IS OXYCONTIN A MIRACLE OR A KILLER?

Cancer patients could die a painful death without it, and drug addicts
could die from abusing it.

Medical professionals and law enforcement officials are struggling to
make sure neither happens.

OxyContin _ a miracle drug to some, a killer to others _ has become
the recreational narcotic of choice in Southwest Virginia and quickly
is reaching urban areas like Washington as well.

``I've never seen anything like this _ heart disease, cancer, AIDS,
anything. It's killing a generation of people,'' said Jimmy Woodward,
a sheriff's major in Lee County _ one area that has been hit hard by
OxyContin abuse.

William Massello, a state medical examiner in Roanoke, said 43 deaths
in Western Virginia have been attributed to the abuse of oxycodone,
OxyContin's generic name, since 1998.

That number has increased each year, from one in 1997 to three in
1998, 16 in 1999 and 18 in 2000, he said.

One recent fatal overdose was in Bristol Tennessee, where authorities
said Robert Allen Phipps, 35, died from using the drug on March 10.

On Wednesday, Travis Wayne Phillips, 22, of Mountain City died from an
overdose of the drug, authorities said.

Gregg Wood, a health fraud investigator for the U.S. attorney's office
in Roanoke, said that about 160 deaths attributed to oxycodone have
been reported in Florida, 59 have been reported in Kentucky,
Pennsylvania has had 23, Alabama has had about 20, and Maine and Ohio
have had fewer than 10 each.

In Southwest Virginia, five physicians have been convicted of
misprescribing the drug. One of them, Dr. Frank Sutherland of Grundy,
was found guilty Friday of 430 counts of prescribing narcotics without
legitimate medical purpose and could face multiple life prison terms.

Abuse of the drug also has been blamed on an increase in
crime.

A Richlands man was killed last year in the state's first
OxyContin-related slaying, and several area pharmacies have been
robbed and burgled by those seeking the drug or the money to buy it,
police have said.

Wood said OxyContin abuse has come on so quickly that it is difficult
to get exact figures on its impact.

``It's come upon us so fast that we don't have the infrastructure to
track it,'' he said. ``You would imagine the numbers are very high.
Just one doctor-shopper going to the emergency room and faking an
injury can cost $1,000 to the system easily. And that's one person
doing it one time, so the cost of Medicaid alone must be enormous.''

Elsewhere, The Washington Post reported in February that addicts there
who formerly preferred heroin, morphine or methadone were setting
their sights on OxyContin.

According to the January issue of the U.S. Justice Department's
Information Bulletin, Kentucky, Maine, Maryland, Ohio, Pennsylvania
and West Virginia all have reported either a steep increase in
OxyContin abuse or are calling it the state's new most popular drug.

Local incidents, and the popular belief that OxyContin is a dangerous
killer taking over the state and country, are leading concerned
residents and officials to take action.

On April 12, Virginia Attorney General Mark Earley named 25 lawmakers,
doctors and pharmacists to a task force formed to fight prescription
drug abuse, particularly that of OxyContin.

Wood said the Task Force on Prescription Drug Abuse is just one of
many across the state at both the federal and local levels.

At the first meeting of the task force, held May 17 in Abingdon, about
100 residents showed to talk about ways to curb OxyContin abuse.

Some of the suggestions included stiffer penalties for those dealing
the drug and more treatment centers for addicts and education programs
for youths.

Officials from Purdue Pharma _ OxyContin's manufacturer _ said they
were taking steps to educate doctors about proper use and prescribing
of the drug and were planning to produce tamper-resistant prescription
pads.

``I plead with you, whatever you do on this task force, you've got to
have a balancing act. You've got to make this drug and drugs like it
available for patients who need it,'' Dr. David Maddox, senior medical
director for Purdue, told the group.

The company also recently donated $100,000 to the commonwealth to be
used to study whether Virginia should institute a prescription-tracking
system similar to one in Kentucky.

A few weeks ago, Purdue announced an indefinite suspension of
distribution of the most potent 160 mg OxyContin pills. A company
spokesman said earlier that the company was concerned about possible
illicit use of the high-strength pills.

