'HILLBILLY HEROIN' TAKING TOLL ON GEORGIA

OxyContin Painkiller Addiction Concern Grows

LaFayette --- It crept down the Appalachian Mountains from Maine to
Alabama, sending hundreds of victims to morgues, hospitals and rehab
clinics.

OxyContin, the deceptively powerful and highly addictive prescription
narcotic known as "hillbilly heroin," blindsided rural communities.
In southwestern Virginia, at least 43 deaths have been linked to
OxyContin. In Kentucky, "Operation OxyFest 2001" was billed as the
state's largest ever drug roundup. In West Virginia, the attorney
general sued the pill's manufacturer, claiming the highly profitable
pill was irresponsibly marketed.

Now it's Georgia's turn.

Charles David Martin took a handful of pills one recent evening, and
another batch the following morning, and died from an OxyContin
overdose in this northwest Georgia town near the Alabama and
Tennessee lines. The 15-year-old Covington boy was "looking for
acceptance," according to an uncle, "and wanted to fit in with the
crowd."

Charles became a poster child for Georgia's latest drug scourge. Last
week, cops, pharmacists, drug counselors and others detailed an
OxyContin epidemic in the making, reaching from LaFayette through
Marietta, Macon, Savannah and on down to the Middle Georgia city of
Eastman.

Used appropriately, OxyContin is an effective, hours-long pain
reliever. But abusers discovered that the 10, 20, 40 and 80 milligram
pills can be crushed, then snorted or injected to produce a wicked
heroinlike buzz.

OxyContin is mainly a blue-collar white man's drug, preying on
unsuspecting buzz seekers like Charles and hard-core addicts like
James Edward Major. In April, Major, 38, was found blue and dead in a
motel bathroom in Marietta a day after he crashed through a
pharmacy's glass door and stole eight bottles of OxyContin.

Authorities expect 100 OxyContin-related deaths in Georgia this year,
up from 62 last year. Business owners anticipate hundreds of millions
of dollars in lost man-hours and drug treatment costs. Parents and
politicians fear teenagers will get hooked on the latest drug fad.

"It's an epidemic out there," says Rep. Terry Coleman (D-Eastman),
chairman of the House Appropriations Committee, who earlier asked
state drug investigators to check out reports of abuse of the drug in
his hometown. "People tell me it's more addictive than even crack
cocaine. Apparently, it's readily available. If it's as big a problem
as I hear it is, it could be we need to outlaw that particular drug
in Georgia."

A death in Alabama

Pat Cook wishes Alabama had. Her son Ryan died of an OxyContin
overdose in December. Ryan was 20, a Gadsden, Ala., native who played
soccer and football in high school and, like many of his peers,
smoked pot.

When a car accident broke his back in 1998, the surgeon refused to
prescribe OxyContin. In pain, Ryan eventually found other doctors
willing to prescribe the narcotic.

"He started shooting up in February" 1999, Cook says. "He was very
open with me. He called one day and said his arm was infected and
that he had bad news for me. He told me he was shooting up. I kind of
suspected it."

Cook says her son was "more easy-going" and "sweet" while high. At
first. "But after a short while, he looked like death warmed over. He
went, in a short while, from a waist of 38 to a 31. His eyes were
black all around."

Two weeks of rehab didn't work. Ten days later, Ryan was dead.

His sister nearly preceded him to the grave.

"I overdosed on Nov. 2 in my brother's house," says Jennifer
Mattingly, 25, a mother of two. "He found me. I was clinically dead.
I had no pulse, no blood pressure. I was stiff and blue. I was in a
slight coma. I'd had a seizure. When I woke up in the hospital, I
thought I was dead."

The birth of her first child three years ago left Mattingly with hip
pain. OxyContin was prescribed. She started with a dosage of two 10-
milligram pills.

"Right then, I knew nothing else compared to how OxyContin took care
of my pain," Mattingly says. "It just gave me a rush before I even
started abusing it."

After a brief hiatus, Mattingly returned to Oxy with an addict's
vengeance. She readily found doctors willing to prescribe the
painkiller. One doctor prescribed 30 Oxys and a codeine-based cough
medicine one week. A week later, he prescribed 24 more Oxys and cough
syrup. The following week, it was 60 pills and syrup. The next week:
90 pills and more cough medicine.

