OXY ABUSE FUELS CALL FOR DRUG REGISTRY

Program Would Track Prescriptions

After seven back surgeries, Nancy Radigan needed a medical miracle.
Instead, she got an oxy chill.

Radigan is among a growing number of chronic pain sufferers denied
access to the strongest medications on the market because doctors are
balking at prescribing opiate-class narcotics. The doctors say
inadequate controls on the dispensing of opiates such as OxyContin are
fuelling addiction and drug trafficking in Windsor and Essex County.

They're calling for a provincial drug registry to track prescriptions
and head off abuse.

Ontario's chief coroner has linked oxycodone, the opiate found in such
prescription painkillers as OxyContin and Percocet, to more than 250
overdose deaths since 1998, including at least six in Windsor, and
police say oxy trafficking is behind at least two murders and a
massive increase in break-ins.

"All the drug abuse is hurting people who really need those drugs,"
said Radigan, 48, who has been unable to find a doctor to prescribe
painkillers since her family physician closed her practice July 31.
She has been on the medication four years. "I had six names from my
doctor but none of them would touch me when they saw I was on a
narcotic. I've gone to 30 doctors and no one will take me. It's a
scary feeling because my doctor gave me prescriptions for three months
and when they're finished I'm in trouble."

There are an estimated 600 intravenous opiate drug abusers in Windsor
and Essex County, according to Dr. Tony Hammer, who treats addicts. He
admits the number could be "20 times" higher if those who snort or
swallow the pills, which when crushed deliver the narcotic all at
once, are included. Introduced in 1996 as a wonder pill for cancer
patients, oxy delivers a heroin-like euphoria when its time-release
feature is defeated.

Critics say there are inadequate safeguards preventing addicts from
going from doctor to doctor for repeat prescriptions -- so-called
double doctoring -- and legitimate patients are paying the price.

"It puts us in a very difficult position, and it's extremely difficult
when they turn up in our offices," said Dr. David Paterson, president
of the Essex County Medical Society. "You shudder each time they come
through the door, because they're not easy to treat. But the result is
that those poor people end up with no one to help them."

Oxy abuse has rippled across the country, from a suicidal London man
who leaped off a downtown parking garage, to a 100-per-cent increase
in armed robberies in St. John's, Nfld., that police blame squarely on
the drug.

"He was only 26 and that drug drove him to the streets to get more of
it," said Linda Gardiner, whose son Chad jumped to his death from the
London Galleria parking garage. "Tell parents to look in their
children's eyes, because if I could have seen a photo taken of my son
a couple of months before he died, I would have seen how bad things
were.

"I didn't see it until two days after he died. That picture gives me
the drive I need to get out to talk about this drug."

Chad Gardiner was taking oxy to control the pain of a genetic foot
disease when he became hooked on the drug and lapsed into a suicidal
depression.

Ironically, his father was on oxy when he died of liver failure a year
earlier.

"My husband died knowing that our son was in deep trouble because of
the drug," said Linda Gardiner, who is developing a magazine on the
devastation she says can be caused by OxyContin. "No doctor ever told
me that the drug could be addictive."

A Newfoundland task force has recommended giving police access to the
confidential information of addicts suspected of illegally obtaining
prescription drugs.

While critics argue such power is an invasion of privacy, the idea of
an electronic registry linking doctors to pharmaceutical information
is gaining popularity.

The Canadian Pharmacists Association, which backs the registry, says
it would cost about $50 million per province -- less if all provinces
are involved.

"I'd love a central registry to track the huge numbers of people who
pay cash for their drugs," said Dr. Jackie Gardner-Nix, a chronic pain
specialist in Toronto. "The only tracking we have now in Ontario is of
patients who are on the Ontario Drug Plan, which is a very small
number. Those can be picked up within a couple of days of
double-doctoring, but we miss those who pay cash."

The systems cited as being the most effective are in British Columbia
and Alberta, where electronic medical records are being put in place.

"A patient can't go to three different doctors because it will show up
on the electronic health record. Abuse still happens, but this system
certainly keeps it at bay," said Alberta consultant pharmacist Anjli
Acharya.

