More MS news articles for July 2001

Pain pills claiming new crop of addicts

http://www.bergen.com/news/oxyfolo200107072.htm

Saturday, July 7, 2001

By ASHANTI M. ALVAREZ and PETER POCHNA
Staff Writers

In the past few months, a new kind of patient has begun to seek help at drug rehabilitation centers in North Jersey.

The patients are addicted to the prescription painkiller OxyContin -- a hot item on the black market in several other states and one that is slowly making an impression on New Jersey drug abusers.

"We're seeing more and more OxyContin addicts every week," said Phyllis Prekopa, nurse manager of the detoxification unit at Bergen Regional Medical Center in Paramus. "Two years ago it wasn't even part of people's vocabulary. Now everybody knows about it and is talking about it."

OxyContin is manufactured and marketed as a strong pain reliever for people with severe discomfort, such as cancer patients, multiple sclerosis sufferers, and those recovering from major surgery.

Nationally, it began causing problems about 18 months ago in rural states such as Maine and Kentucky, where it became popular with abusers because of its heroin-like effects. It has taken longer to infiltrate the North Jersey drug scene, primarily because of the state's active heroin trade, police and counselors say.

Although authorities at this point aren't sure how widespread a problem OxyContin could become, evidence indicates it is growing in popularity among street users, who crush the pills and snort or inject them to experience its euphoric, heroin-like rush.

In Passaic County, authorities recently arrested two men who work for the manufacturer of OxyContin and charged them with illegally possessing the potent painkiller with the intent of selling it. Last month, Union County officials accused a Cranford man of possessing several thousand pills for sale. And in Ocean County, a nurse from Toms River was charged with stealing 11,000 pills over a 14-month period.

In Gloucester County, prosecutors arrested two county employees and several alleged accomplices, accusing them of using county prescription benefits fraudulently to obtain thousands of OxyContin pills.

"They'll go into the doctor and say they have a previous history of something," said Ocean County Prosecutor Andrew Yurick. "They'll work the physician into giving them OxyContin. They'll go to five pharmacies and get five OxyContin prescriptions."

Although abuse is still small-scale compared to illegal drugs, Ocean County Prosecutor Terrence Farley said, the problem is going to mushroom as long as OxyContin is still on the market.

"I don't see it yet as a major, major drug in the numbers of our major drugs of abuse," he said. "But unless they stop the volume of manufacturing that's being done, it's going to get worse."

An FDA spokesman said government agencies and the manufacturer should finish a plan in the next few months to curb misuse of OxyContin.

"We've been in ongoing discussions with the company about what can be done," said the spokesman, Brad Stone.

Officials for Connecticut-based Purdue Pharma, the company that developed and patented OxyContin, declined to comment Friday.

Spokesman James W. Heins said Totowa-based PF Laboratories is the only manufacturer in the nation for OxyContin and other drugs produced by Purdue Pharma.

Oxycodone -- the active ingredient in OxyContin -- is a generic substance used in 40 different pain medications, but the concentrations found in OxyContin are much higher than in the related analgesics Percocet and Percodan. It is slowly released into the bloodstream to provide a sustained level of medication for pain control.

"It's been tremendous for many of my patients," said Dr. Abe Holiczer, a pain management physician at Hackensack University Medical Center. "It allows them to comfortably go to work and live as close to a normal life as possible."

For those reasons, Holiczer said, his department closely monitors prescriptions to ensure that patients don't hoard the drug, which comes in pills ranging from 10 milligrams to 160 milligrams.

Charles Liotta, the director of the pharmacy at St. Joseph's Hospital and Medical Center in Paterson, said he is warning his colleagues to be careful when filling OxyContin prescriptions.

The drug's popularity on the black market means that pharmacists should beware of people forging prescription slips, Liotta said.

"With that particular drug, it's the pharmacist's responsibility to get ahold of the physician if there are any doubts about the customer," he said.

Authorities say the profit potentials in selling OxyContin are great, exceeding that of many illicit drugs including heroin and Ecstasy.

In most cases, Yurick said, people obtain OxyContin by filling out false prescription slips, robbing pharmacies, or "doctor shopping" -- the practice of going to different doctors and asking for OxyContin prescriptions for minor or non-existent pain.

"Philadelphia is the source city for most drugs in South Jersey," said Ocean County First Assistant Prosecutor Terrence Farley. "I have a guess that some former heroin addict discovered it someplace, and by word of mouth it started to become popular."

It happened quickly, Yurick said.

"Last year, we never even heard about it. We didn't have any investigations going. It was just not here," he said.

If New Jersey is struck by an epidemic, authorities can look to Maine for a sense of what to expect.

Abuse of the painkiller first exploded there because of the region's poor economies, a scarcity of cocaine and heroin, and large populations of elderly people who use the drug to relieve the pain of cancer, arthritis, and other illnesses. Pharmacy robberies have been on the rise there, authorities said.

Last year, in response to OxyContin abuse, the U.S. Drug Enforcement Agency increased the number of agents battling prescription drug crime in Maine from one to four. Their cases have included one of a Bangor man who is accused of selling more than $8,000 worth of OxyContin each week for an entire year.

Authorities said the man got the pills from his wife, who had a prescription, then sold them on the street for about $1 per milligram -- or about $4,000 for a single 100-tablet bottle of 40 milligram pills. The couple allegedly remodeled their home and bought a van with the money.

At a methadone clinic in South Portland, Maine, about a quarter of the 500 patients are OxyContin addicts.

John Destefano, the clinic's director, said people wary of heroin turn to OxyContin and then move on to heroin. When addicts can't find heroin, they use OxyContin, he said.

"For prescription drug addicts, it has become the drug of choice," Destefano said.

Drug counselors in northern New Jersey fear they may soon see similar numbers at their clinics.

OxyContin addicts now make up only a tiny percentage of the 4,000 people who annually go through the medical center's four-day detoxification program, said Prekopa of Bergen Regional Medical Center. But she said she expects the percentage to rise.

"There's less of a stigma to it than heroin," she said. "It's becoming kind of cool to do it."