PAINKILLER A HEADACHE FOR POLICE

Abuse Of Oxycontin Leads To Arrests, Deaths In Region

If it weren't for the small OxyContin pills Jerry Duer keeps in a household
safe, he would be a prisoner in his own bed, watching television and
enduring hours of indescribable pain.

"Imagine someone putting a vise on your hand and tightening it as far as it
will go, and that's better than what it feels like," said Duer, 42, a
software engineer from Manassas who has spine deformities. "It was really
horrible until this drug came along. It normalizes me. It lets me go back
to work, and it's given my wife back to me."

But Duer's savior -- a synthetic painkiller similar to morphine -- has
slipped into an underground world of abusers who exploit it, a world
normally associated with heroin and crack. Although it is a godsend for
millions of pain sufferers across the country, OxyContin has simultaneously
been vilified by law enforcement officials, who have seen it overtake
small, rural towns and kill 39 people in Southwestern Virginia in the past
three years and at least 120 nationwide.

OxyContin has become the most visible element of a new dilemma in drug
control for physicians and authorities: a successful painkiller with
beneficial uses that is abused as a potent street drug.

The drug, which was prescribed nearly 6 million times last year, has become
a mainstream remedy as doctors have looked for new ways to cure pain for
aging baby boomers and chronic sufferers.

"If we start blaming OxyContin, we remove from the market a legitimate pain
medication just as a whole cohort of people are reaching the age of pain,"
said H. Westley Clark, director of the Center for Substance Abuse Treatment
in the U.S. Department of Health and Human Services. "Some people swear by
it, and some people swear at it."

The drug, approved by the Food and Drug Administration with no controversy
in 1995, has come under intense scrutiny in recent months. From small
Kentucky towns to sprawling Prince William County, police have raided
homes, where addicts -- who steal the pills, con a doctor into prescribing
them or buy them from dealers supporting their own habits -- crush the
time-release tablets and snort or inject the drug for a euphoric rush.

Virginia's attorney general, Mark L. Earley (R), has launched a task force
to address the abuse of OxyContin, and the federal Drug Enforcement
Administration confirmed yesterday that it has asked the drug's
manufacturer to consider limiting how it distributes and markets OxyContin
as part of its first national action plan for a prescription medication.

Abuse of OxyContin, unlike other street drugs, began in rural areas, where
narcotics such as heroin are not easily available. But OxyContin has become
so popular -- prescription sales topped $1 billion last year, an increase
of 74 percent over 1999, according to pharmaceutical analyst IMS Health --
that it is obtainable even in the most remote areas of the country.

"It's more accessible because it's at the corner drugstore," said Dennis H.
Lee, the commonwealth's attorney in Tazewell County, Va.

The DEA says abuse of the painkiller has made its way from Appalachia,
across Virginia and into the Washington region, including Maryland and the
District. DEA agents are questioning distributors, doctors, pharmacies and
users in investigations in Washington and its suburbs.

"I don't think anything has exploded the way OxyContin has exploded, and it
continues to be very, very accessible," said Kathryn Daniels, who heads the
DEA's regional drug diversion program.

Doctors say the drug is so addictive because it is so effective. It is
helpful to people like Duer when it is managed properly. OxyContin eases
pain over time, releasing steady amounts of oxycodone that trick the brain
into ignoring what hurts. The time-release tablets allow patients
flexibility and the option of taking fewer pills.

As patients become tolerant, their dosages are increased, sometimes
dramatically. In most OxyContin deaths, abusers -- often first-time users
- -- take a whopping dose of the drug, eliminating the time-release
properties through crushing and snorting the pills or injecting dissolved
tablets.

The large quantity of the drug can immediately stop the heart, doctors say.
"Almost all of the deaths we've seen are from underestimating the power of
the pills," Lee said.

William Massello, assistant medical examiner in Roanoke, said many overdose
victims had injected it and probably died instantly.

"How many pills do doctors prescribe where a single prescription could be
100 lethal doses?" asked Robert Dupont, former director of the National
Institute on Drug Abuse under presidents Richard Nixon and Gerald Ford.

