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Friday, December 19, 2003
Prescription painkiller abuse at epidemic level
By Ryan Justin Fox, Special to Stateline.org
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Abuse of the powerful prescription painkiller OxyContin has reached epidemic proportions that police and health experts compare to crack cocaine addiction, prompting Florida lawmakers and state legislators throughout the country to take countermeasures.
"[Florida] is seeing five deaths a day," the state's drug chief, James McDonough, said of the narcotic. McDonough said that, just several years after the drug's introduction into the marketplace, abuse of OxyContin surpasses heroin and cocaine and has become "an epidemic of enormous proportions."
Earlier this month, Florida Gov. Jeb Bush (R) launched a task force to investigate the extent of OxyContin abuse, and state Sen. Burt Saunders (R) introduced legislation aimed at helping law enforcement and health officials combat abuse of the drug.
The legislation would establish a monitoring system allowing state health officials to track prescriptions of the drug. The electronic system would have a built-in "watchdog" component that alerts authorities when doctors over-prescribe the medication or when patients appear to be "doctor shopping" for physicians willing to prescribe powerful painkillers.
Florida's monitoring system would also require two doctors to sign off on a prescription before a patient is allowed to use OxyContin.
"I think we are light years ahead of the game in this fight," said McDonough, director of Florida's Office of Drug Policy. Part of the legislative package calls for restrictive access to highly addictive drugs over the Internet. "Right now, kids can just sign on the net and get anything they want. We need to put an end to that," McDonough added.
Currently, 15 states have similar electronic monitoring programs in place, said Stephanie Wasserman, a health policy expert with the National Conference of State Legislatures. They are California, Hawaii, Idaho, Illinois, Kentucky, Michigan, Nevada, New Mexico, New York, Oklahoma, Rhode Island, Texas, Utah, Virginia and Washington. Connecticut and Maryland have bills pending that would establish monitoring programs.
Maine, Pennsylvania and West Virginia have imposed stiffer penalties for those illegally selling prescription drugs.
OxyContin, the signature painkiller of Purdue Pharma, has been hailed as an effective pain reliever by doctors and chronic pain sufferers, such as cancer patients and the terminally ill.
An opiate, its active ingredient oxycodone hydrochloride is found in other highly abused prescription drugs, such as Percocet. However, OxyContin's 12-hour time-release formula makes one pill last all day, unlike other painkillers that require multiple doses.
This makes OxyContin the preferred drug of misuse, and abusers chew, snort, dissolve and inject the drug into their bloodstreams for a powerful high similar to heroin.
Reports linked 573 deaths in 2001 and 2002 to oxycodone overdoses in Florida, surpassing the number of deaths caused by heroin. Although all social and economic groups have been affected by the oxy epidemic, experts said the drug has gained headlines because of its big impact on average, middle-aged and working class Americans.
Kentucky, with a large blue-collar and rural population, has been hard hit by OxyContin abuse, said state Rep. Robin Webb (D). A high occurrence of work-related injuries caused by industrial accidents in the state's coal mines and farms has created a high demand for the drug's powerful, morphine-like effects, he said.
Kentucky even passed a resolution to urge neighboring Ohio to take OxyContin off its Medicaid Preferred Drug list.
Kentucky's prescription drug monitoring system has provided a real-time resource for law enforcement and health professionals in conducting official investigations, state health officials said.
"We can't put a burden on our pharmacists, but we need to provide safeguards," Webb said. "I just want my people to stop dying."
Webb introduced unsuccessful legislation last year that would require patients to provide photo identification and a thumbprint before receiving prescriptions.
West Virginia state Sen. Truman Chafin (D) introduced unsuccessful legislation that would have made oxycodone a Schedule 1 narcotic, which would ban all pills containing the substance, including Percocet, Roxicet, and Tylox.
Chafin's state ranked first in OxyContin prescriptions per capita in 2000, and widespread abuse of the drug in rural Appalachia has garnered it the nickname "Hillbilly Heroin."
West Virginia unsuccessfully sued Purdue Pharma for failing to warn doctors and patients of how addictive OxyContin can be.
"I don't want to cut it off to those who really need [OxyContin], but it looks like the abuse is outweighing the beneficial effects right now," Chafin said.
Contact Ryan Justin Fox at rfox@stateline.org
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