Pharmaceutical News

Fears over ‘defective’ execution drugs

Execution drugs supplied to the US by a British pharmaceutical company may have been defective, leading to potentially agonising deaths for prisoners.

Execution expert Dr Mark Heath raised concerns today over whether the anaesthetic sodium thiopental sold to Georgia Department of Corrections and used in the execution of murderer Emmanuel Hammond “lacked efficiency.”

The drug was understood to have been supplied by independent pharmaceutical company Dream Pharma, which operates at the back of driving instructors’ office Elgone Driving Agency in Horn Lane, Acton.

Mr Heath said that the same drug was used to execute murderer Brandon Rhode in September but that his eyes remained open – an unusual reaction which indicated the drug was incorrectly administered or that the drug itself was “significantly compromised.”

Again the drug in Mr Rhode’s case was understood to have been supplied by Dream Pharma.

“If the thiopental was inadequately effective, Rhode’s death would certainly have been agonising,” Mr Heath said.

Sodium thiopental is used first to induce a coma followed by two other drugs, pancuronium bromide that paralyses the muscles and potassium chloride, which stops the heart.

Mr Heath added: “There is no dispute that the asphyxiation caused by pancuronium and the caustic burning sensation caused by potassium would be agonising in the absence of adequate anaesthesia.”

He warned that the sodium thiopental vials were dated 2006 which may have indicated the drug had expired.

Human rights charity Reprieve director Clive Stafford Smith said: “It is shocking that Britain has allowed a fly-by-night company in the back of a driving academy to export these drugs.

“Apparently they were not stored, exported or used in a proper way, so that the prisoners are dying excruciating deaths. The British government must initiate an immediate inquiry into how this can happen.”

Business Secretary Vince Cable banned the export of sodium thiopental in late November after the drug that was used to kill Mr Hammond was shipped to the US.

A spokesman for the Department for Business, Innovation and Skills said Mr Cable was willing to consider future requests to ban use of other drugs in such circumstances based on fact and without affecting legitimate trade.

Dream Pharma managing director Mehdi Alavi has refused to comment on the matter.

Feds to Aid Maine’s Fight Against Prescription Drug Abuse

Most of the pharmacy robberies have occurred in Biddeford, Westbrook and Lewiston. But U.S. Attorney Thomas Delahanty says even small towns such as Stonington, Millinocket, Bethel and Waterboro have not been immune. What’s troubling, he says, is that some of the robberies have taken place during the day when store employees and customers were present.

“There is a very high risk of serious injury to these persons by guns and other weapons, and in Rockland in a recent robbery, a machete was used,” Delahanty said. “And there have been assaults by people who have an addictive need to get the medication, usually opiates.”

Oxycontin, sometimes called “hillbilly heroin” because of its addictive nature and popularity in rural states like West Virginia and Maine, is primarily the drug of choice. It’s unclear exactly why. One theory is that Maine’s high population of elderly people, prescribed Oxycontin and other opiates for pain and cancer, contribute to the supply chain. Another is that Maine’s rural workforce is in injury-prone occupations such as forestry and fishing.

Either way, pharmacist Ken McCall, who is president of the Maine Pharmacy Association and an assistant professor at the University of New England, says a recent five-year analysis of prescribing trends in Maine shows a sizeable increase in the use of controlled substances.

“In 2006 there were two million prescriptions for controlled substances in Maine that were prescribed by physicians and dispensed by pharmacies, and in 2010 there were 2.5 million–but our state population, obviously, has been relatively flat,” McCall says.

Law enforcement officials say easy access to addictive painkillers and other controlled substances–whether from a doctor who overprescribes them, a friend who passes them around, theft from legitimate patients and homeowners, and forged prescriptions–keeps addicts in the drug-seeking business.

Now the U.S. attorney wants to use his law enforcement muscle to address the problem, including making some pharmacy burglaries federal cases that carry tougher penalties.

“When a federal crime has been committed, we will make a federal case out of it by deploying federal investigative agencies and prosecutors,” Delahanty said. “In essence, what we are doing is to add more resources to the investigation and prosecution of pharmacy robberies that we hope in at least some cases will in fact be a deterrent to even committing the robbery.”

Efforts to control the problem date back more than a decade and include better collaboration between law enforcement agencies and better coordination between pharmacies and doctors to spot patient fraud and abuse. But only about 40 percent of prescribers in Maine are registered in Maine’s voluntary Prescription Monitoring Program to track patients’ drug histories.

Kenneth McCall thinks all prescribers should be required to be registered. Biddeford Police Chief Roger Beaupre does too. He also thinks pharmacies should consider posting security guards at their stores. Beaupre says six pharamacies in Biddeford have been robbed in the past year.

He recently hosted a training session on illegal trafficking and prescription abuse for law enforcement agencies. But he says he’s also started keeping track of doctors whose prescription drugs most often wind up in the wrong hands.

“What stands out is when you’ve got prescription medication that’s stolen, and one or two particular doctors are predominately the ones who prescribe these types of medication,” Beaupre says. “So it becomes–okay, how are they dispensing it as opposed to typical other physicians.”

Chief Beaupre says he’s hoping to hold additional training sessions for doctors and pharmacists in the coming months. In the meantime, Democratic state Rep. John Hinck of Portland is sponsoring legislation to make across-the-board changes in the way controlled substances are prescribed and dispensed.

“Maine, unfortunately, is at the crest of a wave of addiction to pharmaceutical drugs, and the abuse leads to cascading problems: addiction, overdoses, drug store hold-ups, rampant petty theft,” Hinck says. “I really think that it’s beyond time to make sure we address it.”

One of those steps will occur next week when a new police protocol for the response to–and investigation of–pharmacy robberies is presented to sheriffs and police chiefs at their joint convention in South Portland.