San Diego Union Tribune

February 19, 2005

Painkiller linked to 3 local deaths
Young overdose victims had much in common


By Lisa Petrillo, STAFF WRITER
and Joe Cantlupe, COPLEY NEWS SERVICE

Barbara Van Rooyan, whose son Patrick Stewart accidentally overdosed July 4 after taking OxyContin, demonstrated against the drug outside a pharmaceutical convention in San Diego.
In the past eight months, two local university students and a recent graduate have died of overdoses linked to the use of the same powerful prescription painkiller.

Patrick Stewart accidentally overdosed July 4 after mixing beer with one OxyContin pill. His friends and family say it was his first taste of what the U.S. Drug Enforcement Administration calls one of the nation's most abused prescription drugs.

Douglas DeWitt had recently celebrated his 21st birthday with family and San Diego State fraternity brothers. The Johnny Cash-loving junior died Sept. 24 of what authorities concluded was the same narcotic painkiller mixed with alcohol and cocaine.

Daniel Ashkenazy was a high-achieving University of California San Diego junior with dreams of becoming a lawyer when he died Jan. 14, the day he was to fly home to Marin County to see his grandparents, who were visiting from Israel.

Instead of celebrating, his mother Pamela Ashkenazy said, the family went to his funeral.

What killed her only child was apparently the same prescription opiate mixed with alcohol, according to preliminary medical reports, although conclusive test results are weeks away.

Now Pamela Ashkenazy has joined a network of activists nationwide trying to sound an alarm about the potential dangers of a drug she had never even heard of before her son's death.

A DEA report linked it to 464 overdose deaths between 2000 and 2002. For the past four years in San Diego County, an estimated 25 people per year – some with prescriptions – have died from oxycodone-related overdoses.

While the three young men are a fraction of the about 300 people who die of all kinds of overdoses in San Diego County each year, their deaths stand out because of their similarities: college success, middle-to upper-middle-class families, popular in their fraternities, known as recreational drug users but not addicts. DeWitt and Ashkenazy, coincidentally, also were members of the same fraternity.

What they also had in common was OxyContin, a synthetic painkiller usually prescribed for chronic and severe pain of the type associated with cancer. But it also has become a party drug. It is so dangerous that the DEA ranks it alongside cocaine and methamphetamine.

But Stewart's mother, Barbara Van Rooyan, thinks OxyContin's legal status is what makes all the difference to young users.

"I keep asking myself why?" said Van Rooyan, a Sacramento-area college counselor. "They (young people) don't think of it as drug abuse. To them it's just a pill. The FDA approved it, the government says it's safe, so that doesn't make it dangerous in their mind."

She acknowledges that her son had experimented with drugs before graduating from SDSU in 2003, where he was a member of Sigma Alpha Mu fraternity. But last summer, her son, a personal trainer, had a long talk with her about getting serious with his life and putting his partying lifestyle behind him.

"He made a mistake, yes, but nobody should die from one pill," Van Rooyan said.

She and Stewart's friends picketed a pharmaceutical convention in San Diego yesterday to demonstrate their opposition to OxyContin, which hit the market in 1995.

Some lawsuits filed by families of overdose victims allege wrongful death. Other critics, including government agencies, have accused the drug's maker of over-aggressive marketing without disclosing the painkiller's potential dangers. Annual sales of OxyContin top $1 billion.

The corporation that makes OxyContin, Connecticut-based Purdue Pharma, disputes such challenges. Prescription drug abuse is hardly a new problem, said spokesman Jim Heins, and Purdue Pharma is not the only maker of oxycodone-based drugs.

Oxycodone is also the active ingredient in such better-known painkillers as Percocet have been on the market far longer, Heins said. "We've become the Kleenex brand of drug abusers. A lot of other people make tissues, but everybody calls it Kleenex."

The big difference, experts say, is potency. OxyContin is designed to deliver pain relief over a 12-hour period. Drug abusers bypass the time-release system, so they can get the whole narcotic supply in one big, heroin-like rush.

A growing problem
Problems with misuse of the drug first made headlines in the late 1990s when it showed up in rural Eastern U.S. communities as "hillbilly heroin" and was blamed for a crime wave among addicts. One U.S. attorney in Kentucky called it "a locust plague." It made headlines again in 2003 when conservative radio talk show host Rush Limbaugh was investigated and sought treatment for addiction to prescription drugs, and several athletes on a Massachusetts high school baseball team – including the coach's son and a top draft pick for the Florida Marlins – admitted addictions.

More than 1 million people over the age of 12 use oxycodone nonmedically at least once last year, according to the U.S. Department of Justice. The most recent national study by the University of Michigan showed OxyContin abuse rising, with 5 percent of high school seniors saying they used it at least once last year.

