State Task Force Meets In Roanoke To Study Plan Of Attack On Abuse Of Drug

OXYCONTIN UNDER MICROSCOPE

A Statewide Prescription Monitoring Program Was One Of The Ideas Discussed
By The Group

The rising number of fatal overdoses from oxycodone-based prescription
drugs now stands at 55 since 1997, Virginia Attorney General Randolph
Beales said Thursday.

Beales announced the figures to a state task force that met in Roanoke to
discuss ways to curb abuse of OxyContin, a prescription painkiller that is
easily converted to a street drug by addicts who crush the pills for a pure
dose of oxycodone that is snorted or injected.

When the panel last met in May, the state medical examiner's office had
recorded 43 fatal oxycodone overdoses in Western Virginia.

As the death toll has increased, so too have reports of OxyContin abuse in
other parts of the state and country. "It's now going everywhere," Beales said.

The task force will meet once more to craft proposals for next year's
General Assembly. Among the ideas discussed Thursday: a statewide
prescription monitoring program aimed at preventing addicts from getting
the drug illegally from doctors, stiffer punishments for dealers, and
increased funding for education and prevention efforts.

The panel was created by former Attorney General Mark Earley, intending to
study abuse of all prescription drugs. But OxyContin has dominated the
discussion, and on Thursday three representatives from the company that
makes the drug were on hand to respond to questions.

David Haddox, senior medical director at Purdue Pharma, outlined a number
of steps the company has taken to fight abuse of OxyContin while ensuring
that the drug remains available to legitimate patients.

Purdue Pharma has gone as far as directing its sales representatives to
discourage doctors from prescribing OxyContin in high-risk areas such as
Southwest Virginia if the physicians are unable - or unwilling - to
determine when the drug is appropriate, Haddox said.

Oxycodone, the active ingredient in OxyContin, is derived from opium and
has a high abuse potential.

However, Purdue Pharma disputes the number of fatal overdoses blamed on
OxyContin.

The drug is often mixed with alcohol and other narcotics that are factors
in fatal overdoses, Haddox said. And when there is a fatality, all an
autopsy can determine is the presence of oxycodone, which is also found in
about 40 other prescription drugs.

Haddox said the company has commissioned an independent forensic
pathologist to study about 100 reports from the state medical examiner's
office and determine how many of the deaths can accurately be attributed to
OxyContin.

When the task force met in May, William Massello, assistant chief medical
examiner, said that death-scene evidence and additional information
provided to his office convinced him that OxyContin was a factor in many of
the deaths.

And there were no oxycodone-related fatalities in Western Virginia from
1990 through 1995 - the year OxyContin was approved by the Food and Drug
Administration, according to Massello's office. The numbers have climbed
steadily since.

But relief could be in sight. Several law enforcement officials from far
Southwest Virginia told the task force that drug sweeps, convictions of
several doctors who overprescribed OxyContin, and increased public
awareness based on media reports have all helped stem the tide of addiction
and crime attributed to the drug.

"It seems to have leveled off and maybe gone down some," Tazewell County
Commonwealth's Attorney Dennis Lee said.

In Lee County, the cost of OxyContin has nearly doubled. "We have driven up
the cost, and I think that's a good indication ... that the supply has gone
down," Lee County Commonwealth's Attorney Tammy McElyea said.

However, OxyContin abuse seems to be gaining a foothold in parts of
Northern Virginia. Lt. Steve Hudson of the Prince William County Police
Department said about half of the county's drug cases now involve OxyContin.

Perhaps the most talked-about solution at task force meetings has been a
prescription monitoring program, a statewide electronic database that would
allow police to determine if a patient is receiving multiple prescriptions
from different doctors. Such systems exist in 18 states.

The system, which would cost at least $1 million to implement and would
require General Assembly approval, might be opposed by the medical
community on the grounds that it could undermine doctor-patient
confidentiality, some task force members said.

Another concern was the amount of time it would take for pharmacists to
enter information into the database.

But Del. Jackie Stump, D-Buchanan County, said the solution to such a
devastating problem as OxyContin abuse might require a little bit of
sacrifice from everyone. "Everybody's got to share a little pain in this
thing to make it work."