Painkiller sales soar across nation

Increase has coincided with rash of overdoses, pharmacy robberies

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NEW YORK -- Sales of the nation’s two most popular prescription painkillers have exploded in new parts of the country, an Associated Press analysis shows, worrying experts who say the push to relieve patients’ suffering is spawning an addiction epidemic.

From New York’s Staten Island to Santa Fe, N.M., Drug Enforcement Administration figures show dramatic rises between 2000 and 2010 in the distribution of oxycodone, the key ingredient in OxyContin, Percocet and Percodan. Some places saw sales increase sixteenfold.

Meanwhile, the distribution of hydrocodone, the key ingredient in Vicodin, Norco and Lortab, is rising in Appalachia, the original epicenter of the painkiller epidemic, as well as in the Midwest.

The increases have coincided with a wave of overdose deaths, pharmacy robberies and other problems in New Mexico, Nevada, Utah, Florida and other states. Opioid pain relievers, the category that includes oxycodone and hydrocodone, caused 14,800 overdose deaths in 2008 alone, and the death toll is rising, the Centers for Disease Control and Prevention says.

Nationwide, pharmacies received and ultimately dispensed the equivalent of 69 tons of pure oxycodone and 42 tons of pure hydrocodone in 2010, the last year for which statistics are available. That’s enough to give 40 5-mg Percocets and 24 5-mg Vicodins to every person in the United States. The DEA data records shipments from distributors to pharmacies, hospitals, practitioners and teaching institutions. The drugs are eventually dispensed and sold to patients, but the DEA does not keep track of how much individual patients receive.

The increase is partly due to the aging U.S. population with pain issues and a greater willingness by doctors to treat pain, said Gregory Bunt, medical director at New York’s Daytop Village chain of drug treatment clinics.

Sales are also being driven by addiction, as users become physically dependent on painkillers and begin “doctor shopping” to keep the prescriptions coming, he said.

“Prescription medications can provide enormous health and quality-of-life benefits to patients,” Gil Kerlikowske, the U.S. drug czar, told Congress in March. “However, we all now recognize that these drugs can be just as dangerous and deadly as illicit substances when misused or abused.”

Opioids such as hydrocodone and oxycodone can release intense feelings of well-being. Some abusers swallow the pills; others crush them, then smoke, snort or inject the powder.

Unlike most street drugs, the problem has its roots in two disparate parts of the country -- Appalachia and affluent suburbs, said Pete Jackson, president of Advocates for the Reform of Prescription Opioids.

“Now it’s spreading from those two poles,” Jackson said.

In 2000, oxycodone sales were centered in coal-mining areas of West Virginia and eastern Kentucky -- places with high concentrations of people with back problems and other chronic pain.

But by 2010, the strongest oxycodone sales had overtaken most of Tennessee and Kentucky, stretching as far north as Columbus, Ohio and as far south as Macon, Ga.

Per-capita oxycodone sales increased five- or six-fold in most of Tennessee during the decade.

“We’ve got a problem. We’ve got to get a handle on it,” said Tommy Farmer, a counterdrug official with the Tennessee Bureau of Investigation.

Many buyers began crossing into Tennessee to fill prescriptions after border states began strengthening computer systems meant to monitor drug sales, Farmer said.

In 2006, only 20 states had prescription drug monitoring programs aimed at tracking patients. Now 40 do, but many aren’t linked together, so abusers can simply go to another state when they’re flagged in one state’s system. There is no federal monitoring of prescription drugs at the patient level.

In Islip, N.Y., teenager Makenzie Emerson says she started stealing oxycodone that her mother was prescribed in 2009 after a fall on ice. Soon Emerson was popping six pills at a time.

“When I would go over to friends’ houses I would raid their medicine cabinets because I knew their parents were most likely taking something,” said Emerson, now 19.

One day she overdosed at the mall. Her mother, Phyllis Ferraro, tried to keep her daughter breathing until the ambulance arrived.

“The pills are everywhere,” Ferraro said. “There aren’t enough treatment centers and yet there’s a pharmacy on every corner.”