'HILLBILLY HEROIN'

Oxycontin Abuse, Deaths Plaguing Appalachia

GILBERT, W.VA. -- Kristen Rutledge had watched friends slowly kill
themselves with OxyContin. Her own cousin, just 18, shot herself in
the head when she couldn't get more of the drug. Girlfriends were
prostituting themselves for another fix.

Still, when someone offered her a yellowish 40-milligram pill, she
took it, chopped it up and snorted it. It was the start of a
three-day binge, and she was hooked.

"It's not like any other drug I've ever done," the 20-year-old says
as she takes a drag off her umpteenth cigarette.

During the next year, her habit grew until she was taking up to eight
"40s" a day, she says. When her dad, a county school board member and
former mayor, found out, she tricked him into giving her more money
by saying she was being threatened by drug dealers.

The cash drain contributed to Tim Rutledge's loss of his grocery
franchise. But Kristen didn't care.

"When I got down to two, I started panicking," she says. "I had to
get out and buy some more."

Many in Appalachia call OxyContin "Hillbilly heroin." Its abuse may
not have started in the mountains, but it exploded here.

Across the region, people have overdosed on the powerful prescription
painkiller and robbed pharmacies and family members to feed their
habits.

"If this was an infectious disease, the Centers for Disease Control
would be in here in white vans," Tim Rutledge says. "There's no doubt
it's very much a plague."

To cancer patients and chronic pain sufferers, OxyContin is a wonder
drug that can return them to a semblance of normal life.

Dr. Michael Levy, director of pain management at the Fox Chase Cancer
Center in Philadelphia, calls Oxy "close to an ideal opiate." While
most strong pain medicines last only about four hours and take an
hour or so to work, patients on Oxy get a steady 12-hour release of
pain medicine with fewer side effects and less risk of liver damage.

"This product is better than anyone thought it would be when it was
released five years ago," he says. "This is a drug we need to
protect, because it really helps patients."

But to addicts who chew the pill or crush it to snort or inject, Oxy
produces a one-shot, heroinlike high that can kill.

Purdue Pharma, the drug's maker, is willing to concede that Oxy abuse
has led to "somewhere between dozens and hundreds" of deaths in the
past two years, says David Haddox, Purdue Pharma's medical director.

"I am sure it has caused some deaths," he says, "but my feeling is
there is a magnification of this in the media."

On Monday, the state of West Virginia sued the drug's makers,
accusing them of pressuring and enticing doctors to overprescribe Oxy
and of failing to adequately warn of potential abuse. Purdue Pharma
called the suit's claims "completely baseless."

Purdue Pharma has taken steps to limit the damage. The company has
stopped shipping its 160-milligram pills and has suspended shipment
of 40s to Mexico because too many were finding their way back across
the border. The firm has offered tamper-resistant prescription pads
in Maine and other states, and it expects to help pay for a federal
pilot program to track narcotics prescriptions in Florida,
Mississippi, Ohio, Virginia and West Virginia. Purdue Pharma sent a
representative to Gilbert in January to address concerns, and it is
running public service announcements on local radio to warn against
abuse.

Law enforcement officials insist the problems have not been
overblown. At least one dealer in Virginia has been charged with
murder, and manslaughter charges were filed in a Florida Oxy death.
Several Virginia doctors have been convicted of illegally dispensing
the drug. Breaking and entering and armed robbery charges related to
Oxy have been filed from Maine to Mississippi.

Michael Pratt, a prosecutor focusing on drug crimes in Kentucky,
Tennessee and West Virginia, sees reasons why OxyContin hit
Appalachia especially hard.

The Appalachian economy has long been dependent on coal and timber.
Those are industries that produce serious injuries, so there are
large numbers of people on painkillers. "A lot of places, you got a
headache, you'll tough it out," Pratt says. "Down here it's like,
'Well, my grandfather's got some drugs. I'll take that and it'll go
away.' And it just escalates."

In addition, OxyContin sells on the street for $1 a milligram -- up
to $160 for the highest-dosage pill. In an area with chronic
unemployment, that kind of money is hard to turn down.

For years, prescription fraud for Valium and other drugs has been a
problem. But this is "a nuclear bomb," says Gregory Wood, a health
fraud investigator with the U.S. attorney's office in Roanoke, Va.

"I was a cop in Detroit and saw crack come through the ghettos, and
I've never seen anything like this."

Neither had the tiny town of Gilbert.

Like many coal towns, Gilbert, population 417, winds like a centipede
along the riverbank, pushing leglike hollows out into the surrounding
hills near the Kentucky line. OxyContin found its way here about five
years ago. What started as a gentle rain soon turned into a flash
flood.

Police Chief Greg Cline blames the drug for at least four deaths in
town, and state police Sgt. J.J. Miller put the number at about a
dozen for the entire county. But that number includes people who may
also have been abusing other drugs.

A mental health counselor tells of a man who was having his teeth
pulled two at a time, because each visit meant a new Oxy
prescription. Kristen Rutledge has known people to shoot themselves
for a prescription. Cline has talked to cancer patients who were
selling some of their pills.

"It seems like if you're around people who are doing it, you catch
it," says Judy Compton, manager of the Compton Inn. "It's contagious."

She knows all too well. Her sister caught it, too.

Jeanie Compton was spoiled. Her mother gave her a red convertible BMW
before she could even drive and a trailer home to live in. When she
wanted to get married at age 15, her mother drove her across the Tug
River.

Now it's all gone. The BMW? Traded for OxyContin. The trailer? Sold
for a few thousand dollars' worth of pills. The husband? Found
slumped over in the bathroom with a needle nearby, dead of a
suspected Oxy overdose.

Jeanie's troubles began around 1991, when her adoring father died
suddenly at age 50. She started experimenting with drugs. Along came
Oxy.

At one point, Joyce Compton says her daughter was raiding the
family's motel for televisions, microwaves and mattresses to supply
her habit. Judy Compton stopped letting her come to her house.

"She'd get up to leave, and my stuff would fall out of her pantlegs," she says.

On more than one occasion, Judy has found her little sister slumped
in a chair, her head lolled over.

Last Sunday was Jeanie Compton's 23rd birthday. She spent it in a
jail cell, where she was serving time for violating home confinement
to seek Oxy. Back home Wednesday, wearing a monitoring anklet, she
says she's ready to get serious about kicking Oxy.

"I've said I'm either going to end up in jail or dead," she says.
"Well, I made it to the jail. I can't come back from the grave."