Acting U.S. Attorney Dwight Holton isn't letting the temporary nature of his position stop him from aiming big.

On Friday, Holton announced he, Gov. Ted Kulongoski and Oregon Attorney General John Kroger have summoned the CEOs of major drug companies to a Nov. 22 Summit on Prescription Drug Abuse.

"This is a terrible problem," Holton said Friday at Portland City Club. "Just devastating."

Since being appointed acting U.S. attorney for Oregon in February, Holton has pushed his prosecutors to use the federal Len Bias law to target heroin kingpins whose product led to fatal overdoses. And he hauled Reed College President Colin Diver in to pressure Reed to tighten the college's lax approach to student drug use.

Now Holton is adding to his list by focusing on a lower-profile problem: Oregonians' extraordinary fondness for prescription painkillers.

Holton told the City Club audience 400 people died of accidental drug overdoses in Oregon last year. The death rate has doubled over the past decade. Half of those 2009 deaths involved prescription painkillers, or "opioids."

But while drugs like OxyContin show up in song lyrics and on numerous YouTube videos, state statistics show the largest number of opioid deaths are caused by methadone.

State Medical Examiner Karen Gunson says it's the pill form of methadone that is killing people—not the liquid methadone dispensed to recovering heroin addicts.

"It's an effective pain reliever, and it's cheap," Gunson says of the pill.

Gunson says methadone is dangerous because it lingers in the body for a long time, so taking a second or third dose can multiply the effect. And she says it's dangerous because the drug can contribute to a irregular heartbeat.

And while Oregon may prefer to be known for leading the nation in microbrews and food carts, we are also national leaders in some less-desirable categories. Federal Drug Enforcement Administration stats show Oregon leads the nation in per-capita methadone usage. Oregon males in the 18- to-25-year-old category also lead the nation in illicit use of prescription painkillers.

Nearly all those who die from prescription drug overdoses are white. And although the stereotypical drug abuser may be a club-hopper, middle-aged Oregonians are popping pills at a high rate. More than one in three fatal prescription drug overdoses in the state occur among Oregonians between the ages of 45 and 54, according to Matthew Laidler, a state epidemiologist, and "more people in the 25-to-54-year-old age group die of unintentional drug poisoning deaths than motor vehicle traffic fatalities."

Holton and Kroger, who worked together as federal prosecutors in New York, hope to replicate what Kulongoski and Oregon lawmakers did by taking ephedrine, a key component of methamphetamine, off retail shelves. Although that move aimed at meth shifted supply from small labs to Mexican cartels, Holton says it reduced the amount of meth in Oregon as well as the danger from amateur labs and concentrated drug flows.

"That professionalized meth, which gives us a better chance to choke off supply," Holton says.

Prescription painkillers should be more transparent than that of illegal narcotics, as doctors and pharmacies create a paper trail when prescribing and dispensing the drugs.

But Oregon is one of only 10 states that lacks a prescription monitoring program (Oregon's will finally go live later this year). And Gunson says doctors often give patients hundreds of pills, which can lead to abuse and diversion.

That's an issue Holton hopes drug companies will help Oregon law enforcement agencies tackle. Several, including OxyContin manufacturer Purdue Pharma, have expressed interest.

"We appreciate the opportunity to be part of the solution," Purdue spokesman Jim Heins says via email.

"A significant part of the problem is just an overabundance of drugs," Holton says. "I'm looking for any ideas [drug companies] have that can reduce deaths and addiction."


The U.S. attorney is nominated by Oregon's senators and appointed by the president. Amanda Marshall, an assistant Oregon attorney general, appears to be the finalist for the position, but the process has stalled. Former U.S. Attorney Karin Immergut resigned in July 2009.