2 LEGAL DRUGS KILL MORE

Deaths from abusing legal prescription drugs in Florida surged during the
first half of the year, while fatalities from illegal drugs held steady or
declined.

And although drug experts are concerned about the deadly persistence of
heroin -- blamed for killing 19 people in the Orlando area -- they are
especially troubled by the dramatic rise in deaths from lethal doses of the
painkiller oxycodone and its cousin hydrocodone.

These findings, part of an assessment by state medical examiners of
drug-related deaths during the first half of 2001, show that in Central
Florida, at least 56 people died from January to June from fatal doses of
the two painkillers.

That was up from 46 deaths from the prescription drugs during the final six
months of 2000.

Across Florida, 165 people died from oxycodone and another 75 from
hydrocodone during the first six months of the year. The two drugs killed
152 people across the state during the last six months of 2000.

The powerful drugs -- sold under brand names such as OxyContin, Percocet,
Lortab and Vicodin -- were not even tracked by the state until July 2000.
That's when Purdue Pharma of Stamford, Conn., started manufacturing its
160-milligram version of OxyContin -- and when law- enforcement officials
saw a surge in abuse and illegal trafficking of the drug.

Relief for extreme pain

The synthetic narcotic, the nation's top seller, became immediately popular
with patients because of the relief it afforded people with cancer and
others with extreme, chronic pain.

But the pills also became the drug du jour among addicts who liked the
euphoric high OxyContin produced.

That surge is prompting Florida's attorney general to launch an
investigation into how OxyContin's manufacturer markets the drug and the
incentives it offers doctors to write prescriptions.

"We're trying to reduce the illegal diversion of the drug OxyContin to
unauthorized persons," said David Aronberg, assistant attorney general for
economic crimes.

Legal painkillers have long been a drug of choice among addicts, but the
trend has surged with the emergence of OxyContin, officials say.

Drug agents describe prescription-drug abuse as "very underrated" and say a
soaring appetite for oxycodone and hydrocodone on the street has put a new
face on drug addiction.

"Executives, cops, doctors, pharmacists, lawyers -- I've arrested them
all," said Orlando police Detective Lloyd Randolph, who arrested a 29-
year-old Orlando woman Tuesday for trafficking hydrocodone.

Drug maker cooperates

So far, Purdue Pharma has cooperated with Florida authorities.

"The abuse of prescription drugs and OxyContin is a problem that we take
seriously, especially since kids make up almost half of the first-time
prescription drug abusers," said Purdue executive vice president Dr. Paul
Goldenheim.

To demonstrate its concern, since Nov. 12, Purdue Pharma has run radio
advertisements in Palm Beach County and three other areas in the country to
discourage teenagers from illegally using prescription drugs.

Palm Beach County, where 54 people died from overdoses of oxycodone during
the first six months of the year, leads the state in painkiller abuse.

For recovering addicts, the investigation is welcomed.

A Lake Mary man, who is drug-free after getting hooked on oxycodone and
hydrocodone six years ago when he took Vicodin for pain after a back
injury, said those making a profit should help curb the illegal use of
prescription drugs.

"As far as I am concerned, they are the supplier," said Philip, 30, about
drug stores and pharmaceutical companies. He asked that his last name not
be used to protect his family and livelihood.

"And like drug dealers on the street, they should be held accountable," he
said.

The state report shows that illegal street drugs remain a problem in
Central Florida, especially the flourishing heroin trade in Orange County.

Cocaine deaths drop

Cocaine deaths, however, dropped from 34 to 24 in the region. Ecstasy
deaths were cut in half, from 10 to five.But it is prescription drugs that
are the target of a host of lawsuits around the country. And drug agents
have become increasingly aggressive, as reflected in the first- degree
murder charges filed against a West Palm Beach doctor who was accused this
summer of improperly prescribing OxyContin.

Counselors at The Center for Drug-Free Living in Orlando said that although
many of the addicts it treats start with legitimate prescriptions, they
eventually turn to the black market on the streets to purchase prescription
drugs illegally.

Orlando drug agents said a 40-milligram dose of OxyContin in Orlando costs
about $40, and 80-milligram pills can go for up to about $160 apiece or
$16,000 for a bottle of 100 doses on the black market. At the drug store, a
prescription for the same item would be about $900.

When the state first started counting deaths attributed to the painkillers
last year, many experts thought deaths were caused by users' crushing the
tablets and snorting them in order to get an intense and sometimes deadly
euphoria.

Federal study

But in recent weeks, a federal review of autopsy reports around the country
showed that almost all the deaths attributed to OxyContin were of people
who swallowed the pill whole or crushed it into powder and mixed it with
food or drink.

The federal study was the first to look into links between overdose deaths
and a brand-name drug. Of the 282 people whose deaths were associated with
OxyContin, fewer than 10 were intravenous drug abusers and only one likely
snorted the drug.

The negative attention surrounding OxyContin has caused alarm in pain-
management circles, where people suffering chronic pain say they depend
upon OxyContin and similar drugs in order to function. They fear the
autopsy reports and other negative publicity will make it impossible to get
drugs that deliver relief from disabling pain.

Those fears aren't completely misplaced.

A growing number of doctors, such as orthopedist Dr. Tom Winters in
Orlando, do not prescribe OxyContin because of its addictive history. And
Florida along with a handful of other states restricts the amount of
OxyContin that Medicaid patients can receive in a month without approval.

Last Friday, a national task force on prescription-drug abuse began looking
into problems with OxyContin.

"The goal is not to shut down the company or ban the drug," Aronberg said
about the investigation he's leading. "We want to protect the patients who
need the drug while restricting access to abusers."