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In York County, prescription drugs —not street drugs — killed more people in 2001 and 2002.
By SHARON SMITH
Daily Record staff
Thursday, September 11, 2003

Lori Beth Kemper died last June on the bedroom floor of her Dillsburg home.
She was 43 years old. She was the mother of two girls and engaged to be married. She worked as a computer company representative.

She had also been abusing drugs for a long time.

A fatal dose of opiates killed her.

When the York County Coroner’s Office went to her home, they found Kemper had been taking a whole host of prescription drugs.

She took Ambien for insomnia; Prinivil for high blood pressure; Neurontin for chronic pain or seizures; and Kadian, the painkiller morphine. She also had recently been taking OxyContin.

The insurance company questioned whether she had been overprescribed medication, said her fiancé, Fred Walters Jr., but investigators found her doctor had done nothing wrong.

Kemper, a Canadian, had other doctors from her native country who would write her prescriptions, Walters said.

“She could buy a thousand at a time,” he said. “You can go up there and buy it like aspirin.”

In law enforcement circles, Kemper would be known as a “doctor shopper,” someone who goes from doctor to doctor looking for multiple prescriptions.

At the coroner’s office, Kemper is known as one of 30 people who accidentally overdosed in 2001 and 2002.

Kemper’s file is housed in a green filing cabinet marked “trauma.”

Manila folders hold several other overdose cases.

Among them a nurse, a house-

wife, a Harley-Davidson worker suffering from cancer, a senior citizen, a father who struggled with back pain and a pharmacist who was working temporarily in Hanover after being fired from his job for stealing prescription drugs.

All of them had families. All of them had jobs.

All of them are dead — 20 from prescription drugs.

In 11 of the 20 prescription drug cases, the York County coroner found OxyContin or oxycodone in the people’s systems or among the drugs that they were taking.

Growing problem

The federal government has identified Pennsylvania as one of several states that has a substantial OxyContin and prescription drug problem.

Still, state and federal officials cannot say how many Pennsylvanians fatally overdosed from painkillers.

The Pennsylvania Department of Health does not keep track of what drugs are killing people.

The federal government, through the Substance Abuse and Mental Health Administration, does maintain data on drug overdoses from certain parts of the country that give a snapshot on how prevalent painkiller abuse is.

Nationally, emergency department mentions of oxycodone overdoses climbed from 100 in 1996 to 11,100 in 2001.

Oxycodone is the main ingredient found in the 12-hour time-release painkiller OxyContin.

For combinations of pain-

killers, the numbers are much higher.

For example, the nation’s emergency rooms in 1994 saw 44,518 painkiller overdoses. That number climbed to 99,317 in 2001.

The bulk of the people visiting emergency rooms from prescription drugs in 2001 were 26 to 34 years old.

The second-largest group fell between the ages of 35 and 44.

Purdue Pharma L.P., the company that makes OxyContin, as of Aug. 14 had 290 lawsuits pending nationwide, said James Heins, spokesman for the company.

The company has been sued seven times by Pennsylvanians. So far, nobody has successfully sued the company.

As of Aug. 20, 42 lawsuits filed against Purdue Pharma had been dismissed.

While SAMHSA can look at the data and tell what drugs need to be targeted or where treatment programs are needed, it cannot answer the basic question of why more people appear to be abusing prescription drugs.

“There are just fads and fashions, and it’s just very hard to give a real answer,” said Leah Young, a spokeswoman for SAMHSA. “‘Why’ is a question no one can answer.”

Some of the theories, though, are that prescription drugs pose less of a danger than the street variety.

Because they don’t have to be injected, they’re more appealing.

“They mistakenly believe because the drugs are approved for medical uses it won’t harm them, and that’s a mistake,” Young said.

“They’re opiates — just like heroin. When you misuse them, it’s the same as taking heroin.”

OxyContin emerges on the market

OxyContin came on the market in 1996 and was touted for its ability to help people with chronic pain.

Less than 10 years later, the powerful painkiller has been likened to heroin by some in law enforcement for its similar high and potential for abuse.

