OXYCONTIN ABUSE PERSISTS

Security Precautions

Purdue Pharma, maker of OxyContin, does take security precautions with the
drug, including the following:

Tracking shipments of OxyContin to the point of sale using GPS tracking
devices and radio transmitters;

Funding non-promotional educational programs teaching health-care
professionals how to recognize and reduce diversion of prescription drugs
by drug traffickers and abusers;

Providing tamper-resistant prescription pads to doctors. Currently, about
300 doctors use the pads in Massachusetts, the company says.

Oxy addicts often move to cheaper heroin

For those asking, "Why Melrose?" or "Why now?" in response to a recent rash
of Melrose drug overdoses, local police, health officials and treatment
workers offer one answer consistently: Abuse of the prescription painkiller
OxyContin, they say, is leading to heroin addiction and drug overdoses
among young people in suburban communities, including Melrose.

In a recent focus group study of heroin addicts in Gloucester, all of the
teen-age participants said they started using heroin when a previous
addiction to OxyContin became too expensive; heroin is about one-tenth the
price of OxyContin on the street.

Eastern Massachusetts has become a "major hot spot" for OxyContin abuse,
said State Rep. Peter Koutoujian, D-Newton, chairman of the House Committee
on Public Health.

"The North Shore has been particularly ravaged," he said. "Use by young
people is off the charts."

Last week, U.S. Representative Stephen Lynch, D-South Boston, said he will
push for a nationwide ban on the drug, known on the street as "Oxy's," or "OC."

The Federal Drug Enforcement Agency has also identified Maine, Virginia,
West Virginia, Arizona and Pennsylvania as states where OxyContin abuse is
concentrated.

But doctors, pharmacists and representatives of Purdue Pharma, which makes
OxyContin, say the drug itself is not to blame for its widespread abuse.

OxyContin is known to pharmacists as a "semi-synthetic opioid agonist." It
is classified as a narcotic because of its effect on the brain. Its effects
are similar to other narcotic pain-killers, such as codeine, methadone or
morphine, when taken as directed.

When abused, its effects are similar to heroin, also a narcotic. However,
OxyContin, typically $1 a milligram on the illegal market, may cost 10
times as much as an equivalent dose of heroin.

"It has unfortunately become branded as a drug of abuse," said James Heins,
director of public affairs at Purdue, "and so there's an illegal market for
it."

According to Melrose resident Bob Jamison, a psychologist at the Brigham
and Women's Hospital Pain Management Center, not all the blame rests with
OxyContin.

"I think there's also a lot of cases for which you would say this is one of
the better, more effective medications we can give these people," he said.
"It has given some patients their lives back."

Jamison, who sits on the recently formed Legislative Commission on the
Effects of Prescription Drug Abuse, acknowledged the current problem with
OxyContin, but said the prescription painkillers Percocet and Vicodin can
be equally insidious. "There are some pockets of the U.S. where the biggest
abuse population is Methadone," and Vicodin was recently named the most
widely abused prescription drug in the U.S., Jamison said.

Meanwhile, Klonopin, a commonly abused prescription anti-depressant, has
been connected to two overdose deaths in Melrose, in the past two years.

However, in its ratings for abuse susceptibility, the Food and Drug
Administration classifies Vicodin and Klonopin as Schedule III and Schedule
IV drugs, respectively. OxyContin, along with Percocet and Codeine, is on
Schedule II - the list of prescription drugs most susceptible to abuse.
Schedule I is reserved for illegal drugs that have no legitimate use.

In 1996, OxyContin was introduced as a longer-lasting dosage of oxycodone,
a drug prescribed for treatment of moderate to severe pain. Each OxyContin
tablet contains a time-release mechanism that stretches a dose of the drug
over approximately 12 hours.

When abused, pills are usually crushed and snorted, or chewed and
swallowed, releasing the relatively large dose of oxycodone all at once.

OxyContin was the most-prescribed Schedule II drug in 2002, according to a
2003 DEA report. A 2002 report showed deaths from oxycodone more than
quadrupled in the three years after OxyContin was introduced, going from 51
in 1996, to 268 in 1999.

"It's being prescribed inappropriately, in my opinion," said pharmacist
Donald Putney, who owns the Green Street Pharmacy in Melrose. OxyContin was
developed originally for patients in severe pain, he said. "If you see that
amount of it on the market, you have to wonder how many seriously, sadly
ill people there are."

However, Putney said he would be opposed to a ban on OxyContin, such as the
one proposed by Congressman Lynch.

Jamison said in the past, incentives offered by pharmaceutical companies
have led to over-prescribing of certain drugs, but such practices are now
limited by harsh scrutiny.

"Clearly, there's been some examples of bad behavior," he said, "but now
pharmaceutical companies are very careful about these kind of junkets, so
to speak, and what kind of thing goes on there."

A March 2002 intelligence brief by the DEA named "illegal acts by
physicians and pharmacists," such as fraudulent prescriptions, as the
primary source for illicit pharmaceuticals. Second, the report listed
"doctor shopping," where individuals with real or fabricated ailments visit
numerous doctors. The third most common source, the brief stated, is theft
from pharmacies and residences.

Heins said Purdue has no way of knowing exactly how much OxyContin is being
diverted to the illegal market.

"It's being stolen from medicine cabinets, and it's being stolen from
pharmacies," he said. "Once it leaves a pharmacy, it's out in the
community, and it's difficult for us to track it."

Purdue tracks shipments of the drug all the way to the drug store, he said,
using GPS systems and radio transmitters installed in packaging.

Jamison said much of the responsibility lies with legitimate OxyContin users.

"People who get it, they just have to really treat this as if it's a
serious drug," he said. "They have to lock it up, and they need to take
really extra precautions about contributing to problems."