THIEVES TARGET PAIN-DRUG PATCHES

PHILADELPHIA - A Pennsylvania nurse has been accused of slipping into two
nursing homes where he used to work and stealing medicated pain-relief
patches off the backs of elderly patients in what federal figures show is
an increasingly common type of drug abuse.

"It's terrible to think that someone would stoop that low," said Gary
Dobias, the district attorney in Carbon County, about 70 miles north of
Philadelphia.

U.S. prescriptions for the Duragesic patches and their reservoir of the
powerful painkiller fentanyl increased 33 percent between 2000 and 2001,
and with the drug's popularity have come more reports of abuse, especially
among health care workers.

"For many years, fentanyl was actually the drug of choice of the addicted
anesthesiologist," said Dr. Joel Nathan of the Addiction Recovery Institute
in New York. "Outside of that, we are probably talking mostly about
low-paid people in the nursing industry, like nursing aides and other
uncertified health care workers."

Nationwide, at least 512 people were treated for fentanyl abuse in hospital
emergency rooms in the first six months of 2001, according to the federal
Substance Abuse and Mental Health Services Administration.

While complete 2001 data are not yet available, the numbers point to a
major increase over 2000 when 576 people were treated in emergency rooms
and 1999, when 337 visited emergency rooms. Only 28 fentanyl-related
hospitalizations were recorded in 1994.

Behind the numbers are the abusers - many of whom have access to the drug
at work and know how to extract fentanyl from the patch and inject or
inhale it.

Paul Colasurdo, a licensed practical nurse, was charged last week with
stealing patches from elderly patients in two nursing homes. Colasurdo
boiled the patches in water to extract the fentanyl, then injected it,
Dobias alleges.

Colasurdo denies taking the drugs and is being held on $250,000 bail.

In January, John David Needles, 32, former administrator of a nursing home
in Cedar City, Utah, pleaded guilty to three counts of elderly abuse for
tearing patches off of female residents.

In Massachusetts, nurses' aide Ruth S. Rowe, 26, pleaded guilty in November
to stealing a fentanyl patch off the back of a 90-year-old patient,
extracting the potent drug and drinking it.

Police said Dr. Jonathan Ludwig Koukal, 43, an anesthesiologist in
Jeannette, Pa., committed suicide in Niagara Falls, N.Y., in August after
he was charged with stealing fentanyl from a hospital and replacing it with
sterile water. The watered-down drug was given to several patients during
surgery.

Jamey Phillip Sheets, 32, former co-owner of a Pleasant Hill, Calif.,
pharmacy was found dead Tuesday with six fentanyl patches stuck to his
body. His wife said he was depressed that his pharmacy license was
suspended in connection with a meningitis outbreak.

Doctors note that reports of fentanyl abuse still pale in comparison to
abuse of other narcotic painkillers.

By comparison, nearly 11,000 people were treated in hospital emergency
rooms in 2000 for abuse of oxycodone, the drug sold under the brand-name
OxyContin. More than 7,800 people overdosed on oxycodone in the first six
months of 2001.

Dr. Yusuf Mosuro, attending physician in Temple University Hospital's pain
clinic, said that while fentanyl abuse hasn't become "epidemic," like
OxyContin, it has the potential to become a bigger problem unless doctors
carefully control who gets the drug.

"The problem with OxyContin is that it was being marketed to primary care
physicians to treat all sorts of severe pain, and these doctors were not
always trained properly on how to make sure that the medication wasn't
abused," Mosuro said.

The Duragesic patch, which is made by Janssen Pharmaceutica, has been
marketed far less vigorously than OxyContin, Mosuro said, and is prescribed
most by specialists in hospitals, where it is kept under lock and key.

Still, the Drug Enforcement Agency considers fentanyl a potential drug of
abuse that can come in doses more than 100 times as powerful as heroin.

Janssen spokesman Greg Panico said the company monitors reports of abuse
and urges doctors to prescribe the drug responsibly.

"These drugs are carefully controlled, and it is really the physician who
has been (responsible for ensuring) that patients who receive them are
appropriate or in chronic pain."