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Overdoses lead to search for safer painkillers

By Chris Tisch, Times Staff Writer
In print: Monday, May 19, 2008


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In the face of increasing deaths from overdoses of prescription painkillers, several pharmaceutical companies are trying to bring to market drugs they say are abuse resistant.

Last year, about 2,000 Floridians — 500 in the Tampa Bay area — fatally overdosed on prescription drugs. The vast majority of the lethal drugs were opioid painkillers like oxycodone, hydrocodone and morphine.

Pharmaceutical companies say many of the people dying are abusing the drugs by crushing, biting, snorting or injecting time-released pills. This provides a powerful, heroinlike high.

The Food and Drug Administration has encouraged manufacturers to study ways to make their drugs less susceptible to abuse.

Several companies are seeking approval of new formulas this year. Some of the drugs are rubbery or gel-like and can't be crushed. Others have substances embedded in the pills that offset the euphoric affects of the drug if it is crushed or manipulated.

"Our goal is to address a public health concern," said Dr. Joseph W. Stauffer, chief medical officer at Alpharma Pharmaceuticals, which hopes to have an abuse-resistant morphine pill on the market by next year.

But this month, a panel of FDA advisers expressed skepticism about an abuse-resistant form of OxyContin. Panelists said OxyContin maker Purdue Pharma hadn't provided enough evidence that its new product would deter abuse.

"I'm fascinated with the poor scientific rigor" of the data presented by Purdue, FDA panel member Jeffrey R. Kirsch said. "It's almost insulting."

Purdue said in a statement it would continue working with the FDA on the product.

Larry Golbom of Pinellas County spoke against FDA approval of the new drug during the panel meeting in Maryland. Golbom is a pharmacist with a family member who become addicted to prescription drugs. He hosts a radio show about prescription drug addiction on Sunday nights on WGUL-AM 860.

"There is no logical sense to making more of this product available on our streets," Golbom said. "To present the concept that this is a safer drug would be a tremendous disservice to the medical profession and the American public."

Golbom believes most of the people who die of painkiller overdoses don't snort or inject the drug, but swallow the pills whole.

The St. Petersburg Times analyzed the autopsy reports of nearly 800 prescription drug deaths over a two-year period for a series published in February. The analysis found there is no way to be certain if the fatal drugs were swallowed or taken another way.

Golbom worries that FDA approval of additional drug types would give doctors a false sense of security.

"The fact is that oxycodone is a highly addictive drug in the same category as heroin," Golbom said. "The reality is that pain relief is a side effect of this drug."

Last year, Purdue agreed to pay $634-million to settle criminal charges that it misled doctors about the risks of OxyContin, which had more than $1-billion in sales last year.

Golbom said the drugs proposed by other companies also should be scrutinized. He said the FDA needs to better define when opioid painkillers should be prescribed.

But Stauffer said the indications are clear. He said the new drugs will help ensure that drug abuse is deterred, while those who need painkillers can continue to receive them. "There are dual public health issues at stake here," he said.

Stauffer said only a small percentage of people prescribed painkillers become addicted. He said the drugs help far more people than they hurt.

Alpharma's abuse-resistant drug has gone through trials that have found it to be safe and effective, Stauffer said. The pills are embedded with a substance that blunts the euphoric high users would receive if the pills were crushed.

King Pharmaceuticals also hopes to submit by June an application for its abuse-resistant oxycodone drug, Remoxy.

The gel-like Remoxy, which has successfully completed trials, does not lose its time-release mechanism if crushed, said James E. Green, King's executive vice president of corporate affairs.

Green acknowledged there is no way to ensure drug abusers won't find some way to defeat the abuse-resistant features of the new drugs.

"I don't know that you'll ever have anything that is tamper-proof," Green said. "You just don't want it to be easy for people to tamper with."

The drugs could mean billions of dollars for the companies.

Last year, sales of opioid painkillers totaled $6.37-billion in the United States, a 52 percent increase over 2002.

Dr. Lynne Columbus, a Palm Harbor pain physician, said the abuse-resistant pills are a good idea.

"I think they will help a lot," she said. "It will give us a medication we can prescribe and sit back and relax and know people can't bite it and overdose."

Information from Bloomberg News, Dow Jones Newswires and the Associated Press was used in this report. Chris Tisch can be reached at 727-892-2359 or tisch@sptimes.com.