Mattingly was no longer swallowing the pills; she was mainlining,
popping veins on the backs of her hand, looking for a soft spot to
drive the needle home. She shot up three crushed 40-milligram pills
every two hours. On a bad day, Mattingly went through 12 to 18 pills
a day. Her husband joined her.

"I had to have them to function. I wasn't really getting high
anymore," she says. "There were times my husband and I would sit back
and say if we had a gun in the house, we'd use it just to put us out
of this misery."

More than a medicine

One of every 10 adults suffers moderate to severe chronic pain,
studies show. Americans ridden with sore backs, arthritis, cancer and
other ailments have long been prescribed Percodan, Percocet and a
host of other oxycodone-based painkillers.

But when Purdue Pharma introduced OxyContin in late 1995, pain
sufferers and their doctors hailed the long-lasting narcotic as a
"miracle drug." An opium derivative, OxyContin's time-release formula
typically allows sufferers 12 hours of relief --- the longest-lasting
oxycodone on the market.

"When it first came out, I thought, 'Man, what a great idea,' " says
pharmacist Rick Karsten, a special agent with the Georgia Drug and
Narcotics Agency. "If it's used correctly, it's got great potential."

Doctors prescribed OxyContin in droves. Since 1996, the number of
U.S. prescriptions increased twentyfold to almost 6 million last
year, the U.S. Drug Enforcement Agency said.

Eighty-three percent of Purdue Pharma's revenue last fiscal year, or
more than $1 billion, came from OxyContin, spokesman James Heins
confirms.

OxyContin is a Schedule II drug, meaning a doctor must write a
prescription for every dose. Refills aren't allowed. The restrictions
have done little to thwart a booming black market.

Last month, a federal grand jury in Charlotte indicted 10 people
suspected of illegally selling 50,000 OxyContin pills across
Virginia, West Virginia and the Carolinas. West Virginia, South
Carolina, Ohio, Maine and Florida slapped restrictions on the drug's
distribution to Medicaid patients.

Some pharmacists no longer sell the pills and place "No OxyContin"
signs in their windows to deter robbers. In Pulaski, Va., a handful
of drugstores now require fingerprints from OxyContin users.

A $5.2 billion lawsuit was filed in Virginia in June against Purdue
Pharma. Plaintiffs, who had lost family to alleged Oxy overdoses,
claim the company encouraged doctors to prescribe the drug for many
ailments, not just those leading to severe and chronic pain.

In all, 13 lawsuits from five states have been filed against the
Stamford, Conn., company. At a late April press conference in
Gadsden, Ala., Gov. Don Siegelman interrupted a Purdue Pharma
doctor's defense of OxyContin.

"I find this very offensive, and I want you to stop," Siegelman said.
"We've had enough public relations and enough sugar coating of this
issue, and, quite frankly, as governor, I am fed up."

Attorney General John Ashcroft weighed in recently, calling OxyContin
a "very, very dangerous drug." Last month, the U.S. Food and Drug
Administration strengthened the warning labels on OxyContin.

Purdue Pharma got the message.

"We do want to work with law enforcement to curb the abuse of our
product," says Heins, adding that 90 percent of the overdoses
examined by Purdue also turned up traces of other drugs and alcohol.
"We support their efforts to prosecute and incarcerate criminals who
obtain the product by theft and fraud. We want to make sure our
product is available for patients who have legitimate medical needs."

The company mailed letters to 800,000 doctors, pharmacists and others
explaining the labeling changes and highlighting the problems of
OxyContin abuse. The company quit selling the most powerful 160-
milligram pills. Purdue Pharma also announced last month it would
develop a "smart pill" to destroy OxyContin's narcotic power if the
tablet is altered.

News reports say the pill maker was familiar with such chemical
safeguards before OxyContin was introduced. Purdue Pharma says the
revamped pill won't be available for at least three years.

'Wide' abuse in Georgia

Meanwhile, Georgians will continue to discover the narcotic wonders
of a drug known on the street as "Oxy," "O.C.," "Oxycotton" and
"killers."

