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The Honolulu Advertiser

Posted on: Saturday, April 23, 2005

State cracking down on abuse of painkiller

By David Waite
Advertiser Staff Writer

Hawai'i law-enforcement officials increasingly have focused attention on the illicit trafficking and sale of OxyContin, a powerful and highly addictive painkiller.

Keith Kamita, the state Narcotics Enforcement Division administrator, displays OxyContin pills of various doses. State officials say the drug is among the most abused prescription drugs, surpassed only by the illegal use of drugs such as Vicodin, Xanax and Valium.

Gregory Yamamoto • The Honolulu Advertiser

State narcotics officials say it ranks high on the list of most-often abused prescription drugs, surpassed only by illegal use of drugs like Vicodin, Valium and Xanax.

Last year, OxyContin was detected in the bodies of 16 people whose deaths were investigated by the city Department of the Medical Examiner. That does not mean the drug caused their deaths, only that it was found to be present in bodies that were autopsied here, the Medical Examiner's office said.

An increasing number of autopsies here have detected the drug since 1998, when Oxycontin was found in three people.

An 18-year-old Marine machine gunner from Minneapolis was found dead in his bed on April 16 at Marine Corps Base Hawai'i in Kane'ohe. Police have said they believe the man's death was due to a deadly mixture of alcohol intoxication and OxyContin ingestion.

Keith Kamita, state Narcotics Enforcement Division administrator, said OxyContin abusers typically chew or crush and swallow what is meant to be a time-release capsule and wash the drug down with alcohol to "synergize" or amplify its effects. In rare cases, users convert the pills into a solution and inject it into their veins, Kamita said.

OxyContin pills come in 10-, 20-, 40- and 80-milligram doses. Keith Kamita said the pills sell on the street for about $1 a milligram.

Gregory Yamamoto • The Honolulu Advertiser

"We've been watching OxyContin (abuse) here for the past three or four years," Kamita said. "It was popular at first among kids or young adults at rave clubs and its use has been holding steady, if not increasing, in recent years."

The prescription pills come in 10-, 20-, 40- and 80-milligram doses and sell on the street for about $1 per milligram, Kamita said.

The two most common ways the drugs is obtained is through forged prescriptions or by patients who engage in what drug-enforcement officials such as Kamita call "multi-docking," where patients who go from doctor to doctor to get multiple prescriptions for the same medication.

"Some of our doctors out there are just too generous in giving patients what they ask for," Kamita said.

But pharmacies that fill prescriptions for OxyContin and other controlled medications are now required to notify Kamita's office via computer.

Turning up more often

According to information compiled by the city Department of the Medical Examiner, autopsies discovered OxyContin in an increasing number of people who have died here.

The spike in 2001 occurred about the same time or perhaps just a little after its illicit use had begun to soar on the Mainland.

1998 3

1999 3

2000 6

2001 19

2002 14

2003 15

2004 14

"Before we had electronic monitoring, we would see a couple of hundred cases each year for forged prescriptions or multi-docking," he said.

Last year, the number of forged prescription cases dropped to 48, while multi-docking cases numbered 17, he said.

"The word is out on the street that we are doing this and it is a definite deterrent," he said.

The drug goes by the street name "hillbilly heroin" because its effects are similar to those of the illegal opiate and because of its popularity among people who abuse the prescription drug in Appalachia and rural New England.

While continuing to battle illicit OxyContin use, Kamita's agency is girding for abuse cases involving a new and even more powerful painkiller with the trade name Palladone, which was approved last fall by the U.S. Food and Drug Administration for public use.

"It's supposed to be four times stronger than OxyContin," Kamita said.

Reach David Waite at dwaite@honoluluadvertiser.com or 525-7412.