OXYCONTIN - ONE PILL, TWO DRUGS

Euphoric painkiller is a miracle for the sick, a potential death sentence
for abusers.

OxyContin is new-millennium medicine at its best. For cancer patients and
others enduring relentless pain, it is quality of life in capsule form.

But it can be easily abused. Its daylong dose of meticulously gradual pain
relief can be crammed into a brief - sometimes deadly - burst of euphoria.

That's how experts describe the dual-edged nature of the drug. If it is
pulled from the market, many will suffer, some say. But if it remains,
others will die - both abusers and those who use it according to the rules
on the label, others counter.

As with most drugs, OxyContin's roots are anything but sinister. It's the
result of a search for an efficient, convenient way to ease extreme,
enduring physical misery. It was crafted by researchers looking for a way
to provide a steady flow of relief, replacing existing treatments' roller
coaster cycle - a numbing blast of medication followed by the gradual
rekindling of pain.

OxyContin is a long-acting form of Oxycodone, a painkiller that can be
found at various levels in nearly 50 medications.

It comes in 10-, 20-, 40- and 80-milligram pills. The manufacturer also
produced 160-milligram pills in July 2000, but its availability was
suspended this year because of the widespread abuse. A patient is typically
prescribed one dose twice a day.

The drug binds to pain receptors in the body and numbs them. For patients
who feel a constant, debilitating, throbbing pain, OxyContin makes them
sane. It curbs that constant pain and allows them to live comfortably.

"It's a wonderful drug because they can maintain their level of
consciousness," Greene County Medical Examiner Dr. James Spindler said.
"It's a real godsend because you take a small amount and it lasts for 12
hours. It's a wonderful drug for cancer patients or people with severe
nerve pain. ... They can actually be functional and are able to converse
with their families. It's a very good drug, but as with every good drug,
people misuse it."

It is intended to be swallowed whole and a portion of it is absorbed though
the stomach. As the time-release drug progresses through the digestive
system, more of the drug is absorbed in the body.

The time-release aspect of OxyContin is one of the reasons it's so
attractive. Patients are on a steady stream of medication, rather than the
ups and downs of taking a drug every four hours.

But it's that aspect that makes it so dangerous. If the drug is consumed
any way but swallowed whole, it can be deadly. Addicts are known to crush
it and snort or inject it into the body. Doing that takes away the gradual
release of the chemicals. Translation: 12 hours worth of pain relief in 20
minutes.

"We've had several cases where the drug will be prescribed to someone who
will accidentally overdose on OxyContin," Spindler said.

"If they're prone to drug abuse, they find out if you chomp on that little
sucker it's going to give you a real buzz," Spindler said.

"That's not very scientific, but if you chomp on it, it's a real humdinger.
If you bite down just a little bit, next thing you know you're waking up dead."