From a low-slung, cedar-shingled building in LaFayette, Ira Taylor
and other members of an FDA prescription drug task force wage war
against OxyContin's infiltration of northwest Georgia.

Taylor, a detective with the neighboring Fort Oglethorpe Police
Department, handles a slew of paid drug informants for tips on
OxyContin dealers.

"Two years ago, we didn't see any of it in this area," says
Oglethorpe, whose office is filled with confiscated drug
paraphernalia. "It's becoming more prevalent every day. I'm sure the
drug has its use, but it's widely abused here in North Georgia."

Taylor and other task force members recount stories of down-and-out
mountain folk profiting from their pain. An old man dying from cancer
was busted recently for selling some of his Oxys for much-needed
cash. A terribly obese lady on a respirator exchanged some of her
Medicaid- covered pills for cash.

Another woman had 11 doctors lined up for prescriptions. Others
"doctor shop" across county and state lines, searching for compliant
physicians. Of late, though, Taylor sees a more organized and illicit
OxyContin network: a "runner system" where dealers pay for doctor
visits and prescriptions.

'It's the regular people'

Charles David Martin obtained Oxys the old-fashioned way --- from a buddy.

David and his mother, Lisa Williams, visited friends in the rural
community of Naomi, outside LaFayette, this month. It was a late
summer trip before David was to return to Newton High School. David
and two other 15-year-olds who lived in the white-shingled house with
a bright red door went looking for pot from a neighbor. He didn't
have any. He offered Oxys instead, according to Walker County Sheriff
Steve Wilson.

David swallowed a half-dozen. Nothing happened. The boys went to bed.
After a midday breakfast, David swallowed a bunch more. He went back
to bed and never woke up. Acute toxic overdose was the cause of
death. The sheriff says David swallowed maybe 15 Oxys.

"Apparently, it was a young boy looking to have some fun and he made
a mistake," Wilson says. "In the '30s and '40s, kids OD'd on alcohol.
Now kids OD on drugs."

Atlanta has largely escaped the OxyContin scourge --- so far.

In Savannah, a doctor was sentenced to 30 months in jail for writing
illegal OxyContin prescriptions. In Macon, machine shop owner A.V.
Elliott tells of six of his 130 employees who've been fired after
drug tests turned up oxycodone in their blood. (One later died of an
overdose.)

But, mostly, OxyContin's popularity grows across rural Georgia.
That's where you find the mills and factories where men and women
can't afford to miss paychecks. So they take a pill and go back to
work. Medicaid also makes OxyContin more readily affordable to
low-income Georgians.

"You always do see a lot of injuries and back complaints in areas
where you have the textile industry," says Ron Bieri, a special agent
with the state's Drugs and Narcotics Agency. "You don't see nerve
pills; you see pain pills."

Taylor, the Fort Oglethorpe detective, says, "It's the regular
people. It's people a doctor would believe needed the medicine."

Rural communities are also home to a proportionately high number of
disabled and chronically ill people, many of whom remain wary of
doctors until they're really hurting.

"In parts of Appalachia, law enforcement officials have told us that
they've always had a problem with prescription drug abuse," says
Purdue's Heins. "They've also told us heroin and other illicit drugs
are not readily available in these areas."

But the experts don't expect OxyContin to remain the province of
rural Georgia. It's already making deadly inroads into suburbia.
Outside Boston, more than a dozen pharmacies have been held up for
OxyContin by a gang of youths in baseball caps and bandannas. Eleven
overdose deaths have been attributed to OxyContin in and around both
Philadelphia and Miami.

Ryan Cook grew up solidly middle-class in Alabama.

"My brother and I were pretty much the first kids in Gadsden doing
this," Mattingly says.

"Now, kids I know who also know that Ryan died are overdosing. It
just blows my mind."

SMALL PILLS PACK BIG MEDICAID PUNCH

OxyContin use by Georgia Medicaid patients has increased threefold in
two years:

Year..........Net Payments....No. of Pills Dispensed

Fiscal '99....$2,507,370......1,087,349
Fiscal '00....$5,418,284......2,018,603
Fiscal '01....$8,834,067......2,966,516

Source: Georgia Department of Community Health