'EPIDEMIC OF MISUSE' LINKED TO OXYCONTIN

Carilion Expands Help For Addicts

One-third of outpatients seen daily at Carilion St. Albans Hospital near
Radford are trying to kick OxyContin.

Carilion Health System announced stepped-up efforts in Radford and Roanoke
to treat those who abuse the prescription painkiller OxyContin.

The dominant health care provider in Western Virginia unveiled more help
for addicts and safeguards to curb prescription fraud, saying OxyContin
abuse "is spreading with enough speed and intensity to create an epidemic
of misuse."

Carilion's 24-hour hotline for psychological services receives one or two
calls daily from people struggling with OxyContin. Some just want
information. Some want to be admitted to the hospital. One-third of
outpatients seen daily at Carilion St. Albans Hospital near Radford are
trying to kick an OxyContin habit.

"Two years ago, this wasn't on the radar screen for us," said Dr. Richard
Seidel, director of clinical programs at Carilion Behavioral Health.

OxyContin's oxycodone formula relieves pain for 12 hours. But addicts
circumvent its time-release mechanism by crushing the pills and inhaling
the powder or mixing it with water and injecting it for an intense,
dangerous high. More than 35 people in Southwest Virginia have died from
oxycodone overdoses.

Purdue Pharma, the manufacturer, disputes the number of fatal overdoses
attributed to its product, but has taken steps to curb abuse while keeping
the pill available to pain patients. The company announced plans this month
to develop a new version that would be resistant to abuse. That could take
three years.

To develop its new strategy, Carilion researchers questioned about 80 New
River Valley physicians and 15 hospitals, about half of them out of state,
during the past six months. Nearly 40 percent of the doctors agreed that
the region needs more outlets for substance abuse help. Half agreed the
region needs more pain centers.

There was no consensus on how best to treat OxyContin abusers who want
help. But providers agreed that OxyContin addicts - those who have
prescriptions for the drug because they're in pain and those who steal or
buy it on the streets - are more difficult to help than other drug abusers.

The drug's addictive effect "is like a claw that once it gets them it
doesn't let go," said Rhonda Dotson, a licensed clinical social worker with
Carilion.

Carilion favors a two-step treatment approach that involves hospitalization
for detoxification over three to five days, followed by outpatient
psychological care.

Detoxification rids the body of drug residue and treats symptoms of
withdrawal. Psychological care is designed to rid the person of cravings
for their old drug-using lifestyle. Abusers spend an estimated $100 to $300
a day for their drug.

Dr. M. Anderson Douglass, a Carilion psychiatrist, said after the strategy
was unveiled that most insurers won't pay for hospitalization for
detoxification. As a result, some patients don't receive the care, have to
pay for it themselves or leave the bill unpaid.

Spokeswoman Beth Laws at Trigon, the state's largest insurer, and spokesman
Walt Cherniak at Aetna said their policies do cover such care. Douglass
insisted that psychiatrists employed by the insurance companies, whose
approval he needs for hospitalization, don't give it consistently.

St. Albans plans to expand methadone services for detoxication to those who
obtain their OxyContin illegally. It can already give methadone to abusers
who originally were prescribed the drug. Also at St. Albans, doctors will
ask Narcotics Anonymous to hold more meetings.

Meanwhile, at St. Albans and the psychiatric unit at Carilion Roanoke
Memorial Hospital, Carilion intends to offer auricular acupuncture, the
insertion of needles into the ear, to relieve withdrawal symptoms. Licensed
acupuncturists also provide the therapy.

Personnel at both hospitals have begun or soon will begin to verify all
incoming patients' OxyContin prescriptions with their doctors, as well as
prescriptions for similar drugs.