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Executive
Summary
The abuse of
the prescription drug Oxycontin has created new challenges to both law
enforcement and public health officials. In Delaware County, Pennsylvania,
we have documented 18 Oxycodone related deaths in the year 2000 – a dramatic
increase we have attributed to the recent emergence of Oxycontin as a growing
drug of choice for recreational drug abusers in the metropolitan areas of the
Mid-Atlantic States.
In Delaware
County, we have begun to address the Oxycontin abuse problem by applying the
collaborative approach between public health and public safety agencies that we
have adopted through our efforts to combat school violence. By working
together we believe we will achieve our goals of (1) education, (2) prevention,
and (3) prosecution of those who abuse or profit from the abuse of this drug.
It is my
hope that the model of Delaware County’s collaborative approach to combating
Oxycontin abuse will be a model for other counties to learn from and follow
from as they deal with this important public health issue.
Testimony
of District Attorney Patrick L. Meehan
Chairman
Greenwood, members of the committee, ladies and gentlemen. Thank you for the
opportunity to be here with you today to talk about a serious issue that effects
both our public health and the fight against crime. That problem is the
growing abuse of a legal prescription drug, Oxycontin.
The drug
Oxycontin has presented public officials at all levels of government with a
unique problem. One the one hand, this drug, when used properly, as
prescribed by a caring physician, can be a life-enhancing solution to the severe
pain suffered by people afflicted with debilitating injuries and diseases.
On the other hand, when this powerful drug is abused, by being crushed or chewed
and ingested, it can kill. This powerful drug presents such a clear paradox that
a Web site devoted to the controversy surrounding it begs the simple question:
Oxycontin- Savior or Killer?
As a local
prosecutor, my first and foremost concern about this drug is its potential to
become an attractive drug of choice for recreational users and in particular for
the young people who populate the “Rave Culture.” Prosecutors have
already seen the drugs Ecstasy, GHB, and Ketamine become popular with
recreational users because the abusers have deceiving themselves into thinking
that they are not as harmful as illegal drugs such as cocaine and heroin.
This deception occurs for a number of reasons: (1) Because these drugs are
manufactured, not produced illicitly, abusers have a false sense of security in
the drug’s safety. (2) Because these drugs are not taken intravenously,
abusers feels safe from AIDS or hepatitis contamination. (3) Prescription
or chemical drugs come with what I call a “Madison Avenue-type” appeal;
their scientific-sounding names raise the sense of excitement for the user.
And lastly (4) these drugs are readily available. They are, after all, sold
legally at the neighborhood drug store to anyone with a prescription.
Oxycontin
abuse by recreational users is particularly disturbing because the drug can
become a “Gateway” drug to other narcotics, such as cocaine and heroin.
Whenever a recreational user begins narcotic drug use, the potential for
addiction is great. The recreational user who began narcotics with
Ecstasy or Oxycontin may need to continue to get his high, but often finds the
legal supply inadequate or unavailable, sometimes because of price.
Oxycontin is an expensive drug, selling on the street for $0.50 to $1.00 per
milligram. Prescription use calls for 2 tablets a day – each tablet,
through a timed release, providing pain relief over a 12-hour period.
Abusers will crush or chew the tablet to get the instant high, making the drug
potentially lethal, but also requiring more tablets for abusers to stay high.
Because Oxycontin may cost $40-$80 per tablet on the street, addicts may find it
cheaper to buy cocaine or especially heroin, which unfortunately are easily
available in Southeastern Pennsylvania.
The abuse of
prescription drugs has created issues for prosecutors that may require changes
in the law. First, the most important function of law enforcement in the
fight against prescription drug abuse is to combat the sale or “diversion”
of the drug by a new breed of drug dealers. These drug dealers are not of the
usual “street – corner variety”. Increasingly, we are seeing doctors
and pharmacists engage in these “diversion” schemes by selling sale
prescription drugs to abusers. The Bucks County case of Dr. Richard
Paolino is a perfect example of the professional fraud that we know exists when
you have a product like Oxycontin, which sells on the street for $40 to $80 per
tablet and is capable of producing such an addictive high that it is commonly
called “ the Poor Man’s Heroin.”
As you
will hear today from other speakers, Pennsylvania’s Attorney General Michael
Fischer is working with the General Assembly on legislative proposals to give
law enforcement new tools to combat the diversion of prescription drugs.
