DEATHS FROM OXYCONTIN OVERDOSES ON THE RISE

Authorities fear the prescription painkiller could do for the coalfields
what cocaine and heroin has done for some inner-city
neighborhoods.OxyContin, a prescription painkiller known as "pharmaceutical
heroin" by those who abuse it, has caused more than 30 fatal overdoses since
becoming the drug of choice for many addicts in Western Virginia.

The number of people dying from the drug has increased rapidly - going from
one in 1997 to three in 1998 to 16 in 1999 to last year's total of 12 and
counting.

Fatal overdoses are just one measure of the growing problem with OxyContin,
which authorities fear could do to the coalfields what crack cocaine has
done to some inner-city neighborhoods.

"It started as a trickle and it turned into a tidal wave," said Gregg Wood,
a health care fraud investigator in the U.S. Attorney's Office in Roanoke.
"We're just scrambling trying to catch up with it."

The recently compiled figures on overdoses were released this week to law
enforcement officials who gathered in Abingdon to plot ways to deal with
what some are calling a national epidemic in the making.

OxyContin overdoses in Western Virginia now "substantially surpass" those
caused by cocaine and heroin, said Rick Moorer, an investigator with the
Medical Examiner's Office in Roanoke.

Last year's total of 12 overdoses is expected to increase sharply as results
come back from toxicology tests. There were at least 25 other deaths in the
region last year that may be attributable to OxyContin, Moorer said.

Since 1997, there also have been 33 overdose deaths from Methadone, a drug
used to treat addiction to opiates. Authorities believe some of the
Methadone users who overdosed were trying to kick their OxyContin habits.

Although four people in Roanoke have died of overdoses in the past two
years, the real scourge of the potent painkiller seems to be concentrated in
the rural counties to the west.

Crime rates have soared in the coalfields as addicts lie to doctors, forge
prescriptions, write bad checks, burglarize homes and rob drug stores to
support their $500-a-day habits.

In Tazewell County, Commonwealth's Attorney Dennis Lee estimates that
OxyContin is behind 60 to 70 percent of all crimes.

Lee has charged an alleged dealer of the drug with felony-murder in the case
of a fatal overdose. The man is accused of selling OxyContin to a victim who
was partially paralyzed from a stroke, then helping to inject the drug. A
trial is scheduled for Friday.

"I don't think it would be an overstatement to say it [OxyContin] is
currently the crack of Southwest Virginia," U.S. Attorney Bob Crouch said.

Crouch's office has charges pending against two physicians accused of
fraudulently prescribing the painkiller. Earlier this week in Kentucky,
about 200 people were arrested as part of an OxyContin roundup, including a
nurse charged with stealing the drug from her hospital.

Some are finding the market too tempting to ignore. Virginia Medicaid, the
state program that provides health care to the poor, spent $4.5 million on
OxyContin prescriptions last year.

OxyContin, a pure form of oxycodone, has a chemical makeup similar to
morphine. It was approved by the Food and Drug Administration in 1996 for
treatment of moderate to severe pain.

Although it is prescribed in pills, addicts usually lick off a coating
designed to release the drug gradually, crush the pills into powder, and
then snort or inject it to obtain a euphoric high similar to that produced
by heroin.

It doesn't take long to get hooked. Withdrawal symptoms include nausea,
stomach cramps, diarrhea and chill bumps known by users as "cold turkey."

Most people do not realize how dangerous the drug can be. "The public tends
to think that if it's something you get from the pharmacy, then it must be
OK," Crouch said. "And certainly it does not have the same stigma attached"
to narcotics such as cocaine and heroin.

Moorer said most of the overdoses in the region covered by the Roanoke
Medical Examiner's Office - all of Virginia west of Harrisonburg, Lynchburg
and Danville - are accidental deaths by people who mix the painkiller with
alcohol and other illegal drugs.

"These people are getting hooked on it and they are out of control," Moorer
said. "They will steal, they will rob, they will trade guns, they will trade
sex, they will do anything to get it."

Traces of the drug are also showing up in autopsies of people who die from
other causes, such as automobile accidents and violent crimes. Authorities
said they expect the number of recorded OxyContin-related fatalities to
climb even higher as police and rescue workers learn to recognize signs of
the drug.

So far in Virginia, the drug seems to be showing up mostly west of Roanoke.

"Some people don't even know what OxyContin is in other parts of the state,"
Moorer said. "We're out in left field all by ourselves."

Through meetings such at the one in Abingdon, authorities have been trying
to figure out why the western tip of Virginia is one of the first areas to
experience what some believe will soon be a national problem. They have
found the region has much in common with Southern Maine, another place where
OxyContin has taken an early foothold.

Both areas are largely rural and removed from the cocaine distribution hubs
usually found in large cities. And both areas are struggling economically
due to declining industries - coal mining in Virginia, logging in Maine.
Both lines of work are likely to produce back pain and other ailments for
which OxyContin is commonly prescribed.

With one 40-milligram tablet worth $40 on the black market, many people who
use the drug for legitimate reasons are finding they can make some fast
money by selling a few extras.

Other ways to get the drug include feigning back pain at emergency rooms and
burglarizing or robbing drug stores. Crouch said some pharmacies have
stopped carrying the drug and posted signs saying so to discourage potential
robbers.

Law enforcement officials plan to meet again soon and brainstorm for
solutions. One suggestion that came out of Wednesday's meeting was a
statewide computer system that would track all scheduled drug prescriptions
as they are filled.