ABUSE OF PAIN MEDICATION ON RISE

It has been hailed as a miracle drug for those suffering from severe,
long-term pain, but OxyContin also has been criticized as being too easy to
obtain and abuse.

Officials say there has not been a case prosecuted in Chattanooga for
OxyContin distribution or possession, but they acknowledge the drug is
being distributed illicitly in the area.

Ben Scott, resident agent in charge of the federal Drug Enforcement
Administration office here, calls OxyContin "a drug that's ripe for abuse.

"It's here and we know it's here," Mr. Scott said. "We don't have the level
of abuse as in other areas."

In Boston, armed robbers looking for the painkiller have hit a dozen drug
stores in the past three months. Lawsuits filed recently in Kentucky, Ohio,
West Virginia and Virginia accuse the drug's manufacturer, Purdue Pharma of
Stamford, Conn., of deceptively marketing it. Police in one Virginia town
have asked pharmacists to fingerprint customers filling OxyContin
prescriptions.

More than 120 deaths nationwide have been linked to OxyContin, although
Purdue Pharma officials say their evidence indicates the victims abused
other drugs, as well.

Terry Shapiro, executive director of the Council on Alcohol and Drug Abuse
Services in Chattanooga, said the drug, when abused, produces a high
similar to that of heroin.

"They get started due to physical pain they're having. Where they cross the
line into abuse and why, I'm not sure," he said.

A problem develops when someone taking the drug doubles or triples a dosage
because the user enjoys the effects of the medication, he said.

Paul Laymon Jr., an assistant U.S. attorney, said he has seen evidence the
drug is being abused here.

"I have had at least three investigations in which the primary drug wasn't
OxyContin, but there was OxyContin involved," he said.

But experts point out that OxyContin has helped people who live with
chronic pain.

"For some people pain is a daily, sometimes hourly management problem.
OxyContin has given them a new lease on life," said Kate Malliarakis of the
White House's Office of National Drug Control Policy. "It provides freedom.
It relieves pain so they can function in society."

OxyContin, which has been on the market since 1996, is a timed-release form
of oxycodone, an opium derivative. It is intended for cancer patients and
others who suffer from chronic, severe pain. The drug's manufacturer
reported 6 million prescriptions written for it in 2000.

"The people who need it take it on a daily basis because they have pain on
a daily basis," said Dr. Sandra Hinds, a pharmacist at Moore & King
Prescriptions. Dr. Hinds said she has not seen any instances in which
someone has tried to obtain the drug illegally.

"It's probably going on here, but it hasn't hit that hard," she said.

But Dr. Brad Standefer, pharmacist and owner of Access Family Pharmacy,
said one patient tried to change the quantity of a OxyContin prescription
and was arrested.

"That right there will get you a quick trip to jail," he said.

Pat Fitzpatrick, addictive disorders program director for Valley Behavioral
Health System, said abusers can crush the drug and snort it, mix it with
water and inject it or remove its timed-release coating and take it orally.

"It is on the streets here. I've seen it in almost all age groups,
different socioeconomic groups," he said.

Mr. Fitzpatrick said he has seen both cases of people who buy OxyContin
simply to get high and those who take the drug for legitimate reasons but
get addicted because their usage was not properly monitored. Withdrawal
symptoms are not life-threatening but include chills, muscle cramps and
fever, he said.

Purdue Pharma spokesman Jim Heins said the company has been working on a
10-point plan to help reduce abuse of OxyContin and other prescribed drugs.

"Everyone is talking about drug abuse, but no one is talking about
prescription drugs," he said.

The plan includes cracking down on prescription drugs being smuggled into
the United States from Canada and Mexico, providing physicians with
tamper-resistant prescription pads and developing abuse-resistant drugs.
Distribution of the highest available OxyContin dose, 160 milligrams, has
been temporarily suspended.

The company also is working to educate health care providers to recognize
signs that someone who does not need the drug is trying to obtain it, Mr.
Heins said.

"When used appropriately under a doctor's care, it's safe and effective,"
he said. OxyContin is a Schedule II drug under federal guidelines, meaning
a patient must visit a doctor every time a prescription is needed and
refills are not allowed.

Dr. Standefer said he believes OxyContin is helpful to those who need it
and that the key to cutting down on abuse is strengthening penalties for
those caught with it illegally. He said Access Family Pharmacy gives extra
scrutiny when an unfamiliar customer tries to fill a prescription or when
someone asks for an unusual quantity. All controlled substances are kept in
a safe, he said.

"You couldn't get in it with a cutting torch and a wrecker," he said.

Ms. Malliarakis said steps need to be taken to ensure that patients are not
seeing multiple doctors to get several prescriptions and that health care
professionals pay attention to how users are reacting to the drug.

"Health care professionals need to be better educated about addictions. I
think that's one of the gaps in medical education," she said.