And much like heroin and other opiates, it kills the same way.

“One of the things opioids do, they can reduce the urge to breathe,” said J. David Haddox, vice president of health policy at Purdue Pharma.

Someone who overdoses on opiates will generally fall asleep and not breathe.

Other drugs, such as alcohol, can further suppress the respiratory system.

A rash of OxyContin deaths prompted the U.S. Drug Enforcement Administration to start collecting information from medical examiners and coroners throughout the country.

The DEA in 2002 wrote letters to 775 medical examiners requesting autopsy, toxicology and investigative reports on all the deaths associated with or related to oxycodone or OxyContin for 2000 and 2001.

Reports from 32 states showed that 146 deaths in two years were related to OxyContin.

An additional 318 deaths were re-categorized as OxyContin likely.

“We had seen for several months, or a period of time, lots of press reports about OxyContin deaths,” said Rusty Payne, a DEA spokesman.

“We felt the need to get the data first-hand. In order to get your arms around the situation, you first need to know what you’re dealing with.”

The agency, Payne said, is using the data to determine how to prevent OxyContin deaths, but he wouldn’t specify what preventative measures the DEA was taking.

Purdue Pharma conducted its own study of drug overdose deaths.

The company’s researchers came to a different conclusion than the DEA.

Drawing upon the same sources the DEA used, Purdue Pharma found a small number of cases the company looked at involved OxyContin.

In many of the cases, multiple drugs were found and OxyContin was not present.

“What it shows is drug abuse is a very dangerous activity,” Haddox said. “Polydrug abuse is a very dangerous activity.”

Company officials also are quick to point out that at least 45 other drugs on the market besides OxyContin contain oxycodone.

Although some Pennsylvania coroners are now submitting quarterly overdose reports to the DEA, the federal agency will not disclose how many OxyContin or oxycodone-related deaths have occurred in the state because of a disclosure agreement between the state and the DEA.

York County’s deaths

While the state does not mandate autopsies and drug testing is optional in accidental drug overdoses, such procedures were often conducted in York County’s overdose cases.

Because of the cost involved, several other counties do not run the tests.

“Every time you do a test, it costs roughly $35 to $50,” York County Coroner Barry Bloss said. Bloss’ deputies also remove medications the person was taking from the home.

“We do this in almost every death,” he said. “You start with the medicine cabinet. We look at the pills. When was it filled? How many were you supposed to be taking? How many are left?”

Bill Graff, York County’s chief deputy prosecutor, reviews the accidental overdose cases at Bloss’ office to see if it’s possible to prosecute someone for delivering drugs that resulted in a death.

“I’m always looking for that overdose where I can prove where the drugs came from,” Graff said. “Behind the scenes, we’re always trying to find that one case.”

That one case has been elusive, though. Graff could not recall successfully prosecuting anyone for delivering drugs that resulted in someone’s death.

“Nobody ever gives up their sources,” Graff said. “Believe me, we have tried. We’ve never been able to connect the dots.”

Despite the best efforts of the coroner’s office, few if any of the prescription drug overdose cases ever get turned over to the police for prosecution of a pharmacist or physician.

“We’re not there to say he prescribed the wrong pill,” Bloss said. “If we would see one particular doctor, we would probably go to police. That would be a clear indication.”

What the coroner’s office can do — and usually does — is trace back where the medications came from.

If a pharmacist or someone with access to prescription drugs has a close relationship to the person who died, Bloss might go to his workplace and tell a supervisor to tighten controls.

“There are a lot of other things that can come out of these investigations,” Bloss said.

More often than not, the prescription drug overdoses are accidental, and it is hard to hold anyone responsible.

“You have to take them as prescribed,” Bloss said. “Anything else, it could have bad effects — even lethal. You can overdose on methadone the same as you can heroin.”

Nobody knows this better than Lori Kemper’s fiancé. Kemper may have needed the painkillers right after she had back surgery, he said.

In the end, Kemper’s prescriptions not only killed her pain, they killed her.

“They’re addictive things,” Fred Walters Jr. said.

Reach Sharon Smith at 771-2029 or