear and concern that we have had about this drug," Hutchinson said. Dr. David Gauvin, a pharmacologist at the DEA, said medical examiners in 30 states had reported about 1,010 overdose deaths involving oxycodone since January 2000. Based on responses to date, the agency concluded that OxyContin was "directly linked" as a factor in 110 overdose deaths because tablets were either found in a person's stomach or a prescription for the drug was found on a body. Other confirmation came from reports on interviews with witnesses. Dr. Paul Goldenheim, the vice president for research and development at Purdue Pharma, said DEA's data were consistent with the company's findings. But he emphasized that none of the information implicated OxyContin in any of the reported deaths. Federal officials have said that abuse of OxyContin has grown faster than abuse of any other prescription drug in decades. Purdue Pharma heavily promoted the drug as safer than other narcotics because its active ingredient was in a time-release mechanism. But abusers quickly learned that crushing the pill disarmed that feature. The company's salespeople gave doctors promotional material about OxyContin that contained cards, which were given to patients along with a prescription. A patient would take the card to a pharmacy for free dosages. Michael Friedman, the chief operating officer of Purdue Pharma, based in Stamford, Conn., said the sampling program was used to acquaint patients with the drug. He said the company had begun a new card program in July but stopped it a few days later when the Food and Drug Administration placed the highest possible warning on OxyContin's label. Asked why Purdue continued to offer free supplies in the face of mounting reports of abuse, Friedman said he considered the people receiving the cards from doctors to be legitimate patients. He estimated that the company had run four or five similar marketing programs for the drug in recent years and that 8,000 to 15,000 cards were distributed each time. "The fact that we're providing a sample to a patient has no connection to some criminal doctor who was taking money for prescriptions," Friedman said. - --- MAP posted-by: Keith Brilhart