RX PAIN DRUG SALES ON THE RISE

ASHEVILLE - Retail sales of prescription painkillers more than
doubled in Western North Carolina over an eight-year period,
reflecting a nationwide increase in the number of people taking
medication for pain. The amount of five major painkillers sold at
retail pharmacies rose 169 percent between 1997 and 2005 in Western
North Carolina, according to Drug Enforcement Administration figures
compiled by The Associated Press. Combined sales of codeine,
morphine, oxycodone, hydrocodone and meperidine were higher in WNC
and in North Carolina than the national average. Retail sales of
these drugs increased by more than 130 percent in North Carolina,
compared with a 90-percent increase nationwide.

Physicians and public health experts say the increasing numbers
reflect an aging population, increased marketing and a changing
attitude toward treating chronic pain.

While the increase in sales may mean the potential for greater abuse
of these painkillers, most WNC physicians and drug treatment experts
say the benefits of the medications outweigh the risks.

"The balance is the challenge," said Dr. Paul Martin, medical
director of ARP Phoenix, an Asheville-based substance abuse treatment
center. "On the one hand, you are getting the medications to people
who need it for pain. On the other hand, you have to minimize the
risk of it going out on the street. The pendulum may have gone too
far one way and we need to get it back to center, but I wouldn't want
to get the ball back the way it was in the '80s." Age and attitude
The reasons for the overall increase in prescription painkiller sales
reflect nationwide trends.

As people live longer, there is a greater need for pain medications.
Eighteen percent of the population in WNC is 65 years and older,
compared with 12 percent nationwide.

Asheville City Councilman Carl Mumpower said the increases in
painkillers reflect cultural attitudes of treating the symptoms of
diseases rather than preventing them, which have been fueled by
pharmaceutical marketing. "We're training people to think the answer
is in a pill," said Mumpower, who is active in combating drug abuse
in the community.

In the past few decades, doctors and patients also have changed their
attitudes toward treating pain.

Not only are more pain centers popping up across the state, but more
primary care doctors are also prescribing prescription painkillers,
said Dr. Timothy Collins, a professor at Duke University and a
neurologist in the medical center's pain clinic.

"Pain is viewed by the federal agencies as a vital sign that is
supposed to be managed properly," Collins said. "Physicians are told
by regulatory agencies that pain needs to be treated, but don't
manage it too well or you'll get in trouble. There is this
schizophrenic attitude about it." Potential for abuse Oxycodone, the
chemical used in OxyContin, is responsible for most of the increase.
Retail sales of oxycodone jumped seven-fold in WNC from 1997 to 2005.
In WNC, hydrocodone sales increased by almost 200 percent from 1997
to 2005, while sales of morphine in the region increased by 270
percent during the same time period.

"Over the last 15 years, people who do have chronic pain have been
able to access medications that they need," said Dr. Anthony Burnett,
medical director at the Julian F. Keith Alcohol and Drug Abuse
Treatment Center in Black Mountain.

"That creates more availability, and because of great availability,
more opportunity for people to take advantage of the system," he
said. Like many communities across the country, Asheville and WNC are
battling abuse and diversion of painkillers. Martin said hydrocodone
is the most widely abused drug in WNC. Prescription painkillers are
the most abused drug by teenagers in Asheville, according to Mumpower.

Doctors are more vigilant about prescribing these painkillers because
of the risk of abuse.

The Asheville City Council set up a committee this week to look into
the issue of painkiller abuse in the community. On July 1, North
Carolina pharmacies started reporting prescriptions of controlled
substances into a central database that can be searched by doctors.

"The medications are just like a car -- responsibility comes from
those who prescribe them and take them," Mumpower said. "Somewhere
between the ditch of overusing and the ditch of under-using there is
a road. I don't think we're there yet."

The Associated Press contributed to this report.