[Last modified: May 21, 2008 02:45 PM]



Comments on this article
by Deana May 20, 2008 4:28 PM
Jan, I feel your pain. If there was a surgery that would cure all my ailments, I would do it in a heartbeat. But until that day comes, I'm living with the help of prescription drugs.
by Lynn May 20, 2008 9:36 AM
Amen and Thank you Barry!! Well Said. To all of you ignorant others, I hope you never experience addiction with any loved ones.......even yourself. Educate yourselves before you run your mouths.......inconsiderate individuals.
by Lenore May 20, 2008 9:36 AM
I feel bad for people that are actually in pain. It's pretty sad that anything is brought forth to help people there are the people that abuse it and screw it up for everyone.
by Lisa May 20, 2008 9:36 AM
Tanya & Barry- you don't have a clue and you wouldn't talk like that if you spent weeks or months with chronic pain. If you want to help preventable deaths start with tabacco or drunk driving, as those kill many, MANY more.
by Lisa May 20, 2008 9:36 AM
This govt can already tap our phone lines, read our email and texts, tell us where and when I can protest their policies, and some of you sheeple want them to chart what's our our medicine cabinets too? Really? Do you not see a trend here?
by Deana May 20, 2008 8:11 AM
Tanya, ignorance is bliss I guess. To people who do not suffer from chronic pain, shame on you for judging those who do. Do you know how many people commit suicide that are in chronic pain???? I am thankful that there is help for me, this medicine.
by HORACE May 20, 2008 8:02 AM
NOBODY SAYS ,MELT IT, CHEW IT,,BUT THE PEOPLE THAT ARE LOOKIN FOR TRUOUBLE,TAKEN CORRECTLY THE DRUG IS A PLUS FOR MANY,,WHAT MAKES A PERSON DO THOSE THINGS,IS HE/SHE HAS OTHER PROBLEMS,AND SHOULD SEEK A PERSON OF INTREST OH LOOKIN FOR A BUZZ,WHY?
by ALAN May 20, 2008 8:02 AM
THESE DRUGGS ARE A PLUS FOR MILLONS, IF TAKEN CORRECTLY .YOU MIGHT HAVE A ROUGH NITE OR COLD SWEATS,,BUT IF YOU A PERSON SNORTIN,MELTIN,CHEWING THESE DRUGGS ,ITS YOUR STUPID ACTIONS THAT MAKE THE DRUGG,KILL. SAME AS A GUN,WHAT YA DO WITH IT,
by Mike May 20, 2008 8:02 AM
People abusing these drugs makes it nearly impossible to get them from a doctor for real pain but somehow you can buy them on the streets for big money. I am now forced to go to soc. serv. drs.. No pain med,can hardly walk,can't stand for 8hrs.ODgood
by jan May 20, 2008 8:02 AM
Outlawing opioids is absurd. For 10 years I had chronic pain and took opioids. Medical science advanced and I had surgery a year ago. Poof. Pain gone. I haven't taken a painkiller or wanted one since. Without them, I would have committed suicide.
by palm harbor resident May 20, 2008 8:02 AM
great make them safer does not matter ppl will find a way to get high. As for our children the job of parents is to educate their children. I agree w/personal responsibility. help is out there if you know an abuser the US does treat addicts
by Adrianne May 19, 2008 9:03 PM
AMEN TANYA!!!!!
by Barry May 19, 2008 8:58 PM
Amazing discussion. The bottom line is 2,000 people died! Something needs to be done to curb this deadly drug. In my opinion Oxycontin should be outlawed.
by Haven May 19, 2008 7:39 PM
I'm so tired of the families of drug addicts who intentionally misused narcotics whining about how it's everyone else's fault.The fault lies with the person who purposefully snorted, injected a drug JUST TO GET HIGH. How about some responsibility???
by Wayne May 19, 2008 6:07 PM
The “new” versions will extend the patents and costs to those in pain, and probably reduce the effectiveness. To inhibit their availability to those who legitimately need them for the benefit of those engaged in criminal activities is absurd.
by Arroyo May 19, 2008 5:12 PM
Lynn, Mike:Dead on ignorance!For those with family members who are "addicts",don't for a second think "if only Oxy didn't exist" is a positive statement.If it wasn't Oxy, it would've been Meth, Coke, Pot, or even FOOD.IMO most ADDICTS are SOCIOPATHS!
by TANYA May 19, 2008 5:11 PM
UNLESS YOUR DYING, OPIOIDS SHOULD NEVER BE PRESCRIBED AND ANYONE WHO HAS THEM,THAT ARE NOT PRESCRIBED,SHOULD GO TO PRISON! MD'S HAVE BECOME DRUG LORDS IT'S ALL ABOUT THE $$$. WE NEED SOCIALIZED MEDICINE FOLKS, NO OPIOIDS! FOR ANYONE!!!
by Art May 19, 2008 5:11 PM
Kay? What's your point? Good that they're researching NON-abuseable forms or not? Randy? Partially right as "addicts" have physiological brain damage, and are physically ill,the locus being the brain.We call this "mentally ill."This is sadly a secret
