Pubdate: Tue, 09 Apr 2002 Source: Morning Call (PA) Copyright: 2002 The Morning Call Inc. Contact: http://www.mcall.com/ Details: http://www.mapinc.org/media/275 Author: Hal Marcovitz Bookmark: http://www.mapinc.org/find?186 (Oxycontin) DOCTOR: DRUGS, ILLS DIDN'T MATCH Prescription abuse expert testifies at Bucks OxyContin trial that early refills indicated misuse. Robert Cipollini walked into Dr. Richard Paolino's office complaining about a bee sting. He walked out with a prescription for Xanax, a powerful anti-anxiety drug usually administered to people exhibiting panic attacks. "There is nothing in his diagnosis that shows acute panic attacks or anxiety," Dr. William Vilensky, a nationally recognized expert on abuse of prescription drugs, testified Monday in Bucks County Court. Cipollini later received prescriptions for OxyContin, the powerful painkiller sought by drug abusers because it can deliver a heroin-like high. Vilensky said Paolino wrote an OxyContin prescription for Cipollini when the patient requested a refill just 21 days into a 40- day prescription. "It indicated there was too much medicine being used or something else was being done with it," Vilensky said. Cipollini provided that answer himself last week. The witness testified that he was selling his bottles of OxyContin and Xanax to Severio "Sammy" Borelli of Philadelphia, who recently died of an overdose. Cipollini said Borelli paid him as much as $1,500 a bottle for OxyContin, and that he obtained nine of 10 prescriptions from Paolino for the drug. Cipollini said Borelli sold the drug on the street. Vilensky testified as the trial of Paolino and Dr. Wesley Collier moved into its second week. The two physicians are charged with selling prescriptions for OxyContin and Xanax to drug dealers, who allegedly obtained the prescriptions from Paolino's clinic in Bensalem Township simply by paying the cost of a $60 office visit. On the street, OxyContin brings a price of as much as $80 a dose. Paolino lost his license to practice medicine in the fall of 2000, but allegedly continued to see patients and write prescriptions until his arrest in March 2001. In early 2001, Paolino allegedly enlisted Dr. David Harmon and later Collier to sign blank prescription forms because pharmacies had begun to refuse to fill prescriptions bearing his signature. Harmon pleaded guilty in February. Vilensky has degrees in pharmacology and osteopathic medicine, and has served on the faculties of several medical schools in New Jersey. He has testified in about 400 criminal and civil trials, and was enlisted by prosecutors in Bucks to study the charts of Paolino's patients and render opinions on whether the heavy doses of OxyContin and Xanax prescribed were justified according to Paolino's notes on the charts. In Cipollini's case, Vilensky said, the 25-year-old Philadelphia man received Xanax after complaining of a bee sting in April 2000. By the fall, he also was prescribed OxyContin after complaining of back pain. Paolino performed a cursory examination on Cipollini, and started him out at an 80-milligram dose of OxyContin, which is the strongest dose available on the market. "On the first complaint he gives him the strongest stuff," said Vilensky. "He starts him out with the atomic bomb without knowing if a cap gun would work." According to the medical records, Vilensky said, Cipollini continued to see Paolino into the early months of 2001. Unknown to Paolino, by that time Cipollini had been recruited by the U.S. Drug Enforcement Administration to obtain OxyContin prescriptions from the physician. By January 2001, Vilensky said, Cipollini had been prescribed heavy doses of both OxyContin and Xanax and was coming into the office for refills weeks ahead of schedule. "That should have indicated to Dr. Paolino that his patient was taking twice as much as what was prescribed," said Vilensky. "That didn't faze him, because he gave him another prescription. He was either taking twice as many tablets or was diverting them." - --- MAP posted-by: Jay Bergstrom