PAINKILLER LINKED TO 250 ONT. DEATHS

'Hillbilly heroin' highly addictive. Coroners prepare warning

Canada's chief coroners and medical examiners are preparing a national alert
on the abuse of a popular painkiller they say is responsible for at least
250 overdose deaths in Ontario since 1998 and dozens elsewhere in Canada.

In the past five years 250 Ontario deaths were related "in part or solely"
to oxycodone, an opiate found in the brands OxyContin and Percocet, said the
province's chief coroner Dr. Barry McLellan. In an additional 50 deaths,
oxycodone was found in the bloodstream but other drugs were also involved.

Between 2000 and 2003 there were six deaths in Windsor and Essex County
where oxycodone was a factor, McLellan said. "No part of Canada has been
spared. It's really affecting the entire country," said McLellan.

In Nova Scotia there have been at least 20 deaths, about eight in New
Brunswick and six in Newfoundland, where OxyContin prescriptions increased
400 per cent between 2000 and 2003.

Canada's chief coroners and medical examiners have been tracking OxyContin
overdoses for months. At a recent meeting they decided to prepare a national
alert, likely this fall, similar to past warnings dealing with seatbelts,
airbags and bicycle helmets.

"We consider it a significant number and a significant problem," said
McLellan. "The data we have shows the problem with the drug was getting
worse up to 2003, there's no evidence it is getting better."

For black-market drug abusers, painkillers containing oxycodone are cheaper
and easier to obtain than heroin or cocaine, they're pharmaceutically pure
and they're just as dangerously addictive. Oxycodone is a narcotic extracted
from the opium poppies used to make heroin.

Last week, a 32-year-old Comber woman was sentenced to 12 months of house
arrest after pleading guilty to fraudulently obtaining close to 3,000
oxycodone tablets from 15 doctors in less than a year.

McLellan suspects the main culprit in the overdose deaths is OxyContin, a
long-acting derivative introduced in Canada in 1997 by the Stamford,
Conn.-based Purdue Pharma Inc. Its main purpose was pain relief for cancer
and palliative-care patients.

On the street, where legally prescribed pills have become popular for drug
traffickers, it is known as "hillbilly heroin" or "oxy." In 1999, said
McLellan, the number of oxycodone-related deaths in Ontario numbered in the
20s. In 2003 there were 100 deaths, a five-fold increase.

John Stewart, general manager of Purdue Pharma, said his company is "very
aware and concerned about the abuse of the drug in Canada and the U.S. We
are working closely with governments, doctors and pharmacists to find ways
to deal with the problem."

Working with officials in the Atlantic provinces, where abuse has been
particularly severe, Stewart said Purdue is offering information and tools
to help assess, treat, document and follow patients on opiates.

"The answer to abuse of prescription medications is greater education and
substance abuse treatment.

"The answer to diversion (illegal use of a legal drug) is tough law
enforcement, not restrictions on patients and physicians who treat them,"
said Stewart.

He said there were 641,000 prescriptions issued for OxyContin in Canada in
2003, a five-fold increase from 2000. He said Tylenol 3 remains the most
prescribed drug in Canada at more than 4.5 million prescriptions last year.

McLellan said he has been monitoring OxyContin abuse with his Canadian and
U.S. colleagues.

"They have a serious problem, especially in the northeastern states with the
long-acting drug (OxyContin) and we have similar concerns," McLellan said. "

"We are trying to get a handle on the problem and once we have more
information, and clearly understand the scope of the problem, we want to
make the public aware of the problems with OxyContin."

McLellan said they will issue a public safety message in the fall, mainly
through the country's media, by sending out news releases and possibly
holding full-scale news conferences.

"We've done this before on a wide variety of issues, including bicycle
helmets, air bags, and seatbelts," said McLellan.