PAINKILLER TEARS THROUGH MAINE

OxyContin Addicts, Crime Wave Linked

LEWISTON, Maine - The crowbar rained on Dorothy Treadwell. Once. Twice.
Twenty times. The tiny orange pills her assailant sought scattered to the
ground.

Treadwell, 48, struggled to rise. She gripped a radiator. Again came the
crowbar. The blow left her pinky hanging by a scrap of tendon. She ran
bloodied into the street.

Her neighborhood by the railroad tracks near downtown here is a poor
collection of rickety wood houses aside metal silos of small-time factories.
But such savagery is rare. The assailant, said Treadwell, was Cleve Herrick,
her live-in lover. He is a raging OxyContin addict, she said, desperate -
like hundreds of others in Maine - to obtain the addictive prescription
painkiller, often called ''poor man's heroin.''

''It was pretty bad for this area. I mean, a crowbar?'' recalled James
Theiss, a Lewiston police detective on the case in which Herrick is now
charged with two counts of aggravated assault.

OxyContin, a remarkably effective painkiller, is shredding the social fabric
of parts of Maine, creating a Wild West-like anarchy in many communities,
according to dozens of interviews with state officials, doctors, and police.

Pharmacies are being held up, the gunmen demanding only pills. Neighbors are
robbing, even assaulting, one another. Last year, the number of arrests
involving prescription drugs doubled to 156 and the pace continues this
year. Ten deaths from overdose have been attributed to OxyContin since
January. One couple tried to smuggle the drug from Canada, where it is
cheaper, in the underpants of their handicapped son. Senior citizens with
access to the pills are consorting with drug dealers. More than 30
pharmacists are under investigation.

This week, the Shop 'n Save supermarket chain opted to pull OxyContin from
all 85 of its pharmacies in Maine, fearing more robberies.

''The prescription pain medication abuse is the most serious criminal
problem facing Maine and may be the most pressing social problem,'' said
Maine's US attorney, Jay McCloskey.

OxyContin, manufactured by Purdue Pharma LP, a Connecticut drug company,
also has created a crime boomlet in rural areas of states like Kentucky,
where 59 people overdosed on the drug last year, and Virginia, where the
drug claimed 28 victims. Louisiana and Pennsylvania also report a jump in
the number of both deaths and arrests connected to OxyContin.

But it showed up earliest in Maine, and seems to have taken a turn for the
violent. An education campaign, led by McCloskey, helped doctors and
pharmacists catch on to the early ploys of addicts, such as forged
prescriptions and stories of unbearable pain requiring triple dosage. So
addicts, they said, have turned to brazen crimes.

''There's no question that the level of shoplifting, car thefts, and
burglaries are up in certain areas, probably connected to these drugs,''
said McCloskey.

The OxyContin phenomenon occurs as doctors, long accused of short-shrifting
those in pain, are encouraged by the medical establishment to liberally
prescribe painkillers. Those pills, Massachusetts authorities worry, could
end up in the Commonwealth, where physicians and law enforcement authorities
say they're already seeing an increase in trafficking and addiction.

''It's nowhere near the level of Maine's problem, but it's increasing,''
said Diane Brackett, special agent in the US Drug Enforcement
Administration's New England field office.

OxyContin was first sold in late 1995, and now tops $1 billion in annual
sales, outpacing the impotence drug Viagra. The pill is popular because of
its time-release mechanism that slowly pumps its soothing, numbing effects
over 12 hours, whereas most painkillers require multiple doses throughout a
day. But crush the tablet and snort it, as addicts do, and its power is
unleashed in a single, euphoric wallop.

The transition from patient to addict, whether voluntary or not, is
happening with alarming regularity, authorities say. That was evident in the
case of Mitchell Wall, considered by authorities as the ringleader of
Maine's largest OxyContin conspiracy. The case, detailed in court documents,
provides a window into how OxyContin spread.

Wall, 39, worked as a cook at the Big Stop restaurant in Searsport. The high
school dropout admitted to smoking pot at age 12, taking LSD every other day
at age 18, and using cocaine and heroin since age 25, according to
documents. He was in and out of drug rehabilitation centers, and had
convictions for assault, drug possession, and weapons violation, according
to documents.

He seemed an unlikely person to be hanging out with a man like George Hynes,
a retiree on a $475 a month pension. Hynes suffers from a lumbar disc
problem, according to documents, leaving him in constant pain. His doctor
prescribed OxyContin.

On Aug. 8, 1999, Wall obtained 90 OxyContin pills from a pharmacy in Saco.
The name on the prescription: George Hynes. Ten days later, Wall used
Hynes's name again.

A massive sting by federal, state, and local police - the biggest medical
fraud case in Maine history - resulted in the arrest of Wall, Hynes, and
nine others, a loose collection of retirees like Hynes and troubled drug
users like Wall. Authorities documented 29 cases where Wall forged
prescriptions, according to documents, a string of fraud that netted more
than $100,000 worth of OxyContin.

Why has OxyContin abuse surfaced so loudly in Maine? The question has no
easy answer, but Dr. Tim Clifford, medical director of Maine's Bureau of
Medical Services, thinks a partial explanation lies in Washington County, a
poor rural area along Maine's coast where the OxyContin problem is heaviest.
Clifford analyzed painkiller prescriptions there.

''The reasons why Washington County stood out like a sore thumb was
attributable to a very small number of physicians. Actually just one
physician,'' he said.

That physician was Dr. Donald Robertson of Machias. His patients were taking
far more OxyContin than they should have, given their diagnoses, said
Clifford. Authorities confronted Robertson and stripped him of his ability
to prescribe narcotics. Twenty percent of his patients immediately checked
into substance abuse programs. The rest went to other doctors and, Clifford
found, were soon being prescribed high levels of the drug, a sign they were
addicts.

''Being a new medication, a lot of doctors were unfamiliar with how to use
it,'' said Clifford.

But now, he said, there is a new problem: ''Physicians are getting such
conflicting messages. Professional groups and patient advocates are saying
there's this need to aggressively treat pain. But others are saying you have
to be very, very careful in using narcotics. Pain is a subjective sensation.
It's hard for doctors to validate that the patient is in pain.''

Purdue Pharma, OxyContin's manufacturer, based in Stamford, Conn., said it
has tutored doctors to ferret out abuse and yesterday announced a new effort
aimed at both health care professionals and law enforcement authorities.
Executives at the company, which at the same time vigorously promotes the
drug, are concerned that efforts to restrict its sale will be harmful to
people who legitimately need the popular pill.

''Our sales force promotes our product based on the FDA guidelines,'' said
James Heins, a spokesman for Purdue Pharma.

Heins said OxyContin's evils are being exaggerated by overzealous police.
Its active ingredient is found in about 40 other painkillers, so when
overdoses occur, they could be caused by one of those other drugs, he said.

OxyContin's effectiveness in treating pain probably guarantees it will be
around for some time to come.

''My dad was in an automobile accident a month ago and was prescribed
OxyContin,'' said Matthew Erickson, an assistant attorney general in Maine
who investigates drug crimes. ''It's a wonderful drug when used
appropriately. The whole issue is complicated for that reason.''