Deaths Linked To Painkiller Raise Fear

OxyContin - a drug used by cancer patients - is increasingly abused. Officials in the region are alarmed.

By Elisa Ung

More and more bodies tested in morgues around the Philadelphia region show traces of the chemical found in OxyContin, chilling coroners with the realization that the powerful painkiller, when abused, has become a major people killer as well.

Chewed, snorted or injected for its heroin-like impact, OxyContin has been on the market since 1996, intended as medicine to ease pain in cancer patients and others. Death reports only now being compiled in the region show the extent of its abuse, with or without other drugs or alcohol.

The rising death toll of recent months has alarmed coroners and police. Many report younger victims and more cases in the suburbs.

Most coroners in the region say they began to see deaths rise last year, around the time that police saw OxyContin become a popular street drug. In 1999, oxycodone - the drug's primary ingredient - showed up in 17 bodies in Philadelphia. In 2000, the number rose to 41. In the first six months of this year, tests found the drug in 39 bodies and was the cause of death in 11 of those victims.

Also alarmed are patients who fear OxyContin hysteria will keep them from getting needed pain medication.

"In the area of prescription drugs, it's phenomenally different than anything we've seen as far as the fatality aspect," said Andy Demarest, who investigates controlled substance cases as Pennsylvania senior deputy attorney general. Particularly troublesome, he said, are the increasing reports of first-time abusers who chew only one of the time-release pills and succumb to the rush when the entire 12-hour dosage is released.

"Here you don't have to take 20 Vicodan to die, just the one OxyContin pill," Demarest said.

In Delaware County, oxycodone-related deaths rose so sharply in the last 18 months that county officials have made awareness a priority public-health issue. And in Philadelphia, legislators have called for public hearings because of the dramatic increase in oxycodone-related deaths.

Philadelphia Police Inspector Jerry Daley described the increase as particularly alarming. "It's going up at a tremendous rate that would cause anyone to look at it and say, 'Hey, what's going on?'" he said.

A federal survey shows the eight-county Philadelphia region's 115 oxycodone-related deaths from 1997 to 1999 led the nation for all three years - but authorities are uncertain whether the distinction reflects the country's worst problem or its best reporting of the statistics.

Philadelphia's oxycodone death toll, like the nation's, still pales compared to deaths from heroin and cocaine, officials are quick to point out. They don't hesitate to blame OxyContin for the recent, sharp fatality increases - not other, weaker oxycodone brands such as Percodan, Percocet and Tylox. Percodan and Percocet contain 4 to 5 milligrams of oxycodone, while OxyContin has 10 to 160.

"This drug [oxycodone] has been in use for 80 years," said Guy V. Purnell, chief toxicologist in the Philadelphia Medical Examiner's Office. "The controlled release has not been. It's that elevated dosage that's killing them."

In Delaware County, the sudden rise in deaths - from five in 1999 to 17 in 2000 - shocked coroner Fredric Hellman, who during an autopsy found four 40-mg OxyContin pills in a victim's stomach.

"When you see two deaths, three deaths, five deaths and then - 17 deaths!" Hellman said. "It doesn't take a rocket scientist to realize it's the OxyContin."

Delaware County's oxycodone victims were mostly middle-aged white men, but authorities believe the drug - known as "Oxy" or "OC" on the street - is flowing among teenagers. District Attorney Patrick Meehan fears OxyContin may be a gateway to heroin use.

"There's the perception," Meehan said, "that because it's a manufactured drug, it's somehow not as dangerous as an illegal drug."

OxyContin is blamed for the deaths of at least six people, four of them teenagers, in Philadelphia's Fishtown, Port Richmond and Kensington neighborhoods in recent months.

The only New Jersey county in the Philadelphia region reporting any oxycodone deaths in the last two years is Burlington, with a single victim. But authorities say the problem extends far beyond the city and is acute in many rural areas.

Eleven years ago, former Southwest Philadelphia resident Louise Morton moved her six children to the tiny Pennsylvania town of Noxen, in Wyoming County, to escape Philadelphia's drugs and crime. It didn't work.

On April 29, her son, Nick, 21, a construction worker with an engaging smile, died after drinking and taking OxyContin he had bought on the street. Morton said she was stunned to learn her son was an abuser.

"He was in an Easter play," she said. "He went to church. I had no suspicions whatsoever. If he knew it would kill him, he wouldn't have taken that pill."

The Pennsylvania Medical Society this week called the increasing abuse of OxyContin "alarming" but emphasized its support of the drug for legitimate patients, chronic-pain sufferers.

Among those concerned is Michael H. Levy, director of the pain-management center at Fox Chase Cancer Center, who fears that his patients will choose to suffer rather than take painkillers that might be addictive.

"OxyContin is probably one of the best drugs we've seen in the past 10 years and really helps these patients," Levy said. He cited the drug's long hours of effectiveness and fewer side effects than other painkillers.

But Levy says his OxyContin patients are so aggressively questioned at pharmacies that filling their prescriptions becomes an ordeal.

Purdue Pharma, the drug's manufacturer, says it wants to prevent OxyContin from getting into the hands of abusers. The company pulled its strongest 160-mg OxyContin pills off the market in May and issued tamper-proof prescription pads, which resist copying and scanning. About 240 doctors in Pennsylvania use them.

Demarest said the state Attorney General's Office was replacing its tedious manual system with computerized tracking to audit prescriptions from doctors to pharmacies. That should allow quicker tracking of abusers who "doctor-shop" for prescriptions, he said.

Source: http://inq.philly.com/content/inquirer/2001/07/15/front_page/OXY15.htm