OXYCONTIN: DOCTORS, POLICE SAY ABUSERS MAKING BAD USE OF A GOOD DRUG

For years we have heard of police combating drugs such as marijuana,
cocaine and heroin. But now officials in Rowan and Cabarrus counties
are paying attention to a new drug - a legitimate drug that is being
misused.

Police says OxyContin is making some dealers a tidy profit and hooking
- sometimes killing - its users, including at least one victim in Kannapolis.

OxyContin has made itself known in dramatic fashion. According to the
State Bureau of Investigation, the prescription drug contributed to 28
deaths in North Carolina in 1999, but only a year later, investigators
connected it to 70 deaths.

Likewise, in 1999, OxyContin was blamed as the sole cause of six
deaths in the state. In 2000, that number had more than tripled to 21
deaths.

Sammy Monte Andrew Bringle died of an overdose on Nov. 18. An autopsy
found oxycodone, the base ingredient of OxyContin, in his system.
Authorities believe the 17-year-old A.L. Brown student stole the drug
from Martin Drugs in north Kannapolis, where he worked.

OxyContin, an opiate derivative, is a controlled time-release tablet
prescribed for pain. Doctors prescribe it for problems ranging from
fractures, joint and back pain and arthritis to cancer and childbirth.
The drug also falls under the generic name Oxycodone HCL.

OxyContin, a schedule II narcotic, is among the drugs with the
greatest potential for addiction. Other schedule II drugs with the
same potential include painkillers methadone, mepergan fortis,
percodan, percocet, tylox and narcotics such as Ritalin, which is
commonly prescribed for Attention Deficit Disorder.

Aside from potentially fatal doses, the major risk is addiction,
according to Tim Williams, pharmacist for Rowan Medical Facility at
Rowan Regional Medical Center. "They need more and they'll get it any
way they can," he said.

Addiction

Individuals who take the drug run a high risk of becoming addicted,
according to Williams, who has been a pharmacist for 22 years. He said
much of this addiction can be attributed to doctors over prescribing
the drug.

As a pharmacist, Williams is frustrated by the growing problem with
addiction and looks to physicians to help solve the problem. "I think
that doctors need to be especially careful about how they prescribe
OxyContin or any narcotic," he said.

To obtain any schedule II drug, patients must have a written
prescription every time they need a refill. Some doctors avoid the
annoyance of writing repeat prescriptions, Williams says, by writing
prescriptions for a large number of pills. He said he has seen a
prescription for up to 270 pills.

Purdue Pharma LP is the pharmaceutical company that manufactures
OxyContin. The company has gotten national attention in the recent
months about its controversial product, and in a recent news release,
the company said it is concerned about the diversion and abuse of the
drug. Jim Heins, assistant director of public relations for Purdue,
acknowledged that OxyContin, even if taken as prescribed, may create
physical dependency, though he said that's "very rare."

People get addicted when they abuse the drug, Heins
said.

Dr. J. David Haddox, senior medical director for health policy at
Purdue, said that a person who has no history of drug abuse has a very
low risk of developing an addiction to an opioid if taken as directed.

Pain specialist Dr. Alan Spanos, who has a private practice in Chapel
Hill, N.C., and teaches at UNC Chapel Hill's medical school, thinks
that part of the problem - aside from doctors engaging in criminal
activity - is doctors under prescribing medications for those who
legitimately need them. He said when patients do not get the needed
amount of medication, they can exhibit addiction-like behavior. "It's
not a disease, but a predicament."

However, Spanos said, some blame does fall on the addicts themselves.
"Addicts want to blame their addiction on someone other than
themselves," he said.

Williams, the Salisbury pharmacist, said that aside from the quantity
of pills prescribed, some doctors continue to write prescriptions for
people who have been on the drug for an extended period of time. He
said patients who have been on the drug just a few weeks may need to
be weaned off it.

"If people are going to abuse these drugs, tighter controls need to be
put on these drugs," Williams said. "It should not be allowed any
more." He pointed out the effects on the patient's family as well as
the long-term cost to the health care system.

Several Rowan County doctors contacted by the Post last week said they
did not have time to comment.