The system relies on triplicate prescriptions. One stays with the
doctor and the patient is given two copies to present to a pharmacist
within 72 hours. After that it's no longer valid, but once presented
it can be kept on file and partially filled.

A pharmacist fills out information on the bottom of the script, the
patient signs as having received the medication with a note made of
the drug's special code and quantity.

The pharmacy keeps a copy and the third is sent to the province's
College of Physicians and Surgeons, where it is entered on a database.

The records are under tight security. The computer program shuts down
automatically if unattended for longer than five seconds. Every
keystroke is registered and anyone caught accessing a file without
authorization is fired, said Acharya.

"This should definitely be used across the country, and I believe it
will because there's no stopping it," Acharya said.

Under the province's privacy legislation, "nobody tells anybody
anything," leaving pharmacists with their hands tied, said Windsor
pharmacist Mike Hunter. "If our inspector found a particular name
turning up in pharmacy A, and again in pharmacy B, she could not share
that with us," said Hunter.

"If your legal authority is telling you what they won't do, you're
left to fend for yourselves to figure out how to combat this."

Charlene Haluk-McMahon, president of the Essex County Pharmacists'
Association, endorsed the registry. "It would be great to develop a
pipeline of information between physicians and pharmacists, but with
Ontario's present confidentiality laws the government would have to
step in," said Haluk-McMahon.

Calling it a "troubling issue," Ontario Health Minister George
Smitherman pledged to work with Health Canada and regulatory bodies to
curb oxy abuse. Canada's coroners and chief medical examiners are
planning a national alert on oxy this fall.

A spokesman for Purdue Pharma Inc., the Connecticut-based manufacturer
of OxyContin, said that while he's concerned negative publicity is
keeping some doctors from prescribing oxy, it also may help reduce
unwarranted prescriptions and abuse.

"It has raised awareness, particularly allowing doctors and patients
to be more circumspect about the drug, and whether it's the right drug
for the right patient, " said John Stewart, general manager of the
company's Canadian wing.

"We developed this drug to bring to the patient all the good that a
drug like oxycodone can bring. Certainly abuse by a small number of
people can get in the way of optimal pain management."

In Newfoundland, Purdue is funding drug education for teenagers and
underwriting the introduction of a tamper-proof prescription pad. Pads
will be "physician specific" and sequentially numbered so they can be
tracked if stolen.

"They're made by the same company that supplies special paper for bank
notes, so a physician's writing can't be erased or removed," said
Stewart. "It also can't be photocopied without it looking like a photocopy."

Ontario's chief coroner Dr. Barry McLellan outlined the province's
overdose problem to a medical group in Washington last week, stressing
the high percentage of deaths in which oxycodone is found in the
bloodstream.

OXY 'ALL OVER'

Tracking the trail of illegal OxyContin pills has become a full-time
job for a team of Ontario Provincial Police officers, with some
chasing double-doctoring patients and others going undercover to catch
drug dealers.

"We have at least eight investigations going on at any given time, and
for a period we had 17 at one time," said Det.-Const. Jeff Johnstone.

"We're finding more pills in search warrants and our undercover guys
are purchasing a lot of the oxy drugs."

Undercover cops say they have no problem finding OxyContin pills.

"They're so popular you can find them in the cities and small towns,
just all over," said Jack, an undercover cop who does not want to use
his real name.

"I purchase them from the bad guys in drug houses or guys who sit at
the table counting them out from a big bag on the kitchen table."

Jack said the pills come from either legitimately obtained
prescriptions, or from criminal activity.

"Sometimes they get stolen from pharmacies, other times through
residential break and enters, for example a teenager knows his parents
or grandparents are on oxy, so goes to grandpa's house to steal a
few," said Jack.

"Other times drug traffickers get them from people who were prescribed
them for pain."

Jack said it's not just criminal biker types selling oxy.

"There's no stereotypical person and it's often just regular people,
from all stratas of society. It's just a way to make money. There are
no networks, just individuals," he said.