Pubdate: Mon, 14 Aug 2006 Source: Times Leader (Wilkes-Barre, PA) Copyright: 2006 The Times Leader Contact: http://www.timesleader.com/ Details: http://www.mapinc.org/media/933 Author: Rory Sweeney Bookmark: http://www.mapinc.org/heroin.htm (Heroin) FENTANYL'S TENTACLES GROWING IN REACH Strong Painkiller Is Linked With Local Heroin Deaths And Illegal Possession By Nurses When a wave of fentanyl-related overdose deaths rolled eastward earlier this year, the painkiller made headlines as the newest pharmaceutical to hit the streets, with a deadly efficacy and a rising demand. But the highly potent opiate has been abused for years - even here in Luzerne County - and that abuse hasn't been limited to the archetypical addict. Illicit use of the analgesic in the medical profession was first noticed in the mid-1970s, less than two decades after its initial synthesis, and persists today, according to the U.S. Drug Enforcement Administration. Abuse in the health sector locally has existed since at least 2004, when a nurse was punished in response to a conviction for illegal possession of fentanyl. Another nurse was suspended for the same reason earlier this year. Neither conviction stemmed from drug thefts in Luzerne County. In April, the Pennsylvania State Board of Nursing suspended Theresa Kamus-Kelly's license for three months and ordered the Kingston woman to serve three years of probation. Two years ago, the board revoked the nursing license of Drums native Paul A. Colasurdo for stealing fentanyl patches from his job to feed his fentanyl addiction. While fentanyl abuse is "rare," DEA public information officer Bill Hocker said it's been a particular problem among medical professionals. A survey published in a 2002 issue of the journal Anesthesia & Analgesia analyzed drug use by anesthesiologists at U.S. academic medical centers. The study, which reported abuse by 1 percent of faculty members and 1.6 percent of residents, found fentanyl was the favorite controlled substance. But it wasn't until a rash of more than 400 deaths from fentanyl-laced heroin overdoses nationwide earlier this year that the public noticed the drug, which has been estimated at roughly 100 times more potent than morphine. The drug causes respiratory depression, leading to asphyxiation, according to Luzerne County Coroner Dr. Jack Consalvo. In Luzerne County, fentanyl is indicated in at least five recent overdose deaths. A spate of three fentanyl-related overdose deaths in two months alarmed Consalvo enough in May to ask the DEA to remove the drug from the market. Such a ban might limit the availability of fentanyl, which, evidenced by cases like those of Colasurdo and Kamus-Kelly, is easy for medical professionals to obtain. The nursing board called Colasurdo's actions "a most egregious violation" when revoking his license in August 2004. Colasurdo, now deceased, had pleaded guilty to, among other charges, three felony counts of criminal conspiracy in March 2002 in Carbon County and guilty to three counts of theft by unlawful taking and defiant trespass in April 2003 in Schuylkill County. Working at a nursing home, he would support his addiction to fentanyl by removing fentanyl Duragesic patches from elderly chronic-pain sufferers and inject the liquid from the patch, Colasurdo admitted to the nursing board. He also said he would go to the home when he wasn't working to steal patches. He said his addiction began at age 17, after a doctor prescribed him painkillers after a car accident. At the time of the hearing in 2004, he claimed he went to counseling and attended Narcotics Anonymous meetings several times a week, a claim substantiated by his mother, Janice. His family confirmed Aug. 4 that he died in October at age 24 of a drug overdose, but declined further comment for this story. In the more recent case, Kamus-Kelly pleaded guilty in Lehigh County to possession of a controlled substance and acquisition of it by fraud after supervisors found a small vial of fentanyl in her locker at the Lehigh Valley Hospital. The guilty plea last October triggered an automatic suspension of her nursing license in January. Kamus-Kelly said she didn't use fentanyl, but admitted to police she obtained it by faking hospital records. She later told the nursing board she had become addicted to Vicodin, a moderately potent opiate she used by prescription to handle pain after two neck surgeries. She did not return multiple calls for comment. In April, she accepted a consent agreement with the nursing board of a three-month license suspension and three years of probation thereafter. Kamus-Kelly told the board that after being confronted at the hospital, she attempted to enter voluntary recovery programs twice and wasn't admitted, but successfully completed a treatment program at the Marworth chemical dependency center in Waverly. In August 2005, after disclosing her addiction problems and the resulting criminal charges, she landed a registered nurse anesthetist job at the Berwick Hospital Center. She received random drug screenings under the supervision of Lawrence Reid, the medical director of the hospital's anesthesiology department. But the license suspensions have kept her from working since January, even though the hospital is "willing and desirous of re-employing" her because she will be under supervision and is "an excellent nurse from the standpoint of both technical skills and compassion for her patients," according to a letter written by Reid to the State Department's prosecutor. In June, after being told she could not work as a regular nurse until mid-July or a registered nurse anesthetist until July 2007, Kamus-Kelly petitioned for a modification of the consent agreement that would allow her to work. The petition was discussed at a board hearing on Friday afternoon in Harrisburg, according to state Department of State press secretary Leslie Amoros, but the board's decision was not known. - --- MAP posted-by: Beth Wehrman