Friday, August 24, 2001
State task force meets in Roanoke to study plan of attack on abuse of drug
OxyContin under microscope
A statewide prescription monitoring program was one of the ideas discussed by the group.
By LAURENCE HAMMACK
THE ROANOKE TIMES
The rising number of fatal overdoses from oxycodone-based prescription drugs now stands at 55 since 1997, Virginia Attorney General Randolph Beales said Thursday.
Beales announced the figures to a state task force that met in Roanoke to discuss ways to curb abuse of OxyContin, a prescription painkiller that is easily converted to a street drug by addicts who crush the pills for a pure dose of oxycodone that is snorted or injected.
When the panel last met in May, the state medical examiner's office had recorded 43 fatal oxycodone overdoses in Western Virginia.
As the death toll has increased, so too have reports of OxyContin abuse in other parts of the state and country. "It's now going everywhere," Beales said.
The task force will meet once more to craft proposals for next year's General Assembly. Among the ideas discussed Thursday: a statewide prescription monitoring program aimed at preventing addicts from getting the drug illegally from doctors, stiffer punishments for dealers, and increased funding for education and prevention efforts.
The panel was created by former Attorney General Mark Earley, intending to study abuse of all prescription drugs. But OxyContin has dominated the discussion, and on Thursday three representatives from the company that makes the drug were on hand to respond to questions.
David Haddox, senior medical director at Purdue Pharma, outlined a number of steps the company has taken to fight abuse of OxyContin while ensuring that the drug remains available to legitimate patients.
Purdue Pharma has gone as far as directing its sales representatives to discourage doctors from prescribing OxyContin in high-risk areas such as Southwest Virginia if the physicians are unable - or unwilling - to determine when the drug is appropriate, Haddox said.
Oxycodone, the active ingredient in OxyContin, is derived from opium and has a high abuse potential.
However, Purdue Pharma disputes the number of fatal overdoses blamed on OxyContin.
The drug is often mixed with alcohol and other narcotics that are factors in fatal overdoses, Haddox said. And when there is a fatality, all an autopsy can determine is the presence of oxycodone, which is also found in about 40 other prescription drugs.
Haddox said the company has commissioned an independent forensic pathologist to study about 100 reports from the state medical examiner's office and determine how many of the deaths can accurately be attributed to OxyContin.
When the task force met in May, William Massello, assistant chief medical examiner, said that death-scene evidence and additional information provided to his office convinced him that OxyContin was a factor in many of the deaths.
And there were no oxycodone-related fatalities in Western Virginia from 1990 through 1995 - the year OxyContin was approved by the Food and Drug Administration, according to Massello's office. The numbers have climbed steadily since.
But relief could be in sight. Several law enforcement officials from far Southwest Virginia told the task force that drug sweeps, convictions of several doctors who overprescribed OxyContin, and increased public awareness based on media reports have all helped stem the tide of addiction and crime attributed to the drug.
"It seems to have leveled off and maybe gone down some," Tazewell County Commonwealth's Attorney Dennis Lee said.
In Lee County, the cost of OxyContin has nearly doubled. "We have driven up the cost, and I think that's a good indication ... that the supply has gone down," Lee County Commonwealth's Attorney Tammy McElyea said.
However, OxyContin abuse seems to be gaining a foothold in parts of Northern Virginia. Lt. Steve Hudson of the Prince William County Police Department said about half of the county's drug cases now involve OxyContin.
Perhaps the most talked-about solution at task force meetings has been a prescription monitoring program, a statewide electronic database that would allow police to determine if a patient is receiving multiple prescriptions from different doctors. Such systems exist in 18 states.
The system, which would cost at least $1 million to implement and would require General Assembly approval, might be opposed by the medical community on the grounds that it could undermine doctor-patient confidentiality, some task force members said.
Another concern was the amount of time it would take for pharmacists to enter information into the database.
But Del. Jackie Stump, D-Buchanan County, said the solution to such a devastating problem as OxyContin abuse might require a little bit of sacrifice from everyone. "Everybody's got to share a little pain in this thing to make it work."
