THE 'POOR MAN'S HEROIN'

An Ohio Surgeon Helps Feed A Growing Addiction To OxyContin

PORTSMOUTH, OHIO- When Jeff Pennington opened up his antiques shop on many
mornings last winter, he would notice dozens of people lined up on the
sidewalk to see the doctor next door. The doctor, 48-year-old orthopedist
John F. "Jeff" Lilly, had once specialized in setting broken limbs. But he
had recently shifted his business to a new discipline called "pain
management." Lilly's patients included everyone from young adults to
grandmothers. But it was curious, Pennington thought. In over six months of
watching this daily parade, he had seen only one patient on crutches.

In fact, prosecutors say, Lilly's pain management clinic was a front for
one of the largest narcotics-selling operations in the Midwest-a pill mill
that fed a soaring demand for illicit substances in this industrial city on
the banks of the Ohio River. Last week, in one of the biggest such cases of
its kind, Lilly pleaded guilty to engaging in a pattern of corrupt
activity; he forfeited his medical license and was sentenced to three years
in prison. In exchange, prosecutors dropped 46 counts of drug trafficking
against him.

The case against Jeff Lilly, prosecutors say, illustrates the growing abuse
of a highly addictive drug known as OxyContin, a morphinelike substance
that has come to be known as the "poor man's heroin." OxyContin was
prescribed in half the cases for which Lilly was charged, and nationwide,
law enforcement officials say, illegal prescription of the drug is
escalating. Statistics are hard to come by, but local law enforcement
officials say that OxyContin abuse is reaching near-epidemic levels in
rural areas such as northern Maine and western Virginia. Demand is driven
by addiction and poverty. But it would not exist, prosecutors say, without
doctors willing to write bogus prescriptions. Doctors, they say, like Jeff
Lilly.

A graduate of Princeton University and the University of Cincinnati Medical
School, Lilly had come to Portsmouth well recommended. But, as is often the
case in areas underserved by medical professionals, the local hospital was
willing to overlook some glaring problems in his past. In the early 1990s,
while a surgeon at Pioneer Valley Hospital in Salt Lake City, Lilly settled
at least one large malpractice lawsuit and was the subject of seven
internal investigations, which resulted in his resignation in 1992. He
joined Southeast Ohio Medical Center in Portsmouth but was fired from a
private orthopedics practice in 1993. At the same time, according to court
documents, Lilly was diagnosed with an unspecified psychiatric disorder. In
September 1998, he resigned from the hospital.

Crime wave. Last year, about the time Lilly started his pain clinic, local
police noticed that drug-related crimes in Portsmouth had started to rise.
Burglaries alone had increased 20 percent from the year before. For a
period of about three months, police records show, homes or pharmacies were
being broken into and robbed of prescription drugs almost daily. A Scioto
County sheriff's deputy was arrested for stealing painkillers; a man tried
to rob a pharmacy of OxyContin; and home break-in reports show the only
things stolen were cash and pills. At the same time, pharmacists were
noticing scores of seemingly healthy young men coming in with prescriptions
for OxyContin.

OxyContin, introduced by Purdue Pharma in 1995, has been hailed as a
breakthrough painkiller because it allows a measured dose of the opiate
Oxycodone to be released into the bloodstream. But abusers, who get a fast
high by smashing the pills, are boosting demand as well. "Drug abuse goes
through fads and epidemics, and OxyContin is on the upturn," says Don
Nel-son, a pharmacologist with Ohio Drug and Poison Control. "When people
become aware of a script doctor, they come in droves."

Their suspicions aroused, the Southern Ohio Law Enforcement Drug Task Force
sent in undercover agents from the federal Drug Enforcement Administration.
And they soon learned why Lilly was so popular. According to Greg Ratcliff,
Portsmouth's chief of police, the doctor performed little or no physical
examination. After collecting $200 cash, he would elicit a complaint from a
patient, make a note of "intractable pain," then give the patient a
prescription. He charged $10 for each narcotic pill, an additional $10 for
each OxyContin.

On March 9, federal agents arrested Lilly as he tried to buy an M-16
assault rifle from an undercover police officer. Meanwhile, agents raided
his office and found he had no nurse, computer, or telephone. At the home
of Lilly's girlfriend Jeri Fisher, federal agents discovered almost
$500,000 in cash, passbooks for offshore bank accounts, stereos and TVs in
their original boxes, and a loaded pistol.

The day after Lilly was arrested, Jeff Pennington, the antiques dealer,
went into Lilly's office for the first time. "It was like a movie set," he
says. There was an X-ray machine that wasn't plugged in, monitors that
weren't hooked up to computers, and an examining room that was nothing but
a table and chair.