DEADLY OVERDOSES

In the Carolinas, OxyContin abuse may have played a role in the overdose
deaths of at least 97 people in 2000 and 2001. A majority were accidental,
most involving other drugs or alcohol.

At least another 104 died of an overdose in which oxycodone, the main
ingredient in OxyContin and about 59 other medications, caused or
contributed to the death. In those cases, it was unclear whether OxyContin
or another oxycodone-based pain pill was involved.

AMONG THE ESTIMATED 201 DEAD

. A majority were white.

. The average age was 40.

. Almost two-thirds were men.

. 139 had levels of oxycodone that toxicologists say were high enough to
cause the death independently, though other drugs may have contributed; 46
had levels of oxycodone capable of causing the death only in combination
with other drugs. Oxycodone contributed indirectly in the remaining cases.

. 67 reportedly struggled with depression; 87 with chronic pain; 96 with
drug or alcohol addiction.

. Three-fourths died of overdoses ruled accidental. Thirty-six were
suspected suicides, including 19 cases in which OxyContin may have played a
role.

. Twenty-three were in Spartanburg, the county with the highest death
count. Mecklenburg reported no deaths. Gaston had 7; Cabarrus, Burke and
Rowan 5 apiece; Cleveland and York 3 each; Iredell and Catawba 2 each;
Lincoln 1.

An April Drug Enforcement Administration study found 464 deaths nationally
in which OxyContin may have played a role. Like the Observer's study, the
DEA report was able to conclude about half the oxycodone deaths potentially
involved OxyContin.

Officials with Purdue Pharma, OxyContin's manufacturer, counter most deaths
are caused by a variety of drugs, and it's impossible to single out OxyContin.

Dr. David Haddox, Purdue's medical director, also says the level of
oxycodone some toxicologists consider lethal is not always lethal in people
who have developed a tolerance to the drug.

"Unless you know a lot about the history of the decedent, it's very hard to
say that this drug killed them," he says.

Haddox, however, says it's clear both oxycodone and OxyContin have
contributed to overdose deaths. The company is conducting its own study.

The Observer tracked suspected overdose deaths with information from the
N.C. Medical Examiner's Office and a majority of S.C. coroners. Thirty-nine
of South Carolina's 46 coroners provided information. Coroners in Anderson,
Barnwell, Clarendon, Greenwood, Lancaster, Laurens and Orangeburg counties
did not respond to requests for data.

Forensic toxicologist Dr. Andrew Mason served as consultant for this
project. Mason, former chief toxicologist for the N.C. Medical Examiner,
now runs ToxicoLogics in Boone, which specializes in forensic toxicology
services.

Mason analyzed complete toxicology and coroners' investigative reports for
all S.C. deaths in which oxycodone may have contributed. Then, he
determined whether oxycodone contributed to the death independently,
contributed in combination with other drugs, or contributed to the death
indirectly. That work in North Carolina was done by the N.C. Medical
Examiner's Office in Chapel Hill.

In most cases, there is no scientific way to determine whether a decedent
died of an OxyContin overdose. Blood tests only determine whether oxycodone
was present.

To determine whether OxyContin may have been involved, Observer reporters
studied hundreds of investigative reports and interviewed dozens of families.

Of the estimated 97 cases in which OxyContin abuse could have played a
role, investigative reports in 73 cases referred to OxyContin. The rest
came from interviews with families and police.

Suspected suicides were included in this study because experts say it's
often hard to distinguish between an accidental overdose and suicide
involving patients who have a history of depression and chronic pain, and
are on heavy medication.