Painkiller's dark side emerges in rural areas

Rampant abuse of prescription drug disrupts Va. town

`It's costing lives'

August 13, 2001|By Todd Richissin | Todd Richissin,SUN NATIONAL STAFF

PULASKI, Va. - The armed robberies of pharmacies have the police chief of this little town concerned, but then he has a lot on his mind these days.

There are the reports of girls prostituting themselves and of some elderly residents suddenly becoming drug dealers. One officer had to shoot a man who allegedly tried to run him down.

In addition to all of that, a lot of people around him are dying young.

"And," says the chief, Gary Roche, "I got a public interest in people not dropping dead."

Pulaski's problems stem from the prescription pain reliever OxyContin, which is being so abused in southwest Virginia and other rural areas that many pharmacies have stopped selling it and doctors have stopped prescribing it.

Simply put, residents here, elsewhere in Appalachia and in a few other scattered regions have developed a drug habit the likes of which neither they nor anyone else has ever seen.

Hailed as a godsend for cancer sufferers and others with chronic pain, OxyContin is showing its devilish side. Demand for the drug among recreational users has led to a wave of robberies, thefts, prostitution and black-market dealing usually more associated with crack cocaine and heroin in the country's urban areas. Dozens of people who have gotten their hands on the drug and abused it have died of overdoses. The luckier abusers are merely among a whole new brand of junkie.

Unlike crack cocaine and other illegal drugs that have taken their toll in big cities, OxyContin is striking places like Pulaski - isolated, economically depressed areas with large elderly populations that have embraced what they regard as a magic pill that eases their pain.

It is just beginning to appear in Maryland, in Allegany County and other rural areas, but also in Baltimore and Baltimore County, where law enforcement officials say it is often used as a substitute for heroin.

"What makes it so tough is it's legal," says Roche, raising his voice to talk above a train chugging down the railroad tracks that helped spawn his town. "I find it on you and you have a prescription for it, there ain't nothing I can do."

OxyContin is a powerful painkiller, a brand produced by Purdue Pharma of Stamford, Conn. Last year it generated more than $1 billion in revenue for its manufacturer.

Officials of the company, while acknowledging the crime and abuse associated with the drug, maintain prescription drugs have always been misused and if their drug weren't around, some other painkiller would be generating problems.

"OxyContin has become the poster child for prescription drug abuse," says the company's spokesman, James W. Heins. "There are other drugs being abused, it's just that OxyContin is getting all the attention."

Addictive qualities

Law enforcement officials and many members of the medical community say there is good reason for that - that OxyContin is different from any approved drug they have seen abused.

The drug's primary ingredient is oxycodone, a man-made opiate similar to heroin, morphine and codeine.

OxyContin contains up to 16 times as much oxycodone as other pain relievers do. Aside from that, what has made it so attractive among legitimate users is how it travels through the bloodstream. It does not offer a quick numbing the way the painkiller Percocet does, for example. Instead, OxyContin is designed to be released by pill into the bloodstream gradually, easing pain for up to 12 hours while causing far less fatigue among patients than other such drugs.

But abusers of the drug figured out how to compress that 12 hours into a single bursting rush so that it provides a buzz that rivals heroin.

Some abusers chew the tablet to break down the time-release mechanism. Others crush the tablets into powder and snort it. The worst-off among them, like Eric Proffit, a 28-year-old father of four, turned to using a needle to shoot it into their veins.

"I was chewing it, getting off, getting off, but then I needed more and more," says Proffit, a lifelong Pulaski resident working at a carnival to earn some money. "Then this dude tells me I'm just wasting it that way."

So he snorted, he recalls, and then he began shooting up. And it wasn't long, he says, before he was hooked on more than 280 milligrams a day, an all-out assault on his body - and a $280-a-day habit. He funded it, he says, mostly by stealing cigarettes from grocery stores in his county and those surrounding it. He was arrested seven times for shoplifting before going clean four months ago.

Why OxyContin is showing up in rural areas rather than in larger cities is a matter of conjecture, but law-enforcement officers say part of the reason is as simple as the age-old business concepts of supply and demand - and risk and return.

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