FORMER ADDICT - DUPING DOCTORS 'SIMPLE'

You'd be surprised how easy it is to con a doctor into believing that
you need narcotics for pain, Joe Leonetti says.

He should know. Before he became sober last June, the Des Moines man
supplemented his methamphetamine habit with OxyContin, Vicodin and
other powerful prescription drugs. He says he obtained many of the
pills by going to emergency rooms or medical clinics and spinning a
tale of back pain or other hard-to-diagnose ailments. "It's really,
really simple," he says.

Addicts swap tips on which doctors are the most gullible, he says,
and on how to avoid detection. For instance, he says, physicians tend
to become suspicious if patients ask for a specific brand of
narcotic, and many doctors seem more likely to believe women than men.

Leonetti says some doctors started him out on less-potent,
non-narcotic medications and sent him to physical-therapy sessions.
He pretended to go along with those measures. "Then, you just say it
isn't working, and they'll give you something stronger," he says.

Leonetti, 29, has been through addiction treatment twice. The first
time, in 1994, he met just one person who had been abusing
prescription narcotics. Last year, when he re-entered treatment,
about half the people he met had been abusing such pills. Many of
them had obtained the drugs by doctor-shopping, or by buying pills
from people who had duped physicians.

He says narcotics can provide a high similar to heroin.

"You don't feel any pain, that's for sure," he says. "You get all
warm and fuzzy. You know that feeling you get right before you fall
asleep? It's just like that."

But as his habit developed, he needed more and more pills to get any
result. Coming off them was terrible, he says. "I felt like I was
going to die."

Leonetti, who is thinking about training as an addiction counselor,
still attends treatment sessions at United Community Services, an
addiction-recovery center near downtown Des Moines. He wants Iowans
to know that doctor-shopping is a common and spreading problem that
enables addicts to self-destruct.

His counselor, Mike Brazelton, says Leonetti's descriptions of the
practice fit what he hears from many other clients. Both men favor a
proposed state system that would automatically track the addictive
medications that Iowans buy. Supporters say doctors and pharmacists
could check the registry to see whether their patients were obtaining
multiple orders of drugs.

"I think it's going to do a lot of people a lot of good," Leonetti says.

Leonetti says he wound up in treatment last year after being arrested
for domestic abuse, which he says was related to his drug addiction.
He says he never worried about being arrested for scamming doctors,
even though the practice is illegal.

At one point, Leonetti says, his health insurer balked at paying for
a prescription because he had already filled so many orders. But no
one reported him to the police. Addicts don't fear prosecution, he
says, unless they do something blatant, such as sell pills or forge a
prescription.

Polk County Attorney John Sarcone acknowledges that addicts rarely
are charged with a crime for doctor-shopping. "We probably have
prosecuted a case or so, but that's probably the exception, not the
rule," he says.

Sarcone says the practice is clearly illegal, but the proof can be
hard to come by. For one thing, he says, doctors are bound by
patient-confidentiality rules, which can prevent them from sharing
information with law officers.

Also, he says, prosecutors would have to prove a patient
intentionally lied about pain, which could be daunting. He says the
proposed tracking system could help provide solid evidence of fraud.