Pubdate: Sun, 10 Mar 2002
Source: Washington Post (DC)
Copyright: 2002 The Washington Post Company
Contact:  http://www.washingtonpost.com/
Details: http://www.mapinc.org/media/491
Author: Josh White and Michael D. Shear
Bookmark: http://www.mapinc.org/find?186 (Oxycontin)

STATE AIMS TO CURB ABUSE OF PAINKILLERS

OxyContin Problem Prompts Creation of Database to Track Prescriptions

Virginia lawmakers approved a pilot program last week that will allow 
doctors, pharmacists and law enforcement agencies to better monitor the 
illegal use and abuse of potent prescription painkillers, for the first 
time creating a state database to track patients and their prescriptions 
for federally regulated drugs.

The program was developed in large part to battle the abuse and illegal 
sales of OxyContin. The powerful painkiller, praised in the medical 
community as a wonder drug for chronic pain, has fueled a wave of abuse and 
crime along the East Coast.

Legislators limited the program's scope to a rural portion in Southwest 
Virginia, where prescription drug abuse has ravaged small towns and 
overwhelmed local and state police.

The program won't touch areas of the state where OxyContin has developed as 
a significant problem, such as Prince William, Loudoun and Fauquier 
counties, where there have been large-scale thefts of the drug and 
widespread reports of abuse and illegal sales. Local, state and federal 
authorities are also looking into a slaying in Loudoun County last year in 
which the victim was an OxyContin patient. Authorities believe he might 
have been killed for his drugs.

Some lawmakers, doctors and law enforcement officials worry that abusers 
will simply drive out of the southwestern region of the state to avert the 
monitoring program, essentially pushing the existing problems into Central 
or Northern Virginia.

Federal authorities said last week that they are investigating doctors and 
pharmacists in Northern Virginia who they believe helped stoke the problem, 
writing prescriptions that were used for abuse or illegal sales in several 
states. Federal sources said they are worried that simply moving the 
problem will make it even harder to tackle.

"I would prefer that it be a statewide program because technically, the 
reason Southwest Virginia has had so many problems was that when Kentucky 
passed their law, the abusers just came here," said Del. Phillip A. 
Hamilton, (R-Newport News), chairman of the House committee that examined 
the program. "It won't impact any pharmacies outside of that region, and, 
truth be told, it's probably a bigger problem statewide than we realize. 
But this is a first step, and an important first step."

Virginia's program, modeled after initiatives in 16 states, requires users 
of all Schedule II drugs to be entered into the database, so state 
officials can easily monitor questionable activity. Other Schedule II drugs 
include morphine, PCP, cocaine, methadone and methamphetamine.

Law enforcement officials in several states have said the quest for 
OxyContin has led abusers -- who crush and snort the pills or inject them 
for a heroin-like high -- to shop for doctors willing to prescribe it. 
Abusers then go to several pharmacies in an attempt to hoard the drug, 
which has a street value that is far higher than its retail price.

Federal officials said a limited program would do nothing to stop the cycle 
of fraud.

"If it's going to happen, it needs to be statewide," said Joseph Statkus, a 
Centreville pain specialist who prescribes OxyContin for chronic pain. 
"Patients are free to go throughout the state to find physicians. We have a 
few patients from down in that area. Even if it is statewide, there's 
nothing stopping patients from crossing another border to get it."

Over the past year, crimes associated with OxyContin -- including abuse and 
illegal trafficking -- have risen sharply in Prince William. In one case, a 
Dale City mother was convicted after she sold several controlled narcotics 
to police and got her teenage son hooked on OxyContin. In Loudoun and 
Fauquier counties, police have investigated several robberies that 
specifically targeted the drug and have made arrests in some cases.

House lawmakers passed the bill after an emotional, hour-long debate last 
week. Several delegates related personal stories about their families and 
friends in urging a vote for or against the legislation.

Del. Clarence E. "Bud" Phillips (D-Dickenson) pleaded for its passage, 
saying OxyContin is a scourge on his community.

"We have women who are prostituting themselves for OxyContin," he said. "I 
have families where the husband and wife are both addicted to OxyContin. We 
have people murdered because of OxyContin."

Tazewell County Commonwealth's Attorney Dennis Lee, who is part of a 
statewide prescription drug task force that recommended the program, 
praised it. He said investigators need a way to quickly access information 
so they can put a stop to deviant behavior before it spirals out of control.

"I think it will make a tremendous difference," Lee said. "I can't think of 
a tool that would be more beneficial than this."

Some said any such program would interfere with patient privacy, while 
others said the program would create a stigma around a drug that has had 
great benefit for millions of lawful patients.

The program worries some lawmakers, who said it could deter doctors from 
prescribing appropriate drugs when they're needed. Officials with Purdue 
Pharma, which manufactures the drug, said they support such programs but 
only if they don't single out high-level pain medications and if they 
protect patients who need the drugs.

Del. Kristen J. Amundson (D-Fairfax) said her father took OxyContin during 
his two-year battle with cancer. She said doctors might be unwilling to 
prescribe such drugs if they know their patients will be entered into a 
registry.

"Once all of the drugs go into a central registry . . . it will have a 
chilling effect on a doctor's willingness to prescribe pain meds," Amundson 
said. "This legislation will have very serious unintended consequences."

Del. Ward L. Armstrong (D-Henry) begged members to defeat the legislation, 
calling it a threat to basic freedoms.

"The freedom of this country, Mr. Speaker, will be eroded from within, one 
piece of dirt at a time, just like the Grand Canyon," Armstrong said. "Why 
in the world do we need to monitor law-abiding citizens?"
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