First, he is seeking to increase the criminal penalties for the theft of either
prescription “scripts” or for the drugs themselves. Second, he is
seeking the creation of a new crime to stop the practice of “doctor
shopping” to acquire prescriptions. Attorney General Fischer has also
been working in cooperation with the federal Drug Enforcement Agency (DEA) to
create an electronic pharmacist reporting system here in Pennsylvania.
These systems, in place in states like Kentucky, have allowed law enforcement to
more closely monitor and catch pharmacists and doctors who participate in drug
diversion schemes. I support their efforts and I hope we will see
legislative action in Harrisburg on these proposals this fall.
But we know
that solutions to the problem of the abuse of prescription drugs like Oxycontin
are not just matter of criminal law. This is a community problem,
requiring collaborative efforts between government institutions, and in
combination with civic and professional organizations. That is the
approach we have taken in my county, Delaware County, which I am proud to share
with you today.
In Delaware
County, the problem of Oxycontin abuse was first brought to our attention by the
work of our Medical Examiner Dr. Frederick Hellman. As you can see from
the accompanying charts (Chart 1), Dr. Hellman has documented 18 deaths in our
county in the year 2000 where at the time of death the decedent had Oxycodone in
their system, usually in combinations with other drugs that the decedent had
been abusing. These 18 deaths represented an explosive increase in
Oxycodone abuse in our county. We had never before had more than 5
such deaths in one year since the introduction of the drug Oxycontin into the
marketplace in 1996. Yet in just the month of April of 2000 alone, (Chart
2) there were 6 Oxycodone related deaths in the county. We have
attributed this increase to the growing popularity of Oxycontin as a drug of
choice for abusers on the east coast. These numbers are proof that Oxycontin
abuse, which first began in southern and midwestern states, has now moved east
to the metropolitan areas of the Mid-Atlantic States.
When Dr.
Hellman brought his findings to the attention of myself and members of the
Delaware County Council, we decided to address the problem by using a
collaborative interdepartmental approach. We focused on three goals: (1)
education, (2) prevention, and (3) prosecution. For us in Delaware County,
this was not a departure from standard practice but another application of our
working county governmental paradigm to a new challenge.
Increasingly, we in county government find ourselves challenged by community
problems that have no easy answer. Under Pennsylvania law, it is the
primary responsibility of county government to provide for systems of law
enforcement and behavioral human services for our communities. We have
found, in Delaware County, that the problems we deal with in law enforcement
generally have a human service aspect that must be addressed. We
have come then, over the last several years, to find that the most efficient and
productive way to do our jobs for our constituents is to work together.
We first
created this collaborative paradigm in our efforts to combat school violence. In
the spring of 1997 I brought together school administrator, teachers, local
police, and behavioral service providers to work together to begin to identify
issues of school safety in our county. In November of 1998, this working
group hosted our first Safe Schools Summit. The result of that summit and
the one that followed was the development of a “Delaware County model” of
training for first responders to incidents of critical school violence.
That model, developed through real school violence simulation exercises, has
been distributed across the country in a videotape format by the National
Tactical Officers Association (NTOA), who have endorsed this training model.
This year we devoted our third Safe Schools Summit to the often overlooked issue
of teen suicide and the need to identify and combat what is the third leading
cause of death for American teenagers.
We are now
applying what we have learned by working together on safe schools, to the
problem of Oxycontin abuse. In July, I held a press briefing along with
Dr. Hellman to begin the educational campaign about Oxycontin. Our County
Council later dedicated a public meeting to the issue and has since required all
county agencies to work together to identify abusers who come into our offices
for behavioral treatment. County Council also has produced a public
informational flier on the dangers of Oxycontin. To further our goal of
prevention through public education, we are getting that flier to our county
agencies and to such groups as the Delaware County Medical Society.
The next,
and perhaps most vital step in our county campaign against Oxycontin abuse, is
the educational effort we will undertake this fall in our schools to raise the
awareness of our young people to of the danger of this drug’s abuse. As
we all know, many students unfortunately begin experimenting with recreational
drugs at an age when they possess a misguided sense of invincibility about such
dangerous things. It is for their protection that we will be devoting our
next Safe Schools Summit to the overlooked issue of prescription drug abuse.
My hope is
that our Delaware County collaborative approach to combating oxycontin abuse
will be a model for other counties to follow, as they face this issue important
public health issue, and I thank the members of this committee for their time
and attention today.
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