Law enforcement officials have said the company also has provided
placebo pills for undercover drug-sting operations.

Police estimate that Bristol Virginia has seen a 10 percent increase
in crimes in the last two years.

``There's no doubt that this epidemic has caused this increase,'' said
Donnie Bradley, an officer with the police department's Special
Operations Unit, acknowledging that neighboring localities have seen a
much higher jump.

He said he believes the statewide database might be the best way to
catch OxyContin addicts as well as doctors and pharmacists who
misprescribe or illegally fill prescriptions for the drug.

``The biggest problem with (OxyContin) is that somewhere along the
line it is legally obtained,'' Bradley said.

According to Bristol Tennessee Police Capt. Blaine Wade, two
burglaries and one armed robbery of city pharmacies have been
connected with OxyContin, in addition to the city's only reported
fatal overdose.

``Bristol Tennessee is just one department,'' Wade said. ``If you
start looking at all of it in Southwest Virginia, you could have quite
a bit of (crime) where there once was very little. OxyContin must be
horribly addictive.''

One of those localities with a much higher OxyContin-related crime
rate is Tazewell County, where Commonwealth's Attorney Dennis Lee
estimated that 75 percent of crime is drug-related and half of that is
connected to OxyContin.

Woodward, the sheriff's major in Lee County, said most of the crimes
there in the past three years have been attributed to the drug.

``Probably 80 percent of our larcenies are due to the problem, and
it's risen from last year,'' he said. ``We've probably had about six
to eight deaths from OxyContin here. ... Now you've got people
stealing off their parents and grandparents to feed their habit.''

More than 1,500 people gathered in Lee County in March to protest
abuse of the drug.

There, Dr. Art Van Zee, a strong opponent of the drug, collected
hundreds of signatures for a petition asking the U.S. Food and Drug
Administration to recall OxyContin.

Van Zee, of St. Charles Community Health Clinic, also has criticized
Purdue Pharma for its heavy marketing of the drug.

OxyContin ranks 25th in advertising dollars spent in medical and
surgical journals. Sales of OxyContin have surpassed Viagra, figures
show.

While Van Zee believes OxyContin's risks outweigh its benefits as a
painkiller, some medical professionals disagree.

``I've heard people say it's an addictive drug,'' said Dr. Ben Cowan,
a Bristol Tennessee doctor who treats cancer patients, some of whom
depend on OxyContin's strong painkilling properties. ``That choice of
words demonizes the drug. It excludes from the discussion a patient's
abuse.

``It's kind of like saying `Those murdering guns' or `Those killing
cars,'^'' he said. ``The person operating the guns or cars is just as
responsible for the damage done as the abuser is for misusing
OxyContin.''

Cowan said that illicit use of prescription drugs constitutes about 30
percent of the drug-abuse problem in rural America.

``Do we have a problem in Southwest Virginia? You bet. Has it been
there for years? It has. Do the data suggest it's all from OxyContin?
They do not,'' he said.

Cowan said that carelessly throwing out numbers _ and not including
all pertinent data _ has caused a panic over OxyContin and has misled
the public.

The doctor suggests that some commonly overlooked pieces of
information are toxicology reports from those who have fatally
overdosed on OxyContin. Those reports might show that other drugs,
like alcohol or cocaine, were taken with OxyContin, he said.

``Polypharmacy abuse is part of the addictive personality. They will
stick a banana up their nose if they think it will get them high,'' he
said. ``It's hardly confirmed in my mind that these were OxyContin
deaths without seeing toxicology reports of what else these people had
taken.''

The bottom line, Cowan said, is that doctors and pharmacists should be
well-educated and work together to ethically handle the problem facing
the area _ something he feels certain he cannot do if OxyContin is
taken off the market.

``I can't cure patients with chemotherapy. I can't make them live
longer than the good Lord's planned. But I can make their days more
comfortable. OxyContin and pain relief are a major part of my
practice,'' he said.

``How can I legally, ethically, morally tell you that I am practicing
state-of-the-art medicine in 2001 if I don't have access to the things
that work?''