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It started with painkillers The family of 22-year-old Frank Mangione III wants others to learn from their son's fatal addiction to prescribed drugs

During the 1980s, "Comfortably Numb" was the title of a hugely popular song for the British rock band, Pink Floyd.

From 2001 until early 2004, it became a way of life for Frank Mangione III.

Then, it killed him.

Memories of their son's death came rushing back to Frank and Mary Lou Mangione Jr. last week, when they read about a drug bust aimed at young people who were dealing and abusing prescription narcotic drugs.

Their son, Frank III, died at age 22 in February 2004. His parents say his addiction to painkillers transformed their son from a caring, easygoing teenager to an edgy young man who sometimes exploded in anger.

"I heard about those kids in the Southtowns, and I was wondering, 'How did they get started?' " said Mary Lou Mangione, sitting in the dining room of her family home in Buffalo's Riverside section. "I was wondering if they started out by getting a prescription from a doctor, like Frank did."

The Mangiones are not alone in their concerns.

The painkiller addictions that harmed celebrities like Rush Limbaugh and the late Johnny Cash also have caused serious problems for many young people in Western New York. One in six American teens has abused prescription drugs, according to a study released in December by Partnership for a Drug-Free America.

"We're seeing more and more high school kids abusing these drugs," said Nancy Cote, Buffalo supervisor for the U.S. Drug Enforcement Administration.

>First, hydrocodone

The Mangiones say their son became addicted to one of the most commonly used narcotic painkillers -- hydrocodone -- after a Buffalo doctor gave him a prescription for back pain. In the last three years of his life, Frank got more than 130 prescriptions for hydrocodone, anti-depressants, sleeping pills and other medications, according to medical records his family kept.

In State Supreme Court, the family has filed a wrongful death, negligence and malpractice lawsuit, blaming a Buffalo medical group, two doctors and two physician's assistants for the death.

They are convinced that federal medical privacy regulations that took effect in 2003 contributed to their son's death. Because of the Health Insurance Portability and Accountability Act (HIPAA), the Mangiones were barred from talking to doctors about their son's growing addiction.

"Six months before he died, I tried to tell one of his doctors that my wife and I were really worried that Frank was becoming addicted to pain pills, [and] we were seeing changes in his personality," recalled Frank Mangione Jr.

Mangione said the doctor told him that, because Frank was legally an adult, he could not even discuss the issue with him. That he still lived with his parents and was financially supported by them didn't matter.

"After that, the prescriptions and dosages increased," Mangione said.

The Mangiones said they talked many times to their son, who said he needed the drugs to control pain.

Members of the Mangione family -- including aunts and uncles -- said Frank was known for his compassion and kindness, even as a teenager. They recalled when he agreed at the last minute to take a girl he barely knew to her senior prom, because her date had stiffed her.

Later, Frank allowed an acquaintance to use his truck to drive to work, because the man had no other way to get there.

"He was a young man who touched a lot of lives with his kindness," said one of his aunts, Charlene Federowicz.

Frank dropped out of high school. He began working with his father at the Buffalo Water Department when he hurt his back lifting equipment in late 2000. His first prescription for pain meds was in January 2001.

Over the next three years, his parents noticed he was increasingly cranky and subject to wild mood swings, sometimes sleeping 20 hours a day.

Several days after having back surgery, Frank awoke on the morning of Feb. 17, 2004, and asked his mother if she would bake him cupcakes.

"I didn't like the way he looked. I went to get the cupcakes in the oven, and then I went back to his room to check on him," she said. "He was gone . . . I tried CPR. The EMTs tried. Nobody could revive him."

An autopsy in the Erie County Medical Examiner's office concluded that Frank died of an irregular heartbeat caused by drug intoxication. A medical examiner said the drugs present in the 22-year-old's body included cocaine, hydrocodone and a muscle relaxer called cyclobenzaprine.

The family had never before seen evidence that Frank used cocaine. If he did, his parents said, his heavy daily use of prescribed drugs must have led him to it.

>Accountability sought

Family members insist their main motivation for suing doctors is accountability, not money. They said they took the highly unusual step of acting as their own lawyers in a wrongful death case because local lawyers told them it would be too expensive to pursue.

The Mangiones wish their son had been sent to a pain management specialist, a doctor who closely monitors the painkillers that are being prescribed and how effective they are.

"We didn't even know a pain management specialist existed until after Frankie died," said Thomas Mangione, his uncle.

According to one of the region's top pain management experts, patients must be carefully monitored when they use painkillers, and some people are more susceptible than others to becoming addicted.

"I could give you hundreds of examples of how [painkillers] have improved the quality of life for patients. But if they get into the wrong hands, or they're misused . . . it's a potentially lethal problem," said Dr. Mark J. Lema, chairman of anesthesiology at the University at Buffalo and Roswell Park Cancer Institute.

Lema has not researched the Mangione death and would not speculate on any decisions made by doctors. But he said it was tragic that a loving and caring father could not legally discuss his son's addiction with a doctor.

"That's heart-wrenching. . . . The government needs to make modifications in this law. The overall concept of HIPAA is to protect individuals from intrusion into their personal lives. But we see situations where it may actually work against an individual's best interests," Lema said.

The Mangiones hope other families will seek professional drug treatment if they think their sons or daughters might be developing problems with prescription drugs.

"We think about him every single day," said Frank Mangione Jr. "I don't know how many times I woke up in the middle of the night, thinking about Frank. And I find my wife sitting on the edge of the bed, crying."


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