Purdue Pharma LP, of Stamford, Conn., which manufactures the pure oxycodone
pills, has made a number of efforts to curtail their illegal use, including
the creation of tamper-proof prescription pads and educational programs.
Spokesman James W. Heins said the company acknowledges that the pills are
being misused.

"We strongly support the efforts of law enforcement officials to apprehend
those criminals who obtain the drug by theft and fraud," Purdue Pharma said
in a statement. "We are also concerned that the criminal abuse of OxyContin
is adversely impacting patients who rely on this important medication to
manage their pain."

OxyContin's popularity coincided with several studies suggesting that
doctors under-treated pain and that terminally ill cancer patients and
other victims of chronic pain were suffering pointlessly. But that
popularity has allowed it to seep into a world of abuse. Prince William
police, for example, arrested 10 people in a raid last month on charges of
distributing the drug illegally.

"We know there's a whole lot of OxyContin on the move," said 1st Sgt. Jay
Lanham. "It has a lot of the same associations with what we saw during the
crack boom or with heroin users; the users are robbing and stealing to get
cash so they can support their habits."

Toby Terry, 31, of Yorkshire in Prince William, admits that in many ways he
embodies the problem. Terry was arrested during the police raid, his house
littered with used hypodermic needles and his wife trying to toss handfuls
of the pills out a back window. Police found a prescription bottle for the
drug -- with Terry's name on it -- and charged him with conspiracy to sell
OxyContin pills.

He says he's addicted and can't imagine going even 12 hours without the
drug. In handcuffs and escorted by a SWAT officer, Terry's eyes welled with
tears as he talked about the withdrawal -- the vomiting, the diarrhea, the
uncontrollable tremors.

"You can try to quit taking it, but you can't," Terry said, adding that he
pays $288 a month for a 60-pill prescription. The price is a small fraction
of the thousands of dollars those pills could fetch on the street, and
Terry says in court records that he has no legitimate income.

In February, Terry was arrested for allegedly breaking into a locker at a
local gym, stealing a wallet with $75 in cash and a number of credit cards.
He was arrested in March for allegedly stealing wallets and purses at
Manassas Mall, where he used pilfered credit cards to buy almost $1,000 in
items to sell.

Jennifer Albright, 32, of Pasadena, has had more success in fighting the
addiction. Albright, who was in a car accident in Las Vegas in October, was
prescribed OxyContin for her neck and back.

Within days, Albright was hooked on the drug, her body relying on its
relief. "My heart was pounding and racing, I was jittery, I had sweats and
tremors," Albright said. "It was a nightmare. This stuff is dangerous. It
punishes you hard."

Albright, a graduate student and a former triathlete, says she can
understand how abusers can get quickly addicted. "Before all this happened,
it was like a picture of myself in a puzzle and all the pieces fit together
nicely," she said. "Then OxyContin came along, and all the pieces got
jumbled in a box. Now, I'm standing here and I can't make any of the pieces
make any sense."

William Hurwitz, a McLean doctor, acknowledges the risks. Hurwitz says he
prescribes the drug to relieve chronic pain from migraines, back ailments
and joint diseases. "It's easy to point your finger at the drug, or the
drug company, or the doctor," said Hurwitz, who briefly lost his license in
1996 for prescription violations unrelated to OxyContin.

Hurwitz prescribed OxyContin to one of the men whose homes were raided in
Prince William. Although the man has not been charged, court papers say he
sold OxyContin pills to an undercover police investigator.

"OxyContin can be a useful tool, but like everything in medicine, it is not
without risks," Hurwitz said. "I'm held accountable for a policy that gives
me a choice to treat patients with these medicines but holds me responsible
for the adverse social consequences."

Because of criminal investigations and DEA scrutiny, some doctors and
pharmacists now are reluctant to prescribe and sell OxyContin for fear that
they'll be duped by abusers.

"Pharmacists treat you like you're an illicit drug user, when I'm just
getting something that I need to be normal," said Duer, a Hurwitz patient
who says he keeps the pills in a safe because he fears someone might steal
them.

"I'm worried that all this alarm will lead to the one thing that has
returned me to my life being taken away from me. There is no way that I
could deal with that."