FATALITIES LINKED TO PAIN PILLS ON THE RISE

Legal Drugs - Deadly Overdoses Up Dramatically Among Utah Residents

About three years ago, the state's chief medical examiner noticed an
alarming rise in drug-related deaths. People were overdosing on methadone,
said Todd Grey. And they weren't addicts using the prescription painkiller
to shake heroin.

A study released Thursday confirmed his hunch: Prescribed pain relievers -
not illegal drugs - were increasingly responsible for Utahns' deaths from
drug poisoning after 1999. By 2003, the average Utahn dying of a drug
overdose was 25 to 54 years old, was overweight and was using one or more
prescription drugs, according to a report released Thursday by the Utah
Department of Health and the federal Centers for Disease Control and
Prevention. The report "basically validated what we had been screaming
about," Grey said. "We knew this was a horrendous problem."

While most of those who died in 2003 were men and from urban areas, the
number of overdoses among women and rural residents had increased. Yearly
overdose deaths in Utah have jumped nearly fivefold, to 391 in 2003 from
just 79 in 1991, according to the report, published today in the CDC's
Morbidity and Mortality Weekly Report (MMWR.)

The largest increase in deaths, to 181 from 45 during that same period,
occurred among people taking prescription drugs. The primary culprits:
methadone, oxycodone and hydrocodone, three drugs commonly prescribed to
treat pain. The drugs have also popped up on the U.S. Drug Enforcement
Agency's radar screen as frequently abused and illegally sold narcotics.
Most of the cases were "polypharmacy," which meant people were using more
than one drug when they overdosed, Grey said.

Tranquilizers, such as Xanax and Valium, commonly showed up in the lethal
mix, while a notably small number of cases involved alcohol. Christy
Porucznik, a CDC epidemic intelligence service officer, spent a year
gleaning the data from thousands of records at the Utah medical examiner's
office, which has jurisdiction over drug-related deaths.

The analysis excluded deaths that were ruled suicides. Another interesting
trend emerged: People with a body mass index (BMI) of 25 or higher
accounted for most of the deaths.

People taking prescription drugs appeared more likely to overdose. "One of
the reasons this is something we looked at is because more and more people
are becoming overweight and obese," Porucznik said. One possible
explanation for the increasing number of deaths is the stepped-up
prescribing of methadone, oxycodone and hydrocodone.

Though Utah maintains a database of controlled substances that are
prescribed, that information is closely guarded due to federal privacy
laws, Porucznik said. However, the DEA, through its Automation of Reports
and Consolidated Systems database, keeps close tabs on retail distribution
of prescription drugs. From 1997 to 2002, the amount of drugs sold in Utah
and the United States increased substantially.

In Utah, the amount of methadone - in grams per 100,000 population -
increased to 1,703 grams in 2002 from 269 grams in 1997; oxycodone, to
9,804 grams from 1,848 grams; and hydrocodone, to 8,122 grams from 4,754
grams. In Utah, the number of drug-poisoning deaths attributed to each of
the three drugs increased at a greater rate than their sales. Ted Steinke,
a Food and Drug Administration investigator in Salt Lake City, said he had
not yet reviewed the report and could not comment on it. Grey, the chief
medical examiner, said he hopes the report will spur further research,
possibly leading to overdose prevention efforts among at-risk
patients. "We've been seeing this for a long time," he said. "A whole lot
of [people] who died shouldn't have died."