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Good afternoon Chairman Greenwood, and members of the House
Committee on Energy and Commerce. I’d like to thank the Committee for giving
me the opportunity to testify today on a problem that is exploding in
Pennsylvania right now. The abuse of the brand name painkiller OxyContin is
rising on a tremendous scale - placing people who are unaware of its lethal
potential in danger, and placing a burden on law enforcement agencies across the
state as they try to contain its distribution. I commend the Committee for being
so quick to shed light on this new danger. Hopefully, by giving the matter the
spotlight this early, we can perhaps stem the tide of deaths that abuse of this
drug is causing.
Since this is such a new problem, allow me to give the
Committee a little background on what OxyContin is and why its abuse has such
devastating effects. OxyContin is a high potency pain killer derived from opium.
When used as prescribed it provides effective pain management for cancer
patients and others suffering from chronic pain. When properly taken, an
OxyContin tablet is time-released and provides the patient with up to 12 hours
of pain relief. The danger arises when that time release mechanism is bypassed.
Abusers will either chew or crush a tablet, so that it can be snorted or mixed
with water and injected -- like heroin. This puts the drug into the system all
at once and delivers an intense high, much like high-grade heroin. This is why
OxyContin is sometimes referred to on the street as "poor man’s
heroin" or "hillbilly heroin."
For example, five milligrams of OxyContin has the same active
ingredients as one Percocet - so chewing or snorting a single 80 milligram
OxyContin tablet is like taking 16 Percocets all at once. Few abusers fully
realize the enormous potency of the drug they are taking, and frankly, this is
why many of them are dying. When taken by a person whose body is in any way
intolerant to the drug, or when taken with other depressants - like alcohol -
the result will likely be the death of the user. The drug slows the respiratory
system. The abuser will lose consciousness and breathing will decrease until it
eventually stops. To date, Pennsylvania has not accumulated the total number of
deaths linked directly to OxyContin abuse - remember that this is still a
relatively new phenomenon - but recently the medical examiner in Delaware County
reported that 17 deaths last year [2000] were attributable to the abuse of this
drug. That’s a significant number, and I believe we can expect to see similar
figures throughout the southeast and across the Commonwealth.
On the street, prices for the drug vary depending on
geographic location. But generally, OxyContin sells between 50 cents and $1 per
milligram. So a 40 milligram tablet which sells legitimately for $4 will bring
10 times that amount on the street. So not only is the drug in demand by
addicted abusers, there is a strong profit motive in its illegal distribution.
Because OxyContin is a Schedule II prescription drug with a very legitimate
value for treating chronic pain - the illegal activity of getting it into the
hands of abusers is centered around pharmaceutical diversion. The illegal
distribution of the drug typically involves the following criminal activity:
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A doctor who fraudulently prescribes OxyContin to
abusers for money.
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A pharmacist who illegally fills an abuser’s
prescription, or who forges prescriptions for abusers.
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Abusers who steal prescription pads, and then write
their own forged prescriptions.
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Dealers, or abusers themselves, who burglarize
pharmacies.
In the past two years, the Pennsylvania Office of Attorney
General has conducted nearly 100 OxyContin abuse investigations throughout the
Commonwealth. Many of these investigations have resulted in arrests, while
others are still pending. Allow me to tell you about some of the recent efforts
the Bureau of Narcotics Investigation has been making in this region of the
State;
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In June, agents arrested a Philadelphia man who
illegally possessed over 3,000 prescription drugs, including a kilogram of
OxyContin. This was nearly 900 tablets, with a street value of $60 per tablet.
Raymond Johnson, of Elsinore St., Philadelphia, was charged with illegal
possession of a controlled substance and possession with intent to deliver. If
convicted, he faces up to 15 years in prison.
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In April, we concluded an investigation into a Bucks
County pharmacist who was allegedly producing fraudulent prescriptions in order
to illegally distribute OxyContin. Lewis Winokur, who practiced in a Bristol
Township pharmacy, is charged with filling fake prescriptions in the names of
customers he obtained from his pharmacy, and sold them to OxyContin abusers. The
names of the customer’s physicians were then allegedly forged by the drug
addicts. Winokur was charged with 11 counts of illegal delivery of a controlled
substance by a practitioner, and tampering with public records. He is facing a
maximum penalty of more than 100 years in prison and more than a $1 million in
fines.
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In March, our BNI agents and Bucks County law
enforcement officers arrested Dr. Richard Paolino, who practiced in Bensalem.
