BILL AIMED AT MAKING OPIATES TOUGHER TO ALTER, ABUSE

By Alex Bloom
Patriot Ledger, February 27, 2012

Ever since OxyContin hit the market more than 15 years ago, drug abusers have found ways to beat the time-release nature of the prescription painkiller to get a fast, powerful high.

Scott Fitzgerald, 24, said that when he was abusing drugs, he and other users would trade tips. One was to wet the pill to dissolve the outer coating, then crush it into a powder so it could be snorted, delivering the drug into the bloodstream all at once rather than over several hours as it is supposed to be used.

“It’s a sick reality, but it’s the truth,” said Fitzgerald, a recovering addict who has been sober for nearly five years. “We always find a way.”

So many followed the recipe that OxyContin abuse created a new wave of addicts, and fueled an epidemic that led to a resurgence of heroin use. The result – thousands of overdose deaths. From 2002 to 2007, the state reported 3,236 overdose deaths, mostly attributed to OxyContin and its cheaper alternative, heroin.

A new bill being pushed by U.S. Rep. William Keating, D-Quincy, is aimed at slowing the epidemic by targeting some of the prescription drugs that serve as the gateway to heroin.

The bill would give the U.S. Food and Drug Administration authority to require manufacturers of oxycodone and hydrocodone – the key ingredients in painkillers such as OxyContin and Vicodin – to create tamper-resistant pills that can’t be crushed into powder.

Dr. Nathaniel Katz, a Natick-based pain treatment specialist who has testified before Congress on OxyContin, said the bill’s requirement on manufacturers of generic oxycodone and hydrocodone products would close an important loophole.

Generic drug producers are required to make sure their drugs are what Katz called the bio-equivalent of OxyContin and Vicodin, but they do not have to have the same tamper-resistant features that brand-name drugs do. OxyContin, for example, was redesigned in 2010 so it couldn’t be crushed into a powder. Katz said addicts simply flock to easier-to-manipulate generic versions of the drug, which are becoming more readily available.

“That’s literally getting away with murder in my opinion,” Katz said.

Doctors prescribe the painkillers to millions of Americans each year for multiple types of pain, including everything from terminal cancer to chronic back pain.

But the drugs are highly addictive, and deadly.

Overdose deaths, Katz said, are only part of the problem. Addicts who contract HIV or hepatitis from dirty needles add to the number of casualties.

“It’s as if you had a major airliner crashing every week in that time and nobody investigating or doing anything about it,” Katz said.

Making prescription drugs more tamper resistant won’t stop everyone from abusing them, Katz said.

“They’re not fool-proof,” he said. “They cannot prevent a committed addict who is clever and resourceful and desperate.”

Keating said in an interview Friday that he realizes the bill, if it becomes law, won’t be a panacea.

“This is just one area to make a dent in the supply side by not making these drugs as available,” said Keating, the former Norfolk County District Attorney.

Katz believes new regulations would go a long way toward preventing occasional abusers from becoming addicts.

“We can accomplish enough without saying we invented a full-proof abuse-proof medication – which we obviously can’t do,” Katz said.

Congress has had the opportunity to act on prescription drug abuse for years, Katz said. OxyContin, manufactured by Purdue Pharma, hit the market in 1996.

Katz has testified to Congress himself on some of the ways to fix the drug.

“This is not one of those mysteries that nobody knows what to do about it,” Katz said. “This is one of those things that people have known what to do about it for a long time.”

Fitzgerald, the recovering addict, agreed.

“When people start dying, whether it’s in war or drugs on the street, there should be an automatic response to how are we going to fix this or what are we going to do to fix this,” he said. “I don’t think there should be any hesitation when it comes to people dying.”

Keating, who was elected to Congress in 2010, said he cannot explain why Congress didn’t act earlier.

“All I know is that in concrete terms, I’ve seen the effects,” Keating said of opiate abuse.

Keating hopes that the epidemic’s prevalence across classes will draw bipartisan support for his bill.

“It does hit every community in the commonwealth,” Keating said. “It does hit every socioeconomic category. This is an indiscriminate killer and we have to get past that stigma.”

Dr. David Fiellin, a primary care doctor and a professor at Yale University School of Medicine in addiction medicine, said Keating’s bill is a further step in the right direction.

“It’s good to see that these efforts are gaining more momentum because this is something that is affecting more and more youths in the country,” he said.