Federal health officials say two primary factors set OxyContin abuse apart from other prescription drug abuse: It contains a much larger amount of the active ingredient, oxycodone, than other prescription pain relievers, and illegal sales of the drug can produce substantial profits. That assessment was made in 2001 by the federal Center for Substance Abuse Treatment – a division of the U.S. Department of Health and Human Services.

A 40-milligram pill of OxyContin costs about $4 by prescription, federal health officials say, but it may sell for $20 to $40 on the street, depending on where it is sold. Selling it illegally, even in small amounts, is a felony punishable by a minimum of one year in prison.

On the West Coast, OxyContin has gone uptown with a sexy street name, "OC," and has clearly arrived on California campuses and others nationwide.

Daniel Ashkenazy was 20 years old with a 3.5 grade-point average at UCSD and a prized summer internship lined up at a local law firm.

Ashkenazy, the son of a diamond dealer, was tall, slender and athletic, an avid runner who played soccer on his high school team and later on his fraternity team.

His roommates and fraternity brothers at Delta Sigma Phi admit they are no strangers to the party lifestyle. Their off-campus home features college-kid staples like posters of bikini-clad women and "Scarface," the classic film about a Cuban drug lord.

Their home is a virtual shrine to Bob Marley, the late Jamaican reggae singer known for his Rastafarian celebration of marijuana.

"Yeah, we love Bob Marley, but hard drugs, no way, never . . . ," said Michael Shapiro, a senior at UCSD who found his friend and roommate dead.

Ashkenazy sometimes spoke of doing "OC" back home, Shapiro said. As he and roommate David Frash, a UCSD junior, think back about what went wrong, they believe Ashkenazy may have brought some of the painkiller back after winter break.

Now they've lost a friend they considered a role model, the one who seemed to have all the smiles and the brains in the world. His roommates say they're both struggling to stay on track with their schoolwork and their lives.

"We're here for each other," Shapiro said. "We're not going away."

Losing a brother
It had been a successful fall rush at SDSU's Delta Sigma Phi. After the pledges left, Doug DeWitt hung out with his fraternity brothers, drinking at least six Bud Lites and a half-bottle of wine over a four-hour period. Around 2 a.m. he headed to bed, and when they didn't see him the next morning, they didn't worry because he was known as a heavy sleeper.

By 1:30 a.m. the next day, nearly 24 hours later, his friends realized something was wrong and they kicked down his bedroom door, where they found DeWitt dead in bed.

"I'll never forget the sight of that as long as I live," said Corey Cabral.

What led to DeWitt's death, the San Diego County Medical Examiner's Office found, was the mixture of oxycodone and alcohol, along with cocaine use.

SDSU officials concluded that the fraternity was not involved in DeWitt's death, but because some members admitted they knew he may have been using drugs, the chapter was suspended.

All fraternity members have been required to take substance-abuse counseling. The chapter must also conduct a public campuswide drug awareness program, which is set for March 1 at SDSU's Aztec Center.

A memorial at DeWitt's fraternity house includes a picture of him and a friend dressed as the Blues Brothers, with the stocky DeWitt playing comedian John Belushi, who also died of a drug overdose.

Preventing others
Patrick Stewart dreamed of launching his own clothing-design business. When he didn't find a job in graphics design, he turned his love of athletics into a career as a personal trainer.

On July 4, he called the Sacramento-area home of his mother and stepfather, a doctor, to wish them happy Independence Day and then around 7 p.m. headed with friends to a luau.

He drank between one and three beers over several hours and someone gave him an OxyContin, according to the San Diego County Medical Examiner's report, which concluded the mixture probably led to his death.

His heartbroken mother was stunned that her health-conscious son had overdosed on a drug she, like Pamela Ashkenazy, says she had never even heard of. Now, she can't stop thinking of OxyContin.

Since her son's death, Barbara Van Rooyan has worked to help others avoid his fate. She has filed a petition with the U.S. Food and Drug Administration in an effort to have regulators force the drugmakers to reformulate OxyContin and reduce its potency. If the drug's potency were reduced, and the time-release system dropped, it would not become such a target for abuse, they argue.

She is also working with a separate group, the Lee Coalition for Health of Lee, Va., to remove OxyContin from the market entirely until it is reformulated. The group has garnered 8,000 signatures and Van Rooyan is leading the effort in California to get more petition signatures.

Van Rooyan lead yesterday's protest of OxyContin at the Pharmacy Foundation of California convention at the San Diego Convention Center.

"I was a sort of nonpolitical person, my energies focused toward my job and family," said Van Rooyan. "But this opened my eyes."

Staff writer Mark Arner contributed to this report.

Lisa Petrillo: (760) 737-7563; lisa.petrillo@uniontrib.com

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