WARNER COMES TO CITY

To Learn About OxyContin "Like A Locust You Know Is Coming," Senator Says

U.S. Sen. John Warner, R-Va., visited Harrisonburg Monday to get a better
understanding of OxyContin from those on the front lines of the battle.
Warner's two-hour fact-finding stopover was in response to the growing
abuse of the controversial pain reliever that, according to the U.S.
Attorney's Office, has claimed the lives of more than 60 Virginians since
1996. Most of the deaths occurred in the southwestern region of the state.
Warner spoke with law enforcement officials from city and state agencies,
representatives from the U.S. Attorney's Office and the state medical
examiner's office to formulate a plan for waging war on the drug. The
meeting was held at the Rockingham County Board of Supervisors in downtown
Harrisonburg.

The Ins And Outs Of OxyContin Two-thirds to three-quarters of the deaths
were termed accidental, meaning the drug was abused by the user, who
accidentally overdosed. Some deaths were suicides.

"It's like a locust you know is coming," Warner told the audience. "And
it's coming."

OxyContin was developed by Purdue Pharma of Stamford, Conn., and was
approved for patient use by the Food and Drug Administration in 1996. It
was specifically designed to treat cancer patients, but it didn't take long
for drug abusers to latch on to the powerful prescription pain reliever.
"It's for people who deservedly need it," Warner said. "Somehow it got out
into the hands of dirty drug dealers."

Drug dealers, for the most part, acquire OxyContin through physicians by
"doctor shopping," going from one doctor to another with complaints of
pain. Once they have acquired the drug, it's sold on the street for 10
times its prescription value of 10 cents per milligram, Gregg Wood, health
fraud investigator for the U.S. Attorney's Office in Roanoke told Warner
during the meeting.

The drug is prescribed in 10-, 20-, 40- and 80-milligram, 12-hour,
time-released doses. Recently, doses of 160 milligrams were taken off the
market by the manufacturer at the request of the U.S. Attorney's Office.
The time-release action of OxyContin can be destroyed by crushing the pill,
which releases its pain-killing relief immediately when it's snorted,
injected or chewed. Some drug users call the euphoric high it produces
better than sex, Wood said.

Prescription Drug Abuse Prescription drug abuse, particularly abuse of
OxyContin, came to the attention of Virginia law enforcement officials in
1997 during an investigation of insurance fraud, said Ruth Plagenhoff,
interim U.S. Attorney for the Western District. The case involved vehicle
accidents being staged and "victims" collecting large insurance settlements
for injuries. In the course of the investigation, three unscrupulous
doctors were identified prescribing medications without legitimate medical
reasons. But where OxyContin is concerned today, prescription fraud
involves a small minority of doctors, Plagenhoff said.

For more than one hour, Warner listened to OxyContin horror stories from
the gathered officials. He asked many questions, returning to one point
several times - that of public education and the responsibility of patients
when it comes to prescription narcotics.

Warner stressed that it's illegal for patients to give away or sell their
prescription medication.

Physician Education Educating doctors on the proper procedure for treating
patient pain was also discussed at length. Complaints of pain are the
leading reasons patients see their doctors. But pain is one of the hardest
complaints to diagnose, and many doctors simply take their patient's word
and prescribe a pain medication.

Wood suggested that doctors follow a strict protocol before prescribing
powerful pain medication, such as OxyContin.

Doctors who treat pain have an obligation to do it correctly, he said. He
suggested that doctors: provide good evaluation and treatment plans; try
conservative treatments first, such as physical therapy; slowly escalate
the use of narcotics; document and review patient progress; assure patient
compliance through pain contracts, urine testing and pill counts; and
understand "doctor shopping" behavior.

But the U.S. Attorney's Office says the most effective program offered "and
one that has the potential to nearly erase the practice of doctor shopping"
instituting an electronic prescription-monitoring program. By connecting
every pharmacy into a computer network, investigators could easily track
prescriptions. Anyone attempting to fill multiple prescriptions of pain
relievers, particularly OxyContin, from numerous doctors, would easily be
found out.

The system is currently working in 18 states, including Kentucky, which has
been hard hit by OxyContin abuse.

Warner told the group he would find out if the Department of Justice could
appropriate approximately $1 million to fund the program in Virginia.