ABUSING PILLS:

Prescription for Trouble Legal Drugs Become a Popular Fix; Experts
Say Rush to Treat Pain Opens Door to Addiction

A brush with methamphetamine addiction couldn't begin to prepare
Nathan Wick for the crushing grip of prescription-opiate dependency.

"Cocaine and meth and all those are nothing compared to the
addictions your body goes through with pain medication," the Medford
resident said.

Off meth for seven years, Wick, 32, started taking Vicodin to
alleviate the pain of a 2002 back injury. As his tolerance for the
prescribed drug increased, he turned to Percocet, an opiate-derived
painkiller. Soon Wick was downing more than his prescribed dosage and
looked to emergency rooms, urgent-care centers and, finally,
street-level dealers for his next fix.

"Pills are so accessible ... it's easy to play the system," Wick said.

Wick is among a growing number of Americans addicted to prescription
drugs, particularly opiates. These painkillers now rank second --
only behind marijuana -- in the country's most commonly abused drugs,
according to statements released last month by the White House Office
of National Drug Control Policy.

The trend prompted President Bush to develop a nationwide strategy
targeting the non-medical use of prescription drugs, a problem that
affects a reported 6.4 million people, including an alarming number
of teens, the president's director of drug-control policy announced
in February in Portland.

Teens between 12 and 17 constituted one-third of all new abusers of
prescription drugs in 2005, according to statistics released by the
Office of National Drug Control Policy. The majority said they
received the drugs from a friend or relative. A third said they
believed prescription drugs are much safer than illegal drugs because
they're prescribed by a doctor, the White House office reported.

Locally, younger addicts of opiate-derived painkillers are replacing
the typically older heroin addicts at Jackson County's methadone
clinic, said Clinic Manager Steve Brummett. Although the stigma
associated with heroin and the lifestyle of an intravenous drug user
have led to the narcotic's decline, the rising popularity of legal
opiates has led to an increase of local methadone patients, Brummett said.

Last year, 160 clinic clients in Jackson County cited "other opiates"
- -- largely prescription painkillers -- and non-prescribed methadone
as their primary drug of addiction, representing 54 percent of
clients, according to statistics compiled by Oregon Department of
Human Services. During the same period, 137 clinic patients were
treated for heroin addiction.

The numbers stand in contrast to heroin's prominence in other Oregon
counties. Heroin addicts accounted for 79 percent of methadone-clinic
patients last year in Marion County, 81 percent in Multnomah and 91
percent in Lane, DHS reported.

Local prevalence of legal opiates comes as no surprise to Jim Shames,
a physician employed by Jackson County Health and Human Services.
Small metro areas such as Medford, Shames said, have higher instances
per population of prescription-drug abuse. A demographic similar to
meth's, the addiction is also more common among Caucasians.

Because Oregon doctors prescribe more opiates than those in other
states, Shames said, he has spearheaded a local project to raise his
peers' awareness of prescription-opiate addiction. His effort entails
showing videotaped interviews with methadone patients who may have
stepped onto the path of addiction in a local doctor's office.

"We have been at the forefront of wanting to treat chronic pain," Shames said.

Improving patients' lives while guarding against addiction poses a
dilemma for many physicians, said Randy Nelson, chief of medicine at
Southern Oregon Rehabilitation Center and Clinics in White City.

"There's a fair amount of pressure to treat pain and to treat it
aggressively," Nelson said.

Physicians at SORCC recognize a certain number of patients -- all
military veterans -- may already have histories of addiction to
alcohol or illegal drugs and, thus, aim to handle those cases without
prescribing more narcotics, Nelson said. Restoring a patient's
ability to function is the goal, rather than erasing all pain, Nelson added.

"It's very, very difficult to have someone pain-free," he said.

Physicians at Pain Specialists of Southern Oregon reserve opiates as
a last resort, said Dr. Joseph Savino. Unfortunately, a number of
patients referred to his office arrive already in the grip of high
doses and at risk for developing tolerance and dependency, he said.

"It's still controversial to use opiates for chronic, non-malignant
pain," Savino said.

In an attempt to forestall abuse of prescription drugs, his clinic
counts patients' pills and conducts random urine screening to detect
medication levels that are either too high or too low, as well as the
presence of other legal or illegal substances.

Among all patients in chronic pain, however, those who suffer
addiction are relatively few, Savino said. While dependence is
characterized by physical symptoms such as tremors and cravings,
addiction is marked by "mal-adaptive" behavior such as forging or
stealing medication, he added.

Theft of prescription drugs is on the rise locally. And the crime
doesn't just threaten businesses, police said.

On Monday, burglars of Franck's Compounding Pharmacy in Medford made
off with fentanyl, a powerful opiate painkiller that can be lethal
even in small doses. The thieves also grabbed hydrocodone, oxycodone
and methadone in amounts worth several hundred thousand dollars on
the street, Medford police said.

The heist was the third pharmacy break-in reported this year in the
county. Burglars also targeted Rogue River Pharmacy on the same day
as Franck's. Rogue Valley Medical Center's Asante Health System
pharmacy was raided for pain pills in early January.

In lieu of outright theft, more prescription-drug addicts have
resorted to forging prescriptions when their doctor won't fill the
bill, police said. Suspects arrested on charges of tampering with
drug records more than doubled between 2003 and 2006. Local police
booked 14 such suspects at the Jackson County Jail in 2003, 19 in
2004, 23 in 2005 and 29 last year, according to statistics compiled
by Medford Police Department.

"It can become a significant drain on the community," Savino said,
adding that his clinic immediately reports anyone suspected of
forging a prescription to police.

Kristin Kinsey, 33, never went so far as to forge a prescription for
OxyContin. But the Central Point resident did steal pills from her
own father, who needed them for a severe back injury.

"I felt desperate. I was sick ... physically," Kinsey said.

She started buying doses of methadone from a friend whose doctor had
prescribed it. Realizing that nothing had worked so well for her pain
or addiction, Kinsey used methadone exclusively for about six months.

"I didn't feel like I was Jonesing for pills," she said.

Kinsey knew about the county's methadone clinic but assumed it was
only for heroin addicts. Running low on her own supply, Kinsey's
friend and methadone connection encouraged her to visit the clinic.
Kinsey's been a patient for three years.

Government-supported programs such as the county's have garnered
criticism for substituting methadone dependency for illegal drug
addiction. But proponents say the clinic contributes to public health
and safety because patients are under the care of a doctor and don't
engage in risky behavior to feed their habit.

"I've had people say, 'I can buy it cheaper,' but the problem is,
it's not a steady supply," Brummett said.

Since becoming a clinic patient more than a year ago, Wick said he
has never relied on another prescription painkiller. Despite feeling
"more healthy" on his replacement drug, Wick said he hopes a regimen
of physical therapy can soon give him the strength to pry the monkey
of methadone off his back.

"I just want to be able to say I'm clean."