[NRSKarenRN]

By Mary McLachlin, Palm Beach Post Staff Writer
Friday, October 5, 2001
http://www.gopbi.com/partners/pbpost...ay/news_3.html

WEST PALM BEACH -- Deaths from painkiller overdoses rose steeply in Florida during the first half of this year, despite intense publicity about prescription drug abuse and efforts to curtail it.

Medical examiners found lethal levels of oxycodone or its chemical cousin hydrocodone, the active ingredients in several popular painkillers, in 243 autopsies, compared to 152 in the preceding six months -- an increase of 59 percent statewide.

Evidence of methadone abuse also went up dramatically. The drug turned up in 143 bodies, 39 percent more than the 104 in the previous six months. Methadone is a synthetic painkiller used as a maintenance drug for heroin and opiate addicts.

Alcohol continues to be the drug most often present in deaths handled by coroners: It showed up in 1,423 bodies during the six-month period. Tranquilizers were second, with 560 instances, followed by cocaine with 502 and marijuana with 303. Most such deaths involved multiple drugs.

The report compiled by the Florida Department of Law Enforcement shows Palm Beach County leading the state in deaths involving prescription drugs, as well as those implicating heroin. It also ranks second only to Miami-Dade County in cocaine deaths.

The Florida Board of Medicine will consider the report when it meets in Miami today. Board members will vote on recommended changes to laws and regulations controlling the painkillers and tracking their abuse.

Oxycodone is the opium-derived base of Percocet, Percodan, Tylox and OxyContin, a powerful pain medication widely abused because of the heroin-like high it produces when crushed and inhaled or injected. Hydrocodone, also an opium derivative, is the active ingredient in Vicodin, Lortab and Lorcet.

Statewide, 455 bodies contained the two drugs either singly, together or in combination with other drugs and alcohol. That's 20 percent more than the 378 reported during the last half of 2000.

Palm Beach County had 38 deaths in which oxycodone was present, but only three were blamed solely on the drug. The rest were in combination with other drugs.

The county had 21 methadone-related deaths, 29 involving heroin and 61 with cocaine, second only to Miami-Dade with 65. The numbers, unfortunately, were not startling, said investigator Doug Jenkins of the Palm Beach County Medical Examiner's Office.

"This is an affluent area, there's a lot of money, and it's a transient area with a lot of people moving through," Jenkins said. "So the drug situation doesn't surprise me."

The Treasure Coast counties of Martin, St. Lucie, Indian River and Okeechobee, ranked fourth in oxycodone and hydrocodone deaths. Their 35 cases were more than double the 15 recorded during the last six months of 2000.

"It's an eye-opening change," Treasure Coast Medical Examiner Riger Mittleman said. "It's something to be reckoned with."

Some of the oxycodone and hydrocodone deaths were suicides, and some were homicides or accidental deaths in which the drugs were present but not the direct cause. A few had taken the painkillers for legitimate medical reasons and died from illness or other natural causes. Purdue-Pharma Corp., the manufacturer of OxyContin, has said it is working on a formula that will neutralize the drug if abusers crush it to overcome its timed-release function. But the company said it could take three to five years to get approval for the new version.

Attorney General Bob Butterworth asked at a meeting of a drug abuse task force last month whether OxyContin should be pulled off the market until a tamper-proof formula is available.

But he said Thursday that the Board of Medicine, which regulates doctors, is going in the right direction with its proposals for a statewide registry to track all controlled drugs, limiting prescription renewals and cracking down on "pill mills" that hand out medications indiscriminately.

"This is a very good drug for a number of people who are in serious pain," Butterworth said. "The board is putting in certain procedures which, hopefully, will stop the irresponsible prescribing of the drug and reduce its misuse."

But he said Purdue-Pharma has a responsibility to get the abuse-resistant formula on the market as quickly as possible.

"And I don't think three to five years is realistic," he said. "I think it can be done in six months. I'm willing to help in any way and to get other attorneys general to help."

Staff Writers Jill Taylor and Sanjay Bhatt contributed to this story.

mary_mclachlin@pbpost.com