WOMAN CHARGED IN DRUG DEATH OF NEPHEW

Man Overdosed Abusing Pain Patch Medication

A Carroll County woman has been charged with involuntary manslaughter in
the death of her 27-year-old nephew, who overdosed after eating the gel
from a pain medication patch that is sometimes abused for its heroin-like high.

Regina Raye Kesselring, 47, of New Windsor also was charged with drug
distribution and reckless endangerment in the death Feb. 4 of Steven E.
Spivey, a heroin user who had been "begging" her for one of the Duragesic
patches she had been prescribed, court records show.

Kesselring, who lives on disability payments of less than $600 a month,
told police she sold her nephew the patch for $50 - and also said she had
sold him patches two other times to supplement her $545-a-month disability
income, according to the charging documents.

The circumstances in Spivey's death are in some ways similar to those
increasingly seen in the abuse of another strong painkiller, OxyContin.
Tablets of that drug are crushed to defeat their time-release properties -
and provide users with a burst of medication likened to a heroin high.

The Duragesic patch is designed to release the drug fentanyl over 72 hours
to patients in extreme pain. But Spivey cut off a corner of the patch,
removed the gel with his finger and ate it, court records show. An hour
later he was found on a couch, his skin blue, not breathing. He died two
days later after he was removed from life support.

The Duragesic patches, produced by Janssen Pharmaceutica, have been on the
market for a decade. The drug company says a million prescriptions have
been written each year for the past three years.

The latest figures from the federal government's Substance Abuse and Mental
Health Services Administration show a rise in fentanyl abuse. In the first
six months of 2001, 512 emergency room visits in the United States were
blamed on fentanyl abuse, compared with 576 for all of 2000 and 337 visits
in 1999.

In 1984, 28 emergency room visits were attributed to fentanyl abuse.

While OxyContin has become sought after by heroin users in metropolitan
Baltimore - and has even been sold by some elderly people with
prescriptions, particularly in depressed, rural areas - the abuse of
Duragesic patches has not been seen in the Baltimore area, according to
experts.

"This is the first time I've heard of this particular drug being used in
this way," said George A. Butler, drug investigator for the Carroll County
state's attorney's office.

Rather, news accounts describe how Duragesic patches have been more
frequently abused by health care workers with access to the drug. In March,
a Pennsylvania nurse was charged with stealing patches from patients in two
nursing homes. He later boiled the patches to extract the fentanyl and
injected it. Last year, an addicted administrator of a Utah rehabilitation
center was charged with ripping patches off five elderly women, withdrawing
the drug via a syringe and injecting it.

Kesselring had been prescribed Duragesic patches by a Westminster doctor,
according to court records, which do not describe her ailment. Attempts to
reach her yesterday were unsuccessful. She was released on $25,000 bond
Sunday, a day after her arrest.

According to charging documents, Spivey went to Kesselring's apartment Feb.
1 to play cards. When the Westminster man started to fall asleep during the
game, others at the apartment told him to lie down. An hour later, after
they found that he was not breathing, they called 911.

Kesselring told paramedics that her nephew had been a heroin user and might
have used drugs before coming to her home, according to the charging
documents. Later, when confronted by police, Kesselring said that Spivey,
after arriving at her home, "began begging" for one of her Duragesic
patches, the documents state. She said she sold him one because otherwise
he might go to Baltimore to buy heroin, according to the documents.

A search warrant for Kesselring's home yielded seven Duragesic patches from
her purse, the charging documents said. Spivey died of a combination of
alcohol and fentanyl, according to a medical examiner's report.