DRUG SUSPECTED IN 282 DEATHS

OxyContin Abuse A Rising Concern

An extensive federal review of autopsy data has found that the powerful
painkiller OxyContin is suspected of playing a role in the overdose deaths
of 282 people in the past 19 months, more than twice the number in some
previous estimates.

The analysis also found that virtually all the deaths were of people who
swallowed the pill whole or crushed into powder, further suggesting that
OxyContin misuse may be difficult to curb. Previously, the overdose deaths
were thought to be people who injected or snorted crushed pills, which
offers a quicker, more dangerous delivery of the drug.

Asa Hutchinson, the nation's top drug enforcement official, recently called
the new finding "startling."

The drug manufacturer, Purdue Pharma, acknowledged recently that even after
reports that OxyContin had been getting into the wrong hands, the company
continued to distribute free seven-day supplies through doctors as part of
promotional campaigns.

This Drug Enforcement Administration study is first to explore links
between overdose deaths and a brand-name drug. Previous reviews had looked
only at drugs' active ingredients, used by many manufacturers.

Besides the 282 deaths, which often also involved other drugs and alcohol,
federal officials said they found that 500 people had died since the start
of 2000 from overdoses involving oxycodone, the active narcotic in
OxyContin and other popular painkillers.

Federal officials could not say whether the oxycodone linked to those
deaths was from OxyContin, a drug for the treatment of severe and chronic pain.

"This verifies the fear and concern that we have had about this drug,"
Hutchinson said.

Dr. David Gauvin, a pharmacologist at the DEA, said medical examiners in 30
states had reported about 1,010 overdose deaths involving oxycodone since
January 2000.

Based on responses to date, the agency concluded that OxyContin was
"directly linked" as a factor in 110 overdose deaths because tablets were
either found in a person's stomach or a prescription for the drug was found
on a body. Other confirmation came from reports on interviews with witnesses.

Dr. Paul Goldenheim, the vice president for research and development at
Purdue Pharma, said DEA's data were consistent with the company's findings.
But he emphasized that none of the information implicated OxyContin in any
of the reported deaths.

Federal officials have said that abuse of OxyContin has grown faster than
abuse of any other prescription drug in decades. Purdue Pharma heavily
promoted the drug as safer than other narcotics because its active
ingredient was in a time-release mechanism. But abusers quickly learned
that crushing the pill disarmed that feature.

The company's salespeople gave doctors promotional material about OxyContin
that contained cards, which were given to patients along with a
prescription. A patient would take the card to a pharmacy for free dosages.

Michael Friedman, the chief operating officer of Purdue Pharma, based in
Stamford, Conn., said the sampling program was used to acquaint patients
with the drug.

He said the company had begun a new card program in July but stopped it a
few days later when the Food and Drug Administration placed the highest
possible warning on OxyContin's label.

Asked why Purdue continued to offer free supplies in the face of mounting
reports of abuse, Friedman said he considered the people receiving the
cards from doctors to be legitimate patients.

He estimated that the company had run four or five similar marketing
programs for the drug in recent years and that 8,000 to 15,000 cards were
distributed each time.

"The fact that we're providing a sample to a patient has no connection to
some criminal doctor who was taking money for prescriptions," Friedman said.