Likeness to heroin

Purdue manufactures OxyContin in a time-release pill, to release the
pain-killing effects gradually. But Williams and local law enforcement
agents say people short circuit the company's intent by crushing the
pills and snorting or chewing what's left - and getting a tremendous,
immediate high. That makes the potential for an overdose great, they
warn.

Purdue company officials say that sensational and inaccurate news
reporting has contributed to fear and reticence among patients and
physicians. For instance, the company disputes the contention that
OxyContin can provide a "heroin-like" high.

"OxyContin is a FDA-approved medication which, when taken orally, is
slowly absorbed into the bloodstream and provides pain relief - not a
'high,' " states a company release.

However, Kannapolis Police Sgt. R.A. Adams, a supervisor in the
department's vice unit, disagrees. He said heroin users are stepping
over their drug of choice to OxyContin, partly due to the similar
effects it gives them. Adams said he recently arrested a long-time
heroin user, on unrelated charges, who said after more than 15 years
of drug use he is now strictly an OxyContin user.

Adams said his department is currently investigating several OxyContin
cases in the community. He said the drug is a growing problem.
Likewise, the Rowan County Sheriff's Department has seen reports
concerning the drug increase in the past six months, according to Sgt.
Kevin Auten, a narcotics investigator.

Some are drawn to the drug by the large profit they can make selling
it. A prescription of 30 20-milligram pills costs about $90 at a
pharmacy. Each pill can be in turn sold illegally on the street for $1
per milligram - or $600 for the same 30 pills. Auten said the 20- and
40-mg pills seem to be the most popular.

The streets

Local investigators disagree about how OxyContin will
circulate.

Mike Dummett, a Salisbury Police narcotics detective, believes
OxyContin will show up in Salisbury as a "party drug," shared
primarily among white teen-agers, rather than a street drug. He said
OxyContin involves too much work for the average street dealer.

Fellow Detective Danny Dyles agreed. Getting OxyContin often requires
visits to more than one doctor, faking symptoms or forging or stealing
prescription pads. The average street dealer would rather sell the
traditional cocaine and deal with one distributor. Less steps. Less
fuss, Dyles said.

On the other hand, Sgt. Auten, the county investigator, said he thinks
the drug will find its way to the street. He expects to see people
starting to sell OxyContin for its high profit and to support their
drug habit.

Cabarrus County Sheriff Brad Riley said his deputies are starting to
see other street drugs take a back seat to OxyContin. He likened the
battle with OxyContin to the advent of crime such as fraud on the
Internet. Law enforcement has to figure out a "new way of having to
get at these people," he said.

So far, most investigations involve people initially prescribed
OxyContin who began abusing it. Although pharmacy break-ins have been
high in other areas of the country, Rowan and Cabarrus officials have
not seen such break-ins. To avoid those types of problems, Auten said
pharmacies should avoid stocking large amounts of the drug.

What Can Be Done

Authorities are working to familiarize themselves with OxyContin to
stifle the growth in the area. Dummett, Dyles and fellow investigator
Sgt. Greene recently took a class in Charlotte on the drug.

Auten said that with any new drug, it takes time to learn the
trends.

The manufacturer also is working with law enforcement officials and
the medical community to address the problem. The company has
initiated a number of programs including:

a.. Brochures for pharmacists and health care professionals to educate
their patients.

b.. A pilot program in Maine and Virginia of
tamper-resistant prescription pads.

c.. Providing law enforcement
officers with placebo OxyContin pills, allowing them to pose as
sellers and busting people who think they are buying illegal pills.

d.. Pledged $100,000 to fund a prescription monitoring program aimed
at frustrating "doctor shopping" while not interfering with the
delivery of medical services.

Local pharmacist Greg Starnes said he has seen so many prescriptions
for the drug in recent months that he calls the doctor on almost
every prescription. Starnes said pharmacists are in a better position
today with electronic technology to verify prescriptions with doctors.

"As a physician it incenses me to think that drug abusers and
criminals are making it difficult for patients with legitimate medical
needs to get the care they deserve," Dr. Haddox of Purdue said.