Pubdate: Sun, 06 Jan 2002
Source: Columbus Dispatch (OH)
Page: 01A
Copyright: 2002 The Columbus Dispatch
Contact:  http://www.dispatch.com/
Details: http://www.mapinc.org/media/93
Author: Misti Crane and Bruce Cadwallader, Dispatch Staff Reporters
Bookmark: http://www.mapinc.org/find?186 (Oxycontin)

MORE OVERDOSE DEATHS BLAMED ON PAINKILLER

Abuse of the prescription painkiller OxyContin first snaked its way into 
Ohio a couple of years ago, hitting hardest near the Kentucky border, where 
it poisoned Ohio river towns before creeping north.

In central Ohio now, illegal use is becoming more common, and the death 
toll from accidental overdoses is mounting, county coroners say. Reports of 
abuse throughout the state have been coming into Ohio's Substance Abuse 
Monitoring Network.

"OxyContin is picking up speed in terms of its availability and use," said 
Stacey Frohnapfel, spokeswoman for the Ohio Department of Alcohol and Drug 
Addiction Services.

The medication intended to ease chronic suffering -- and heralded by some 
patients as a godsend -- has emerged nationwide as many addicts' new pill 
of choice.

Oxycodone, the active ingredient in OxyContin, showed up in 36 of the 
Franklin County coroner's 1,216 cases where toxicology tests were performed 
last year. Of those people, 16 took fatal doses of the drug, according to 
autopsy reports.

James Ferguson, the chief toxicologist for the Franklin County coroner's 
office, is concerned about seeing the drug in more bodies at the morgue.

"I find it is an alarming trend since we only found (oxycodone) in one case 
in 1995 when it was introduced and up to 40 cases this year," Ferguson 
said. "It is now in our top 10 list of drugs found in overdoses."

Of the 16 fatal overdoses, nine occurred in Franklin County. They consisted 
of six accidental overdoses, one suicide, one homicide and one undetermined 
cause of death with a toxic level of the drug. The other seven oxycodone 
overdose cases were autopsies for other counties.

Federal drug agents have estimated that OxyContin has played a role in the 
overdose deaths of at least 296 people since January 2000.

Prescription drug abuse is nothing new. Drugs such as morphine, Dilaudid 
and Percocet have long found their way into the wrong hands.

Experts originally thought that OxyContin would be less prone to abuse 
because its narcotic is locked in a time-release formula. However, abusers 
found that they can crush the tablet and then swallow, inhale or inject the 
powder to give themselves a powerful high.

Like other pharmaceutical medications turned street drugs, OxyContin 
reaches addicts in a variety of ways: through theft; through people duping 
doctors into writing prescriptions; and, in rare cases, through wayward 
doctors.

"We know there have been multiple pharmacy break-ins and robberies where 
the only thing taken was OxyContin," Ferguson said.

No Ohio physicians have been punished by the Medical Board for illegally 
prescribing the drug. One Scioto County doctor voluntarily gave up his 
medical license after he was convicted last February of illegally 
trafficking in painkillers, including OxyContin, to nonpatients.

It's likely that some doctors have been duped into writing prescriptions 
for patients who didn't really need the painkiller.

Dr. Robert M. Taylor, medical director of Mount Carmel Hospice and 
Palliative Care Program, said doctors rely, for the most part, on instinct 
when trying to make sure painkillers aren't being abused.

"A person taking it can intentionally misuse it, and how does a physician 
anticipate that?" he asked.

"Your first inclination is to take the person's word about their pain."

Sometimes, doctors use drug tests to monitor how much painkiller patients 
are taking.

Taylor said he has, on rare occasion, asked patients to sign contracts that 
say they understand the risks of taking the medication and agree to rules 
about taking it.

State Rep. Tom Raga wants to take some of the guesswork out of doctors' 
jobs, and keep abusers from visiting several different doctors for 
OxyContin prescriptions. He plans to introduce legislation aimed at 
tracking prescriptions.

Raga, a Republican who lives in Mason, said he's still awaiting a final 
draft of the bill, but the goal is to provide law-enforcement officials and 
doctors with a database of prescriptions written in Ohio. The Pharmacy 
Board would keep the information; Raga said the idea came from the Warren 
County Drug Task Force.

In other states -- particularly in Kentucky, which has seen a rash of 
OxyContin abuse -- such tracking systems have helped.

"They have one of the best if not the best system in the country," Tim 
Benedict, assistant executive director of the Ohio Pharmacy Board, said of 
Kentucky.

"If I walk into my doctor's office and complain of pain or whatever, the 
doctor has a way to check if I've been visiting other doctors and what 
controlled-substance prescriptions I've gotten recently."

Officials at Purdue Pharma, the Connecticut manufacturer of OxyContin, 
support such prescription oversight.

"You hate to see anyone go out there and not get the care they should be 
getting," Benedict said. "But on the other hand, doctors need to be careful."

Keeping too tight a hold on prescription pain drugs to keep them out of 
addicts' hands hurts those in pain who have done nothing wrong, he said.

"(OxyContin) was a big breakthrough to be able to manage someone's pain on 
a continual basis," Benedict said. "This drug basically has taken (some 
patients) from 'Why do I want to continue to live?' to looking forward to 
every day. They have a life."

Ferguson said he has told Purdue Pharma that the number of toxic cases is 
beginning to mount.

The company has requested copies of all Franklin County autopsies involving 
toxic levels of oxycodone.

The government requires that whenever a drug company hears of an adverse 
effect attributed to a drug that company produces, it must file a report. A 
company spokesman said the Franklin County requests are routine.

In the past couple of years, OxyContin has been making headlines, and the 
company has spent much time defending its importance in treating pain.

Purdue Pharma is working to develop a drug that will deactivate if not 
taken as directed. In December, the company reported that more than $50 
million had been devoted to those efforts.

In the meantime, patients suffering from debilitating pain are comforted by 
OxyContin and should not be robbed of its benefits, said Dr. J. David 
Haddox, the company's senior medical director for health policy.

"Some of these people really have a bad life, they're really suffering," he 
said. "When people start trying to vilify the drug, that really bothers me."
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MAP posted-by: Terry Liittschwager