CHELSEA GROUP CREATES STANDARDS FOR OXYCONTIN

Designed To Reduce Abuse

CHELSEA -- Adolescents who have accidentally overdosed on prescription
opiates such as OxyContin usually take the medication from a family member
rather than buying it on the street, according to questionnaire responses
gathered by a Chelsea youth coalition.

But it's the chain of events that lead to the moment when teens get their
hands on the narcotics that was tackled by the Chelsea Champion Youth
Coalition at a summit May 11.

The summit, which drew a crowd of doctors, pharmacists, state legislators,
and residents, was the culmination of a year's worth of research funded by
an $80,000 grant from the state Department of Public Health. The grant was
used to develop guidelines for local doctors and pharmacists and create a
standard for prescribing and distributing opiates.

Chelsea was selected for the grant because the city already had an opiates
initiative in place and because it was one of several places in the state
with a significant amount of opiate overdoses in the past few years,
according to Amy L. Harris, director of the Chelsea Alcohol/Substance Abuse
Program. The program helped sponsor the summit along with the coalition,
Massachusetts General Hospital, and the Latimer Society.

Harris said doctors, pharmacists, and 19 adolescents worked together to
create the new protocol, which is designed to help patients understand the
implications of obtaining an opiate prescription as well as the dangers of
crushing drugs such as OxyContin, which are designed as time-release
painkillers. When crushed, the entire dose of OxyContin is released
immediately and reportedly has the euphoric effects of heroin. When taken
inappropriately, it is considered a gateway drug to heroin addiction.

"In giving this correct information, we're trying to reduce overdoses by
accident, because sometimes people did not have the correct information
[about their prescription]," Harris said. "Even though we know people crush
their medication to get high, there were some people who didn't know they
risked death by crushing their pills, or that they could overdose by taking
it with alcohol." The Youth Coalition helped put together a pamphlet for
patients receiving prescription opiates, instructing them never to crush
the medication or take it with alcohol and to keep it away from other
household members. The pamphlet also urges doctors to ask patients a series
of questions regarding their history of addiction to alcohol or drugs, and
whether they have ever been treated for substance abuse.

"[Local] doctors and pharmacists will now follow these instructions,"
Harris said. "Up to this point, there haven't been standard protocols."
Some doctors and pharmacists already exercise similar guidelines on an
individual basis when prescribing opiates, said Steven Shraiar, owner of
Margolis Pharmacy in Chelsea and vice president of the Massachusetts
Independent Pharmacists Association.

Shraiar spoke at the summit about the way prescription data is gathered and
what is done with it. After Margolis Pharmacy sends its prescription data
to a New Hampshire contractor, Shraiar said the company assembles it and
sends it to the Department of Public Health, where officials "look for
tendencies of doctors and patients."

Shraiar said he would like the Department of Public Health to use the data
to send individual letters to doctors with questionable prescription
patterns. OxyContin, for example, is a long-acting medication (lasting
between 10 to 12 hours) that should be prescribed as a twice-a-day dosage
depending on the severity of the patient's pain, Shraiar said. Without
revealing which doctor it came from, Shraiar said he received an OxyContin
prescription request that called for three different dosages, four times a
day, totaling 90 milligrams. In most cases, that kind of OxyContin
prescription creates a dependency and can lead to accidental overdoses,
Shraiar said.

"We frequently call the doctors when we get a prescription like that,"
Shraiar said, adding that pharmacists have to fill the prescriptions as
written by doctors. "On occasion, we do tell the patients about the risks,
but then we tell them their doctors have chosen to give them a higher
dose." According to the Department of Public Health, more than 82,000
people in the state received treatment for substance abuse last year.
Although no statistics were available for Chelsea, Boston had a 153 percent
increase in emergency room visits related to OxyContin in the past year.
Still, Shraiar said he is not in favor of a measure by state Representative
Brian Wallace of South Boston and state Senator Steven Tolman of Brighton
to ban OxyContin prescriptions. "It is a good drug, when used properly,"
Shraiar said. Police Chief Frank Garvin, who was at the summit, said
Chelsea, like many other communities, has a problem with opiate addiction
on the streets. While most police raids usually find heroin, Garvin said
there has been an increase in street OxyContin use by Chelsea teens,
despite its higher street value. "The drug that's most problematic is
OxyContin," Garvin said. "OxyContin has unfortunately become the new heroin."

Chelsea police are working on a method to collect opiate overdose data in
the city, but Garvin said it is difficult to track because most people
usually call an ambulance and "we'll never hear about that stuff." Harris,
of the Chelsea Alcohol/Substance Abuse Program, said the coalition hopes to
apply for another public health grant next year, which it would use to
focus on "doctor shopping," a practice used by people seeking to get their
hands on multiple prescriptions.

"The point of this year's work is to get the community to recognize the
problem, taking an interest and responsibility, and extending that to their
families," Harris said.