Our investigation alleges that Paolino’s practice amounted to a revolving door
for OxyContin junkies. The confidential informant, who worked with our agents,
went to Paolino’s office every month to get OxyContin and Xanax without ever
being examined. We allege that it was standing room only in Dr. Paolino’s
waiting room, and most of the patients were gaunt, with dilated eyes. Some
"patients" showed obvious signs of withdrawal. Dr. Paolino allegedly
only accepted cash for office visits -- $66 for the first visit, $59 thereafter.
Paolino was allegedly handing out so many prescriptions that our office was
originally alerted to the problem by a Philadelphia pharmacist who was being
confronted with so many Paolino Oxy prescriptions that he eventually stopped
filling them.
In addition to dedicating agents and resources to
investigating specific instances of abuse, the Bureau of Narcotics Investigation
will be operating regional educational programs for both law enforcement
agencies and health care professionals. Since the abuse of OxyContin is such a
new phenomenon, most local police forces lack the experience to properly target
the problem in their communities. Health care professionals, such as
pharmacists, also need to be educated to the potential this painkiller has to be
diverted into a lethal street drug. The Office of Attorney General’s
experience in dealing with OxyContin abuse needs to be disseminated throughout
the Commonwealth. For although the problem is particularly bad in the southeast,
it will quickly spread.
The first conference -- which was held on August 21st
in King of Prussia -- is designed to give local law enforcement agencies
training in dealing with this new epidemic of drug abuse. We can share our
office’s experience in attacking the problem. We can identify the abuser
population that is likely to possess the drug. We can alert them to the often
elaborate schemes that are used to divert this scheduled drug out of the
hospitals and pharmacies and onto the street where it kills. For example, the
Bucks County case I mentioned earlier involved a medical professional -- a
licensed pharmacist -- manipulating the records of his workplace in order to
duplicate legitimate prescriptions and sell them to drug addicts. This is not a
run-of-the-mill street drug distribution ring with which local investigators are
familiar. Medical professionals, as well, need to be aware of ways this
dangerous drug can fall into the wrong hands.
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These are the actions that our office has taken and will
continue to take in response to this new drug epidemic: targeted enforcement of
the current drug laws and education of local law enforcement agencies. But you,
as members of Congress, are wondering what you can do to assist law enforcement
in fighting the problem. OxyContin presents a somewhat unique problem because it
is a legitimate drug that -- when properly prescribed and taken -- serves as a
valuable tool in treating chronic pain. We cannot simply make its possession an
offense, as the Pennsylvania General Assembly did in 1999 when it made GHB a
Schedule I controlled substance. Any attempt to deal with this problem
statutorily must be aimed at the diversion of the drug from its intended
pharmaceutical use to its abuse as an illicit street drug. Our office has
offered the following legislative recommendations to the Pennsylvania General
Assembly:
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The theft of a prescription blank or a prescription
pad should be a distinct offense punishable as a third degree felony. Right now,
the theft of a prescription blank is graded only on the value of the paper -- a
low misdemeanor. But the potential street value of the prescription drugs that
can be illegally obtained with just one pad of blanks can be thousands --
perhaps hundreds of thousands -- of dollars. That is the value on which the
offense should be graded. Each of those little slips of paper must be viewed as
a significant source of revenue for the OxyContin dealer, and the possible death
for the addict who doesn’t know the danger of the drug he or she is taking.
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The outright theft of a prescription drug should be a
felony offense under the Controlled Substances Act. Currently, the Controlled
Substances Act only prohibits the obtaining of prescription drugs through fraud
or forgery. The simple theft of these drugs is a Title 18 offense, graded on
their actual, legitimate commercial value -- which is relatively low. The
penalty for stealing these drugs should reflect their potential both in street
value and in harm to the user.
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The practice of "doctor shopping" should be
a distinct offense under the Controlled Substances Act. Very often, illicit
prescriptions for drugs like OxyContin are obtained by one individual who visits
doctor after doctor complaining of phantom symptoms. The prescriptions are then
filled and the dealer is in business. This practice should be recognized and
punished for the crime that it is.
Again, I’d like to thank Chairman Greenwood for inviting me
here today to testify on this new wave of drug abuse that threatens our
communities. I believe that directing both the public’s and Congress’s
attention to the abuse of OxyContin at this stage in the trend will help to
minimize the damage it causes.
I would be happy to answer any questions the members of the Committee may
have.
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