by Art May 19, 2008 5:10 PM
AMEN ANNE! That's a Libertarian viewpoint, one I support wholeheartedly (and am a registered Libertarian). This "Drug War" is financially irresponsible, and ought be lifted like prohibition was for the same reasons. Read some Ben Franklin for perspe
by Anne May 19, 2008 4:44 PM
legalize all drugs- addicts will still be addicts, but occasional users won't be in jail. Prohibition doesn't work. Tax the drugs and use money for rehab and drug abuse prevention education
by Art May 19, 2008 4:26 PM
Deana, thank you for saying some of the things I didn't. The #1 problem in the U.S. re. drugs is the secrecy of just how many people use opiods safely, responsibly, and without ANY risk. Let's hope the drug companies do come up with a way to help us.
by Al May 19, 2008 4:25 PM
Boo hoo for drug addicts. Times are tough. Addiction is a disease. Waaah. Dopers are weak people, period. Get tough, get over it, just say no... what ever it takes. But why should those of us with self discipline really care? Go to jail, dopers.
by Mike May 19, 2008 4:11 PM
Drug addicts are just drunks. Those of us who work and follow the rules don't care about drunks. Put them in where they belong.
by Lynn May 19, 2008 3:10 PM
Unless you have walked in an addicts shoes, you can not possible understand the highly addictive nature of oxy. Florida is now the black market state and feeding out of state addicts. Addiction is a disease and should be treated the same. Education!
by Lucy May 19, 2008 2:31 PM
Randy- you are so right. We are one of the few 'modern' countries that treat addictions as crimes and not as medical and/or psychological issues. With the near zero success rate we have, you'd think they may want to try a different approach.
by Dante May 19, 2008 2:18 PM
B- those herbs you are referring to won't be legal as long as Big Pharma has such clout. It would take away a huge slice of their anti-anxiety and anti depression meds. How do you think it got classified as a narcotic anyway?
by Randy May 19, 2008 2:18 PM
We need to treat addiction and alcoholism as the diseases that they are. Until the administration does something besides lock up everyone, this won't get solved.
by Lisa May 19, 2008 2:08 PM
Rhonda, if what you're saying is true, and you know for a fact your daughter is in effect trading sex for prescriptions- what agencies have you reported this to? That is a horrible position for your daughter to be in. I'm sure the local PD would help
by Randy May 19, 2008 1:43 PM
We, unfortunately, always have to balance legitimate use verses diversion of drugs. We cannot legislate morality or make people 100% safe. PERSONAL RESOPONSIBILITY is still needed.. An R.Ph.
by Hdog May 19, 2008 1:32 PM
heroin is a schedule 1 drug, which means it has no safe or accepted medical use in the united states. - oxycodone is in a completely different class and pain relief is the primary effect, not a side effect, is this the kellogs school of pharmacology?
by concerned mother May 19, 2008 1:30 PM
I can't believe you ppl are so dumb to this epidemic that is killing our society our children.Yes my child died from oxy. and it was a drug dealer who gave it to her.It wasn't around when I grew up so y is it now?There are other alternatives avail.
by Adrianne May 19, 2008 1:29 PM
I think all of this lays in the hands of the doctors. I cannot believe that we blame the addicts. Addiction to meds is a wide spread thing and I believe the doctors are the ones at fault!!! They write out scripts like giving out candy now a days.
by Read the Label! May 19, 2008 1:28 PM
If people would only read the label and follow the instructions! Expecially, "Federal law prohibits the transfer of this drug to any person other than the patient for whom it was prescribed."
by Rhonda May 19, 2008 1:24 PM
some of these Dr's (not all) do not care...my daughter is GOING TO DIE.She gives the doctors at an injury clinic $100 and lets him give her a female exam and he gives her 450 roxys 250 oxycodones and 250 zanax. The Dr. knows better
by Deana May 19, 2008 1:17 PM
Applause to the drug companies for finding alternative medicines that prevent addiction. I have chronic pain, and don't know what I would do without them. I'd rather see this happen than banning the drug, especially for those of us who need it.
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