CANCER PAINKILLERS ARE BEING ABUSED ON STREETS

LEXINGTON, Ky., Feb. 8 — Harried police detectives in dozens of rural areas
in Eastern states are combating what they say is a growing wave of drug
abuse involving a potent painkiller prescribed for terminal cancer patients
and other people with severe pain.

Illicit dealers have used suffering patients as well as fakers, the
authorities report, to "doctor shop" to obtain the drug, OxyContin, for
resale. Addicts favor the drug because they have learned to circumvent its
slow time-released protection and achieve a sudden, powerful morphine-like
high.

OxyContin is often covered under health care plans. Police say that when
dealt illicitly on the street it can cost as much as heroin or more. The
abuse of the drug, which has been tracked over the last 18 months, has set
off a wave of pharmacy break-ins, emergency room visits and arrests of
physicians and other health care workers.

Along with Kentucky, law enforcement officials have cited a troubling
number of cases in Maine, Maryland, Ohio, Pennsylvania, Virginia and West
Virginia.

"Heck, we already know it's pretty epidemic down here," said Capt. Minor
Allen of the Hazard police in southeastern Kentucky, where federal, state
and local police rounded up scores of purported dealers and users this
week. The authorities say dozens of deaths may be laid to OxyContin abuse,
but this is strongly disputed by the manufacturer, Purdue Pharma of
Norwalk, Conn.

"Abuse of this drug has become unbelievable in the last year with probably
85 to 90 percent of our field work now related to oxys," Captain Allen
said, using street shorthand for the drug.

The drug's active ingredient is oxycodone, a morphine-like substance that
is also found in drugs like Percodan and Tylox. But while painkillers like
Tylox contain five milligrams of oxycodone and require repeated doses to
achieve pain relief, OxyContin contains 40 to 160 milligrams in a
time-released formulation that controls pain over a longer period. Chewing
or crushing the prescription pill foils its time-release protection,
delivering an instant potent euphoria. Once crushed, the drug can be
snorted by addicts or dissolved for injection. And this new addiction has
occasioned a telltale bit of fresh paraphernalia among teenage abusers,
Captain Allen said.

"We find them carrying pill crushers that are sold in drugstores to help
elderly people swallow their prescriptions," he noted of a growing drug
culture in which the Perry County park has come to called Pillville.

The abuse first drew alarm in Maine 18 months ago in rural, eastern areas
not previously considered drug problems, Jay P. McCloskey, the United
States attorney for Maine, said.

"What is most unusual and disturbing is the number of high school kids and
those in the early 20's who got addicted," Mr. McCloskey said. "We are
talking about some of the best students, some of the best athletes," he
said, noting that his small state was among the nation's largest consumers
of OxyContin on a per-capita basis.

The problem became so urgent in Kentucky that Joseph L. Famularo, the
United States attorney for the eastern district of the state, directed the
roundup of 207 suspects this week in Operation Oxyfest 2001, a nine-month
investigation that produced the biggest drug-abuse raid in state history.

"I personally counted 59 deaths since January of last year that local
police attributed to addicts using the drug, and I suspect that's pretty
conservative," Mr. Famularo said, noting that cancer patients build a
tolerance for the drug while a neophyte abuser may try it and be lethally
stricken.

That number was disputed by the drug's maker. Dr. J. David Haddox, medical
director for Purdue Pharma, said, "I'm concerned about inflammatory
statements like that." He said that overdose deaths typically involve
multiple factors like alcohol, and that exaggeration of abuses may cause
physicians to deny the drug to suffering patients.

Why so many current abuses seem focused across stretches of Appalachia and
other rural areas is an open question. But authorities note that the
prevalence here of retirees and mining workers with health care plans and
prescription cards invites exploitation of the elderly and others by
illicit brokers.

There have been reports of some dealing in New Orleans. But authorities
said there was no evidence of large-scale OxyContin abuse in major drug
markets in New York or other urban areas. Authorities said that one mark of
the new addiction was its rootedness in areas that have had no previous
heavy criminal drug traffic to compete against.

Dealers shop for doctors who may be busy, slipshod or quietly cooperative,
and then they obtain multiple prescriptions in several areas using the same
ailing or not-so-ailing patients, police say.

For their efforts, dealers realize a tenfold profit over the painkiller's
prescription cost. Addicts have been paying about $1 a milligram for the
drug. The top of the line is a powerful 160-milligram tablet intended to
work for up to 12 hours.

Authorities expressed little doubt that the abuse of OxyContin was spreading.

Sgt. Kerry Rowland of the Cincinnati police pharmaceutical diversion squad,
said: "It's becoming the prescription drug of choice from greater
Cincinnati to rural Ohio. It's become rampant because it offers such a pure
high with less risk of arrest or overdose, and many times health care is
picking up the cost."

He said that his squad's average arrests lately include one health care
worker a week caught dealing in prescription drugs.

Another concerned area is the region surrounding Roanoke in southwestern
Virginia. On Wednesday, 100 local, state and federal law enforcement
officials met to discuss mounting overdoses, pharmacy break-ins and other
problems associated with OxyContin abuse there, Robert Crouch, the United
States attorney in Roanoke, said. "The graph is spiking," he said.

Rick Moorer, an investigator with the state medical examiner's office in
Roanoke, said that in 1999 there were 16 deaths in southwestern Virginia
attributable principally to OxyContin in combination with other drugs or
alcohol. There was just one such death in 1997, he said.

Federal data shows that while emergency room visits involving oxycodone
remained stable from 1990 to 1996, such visits doubled from 3,190 in 1996
to 6,429 in 1999, the period that corresponds with OxyContin's introduction
and marketing. That data indicated that deaths attributed to oxycodone
products also grew during that period. Drug company officials insisted,
however, that they were not aware of any significant instances of OxyContin
abuse until about a year ago when they began hearing the first media
reports concerning the drug's abuse.

The new bulletin by the National Drug Intelligence Center warns that the
abuse of OxyContin appears for now to be concentrated in Eastern states.
But officials said that instances of abuse have surfaced as far west as
California.

Chuck Miller, a spokesman for the intelligence center, said, "It's showing
up elsewhere." He noted that the bulletin warned authorities that continued
abuse of OxyContin was likely. Roy W. Hatfield, the police chief of Harlan,
Ky., said: "In the last year, this drug has really shown up around here,
pushing out all the old stuff, marijuana, barbiturates. People think it's a
legal way to stay high. But now they're discovering how easy it is to get
addicted."

Mr. Famularo, the United States attorney here, said his investigation would
continue. "We caught 207," he said. "We didn't catch half of them; that's
how pervasive this thing is."