COAL-FIELDS DOCTOR RAISES NATIONAL CRY FOR HELP

When my father retired in 1976 and moved back to his family homeplace
in Lee County, Va., he set one ironclad rule for choosing doctors.

Pick ones who will outlive you, he said.

The maxim led him to the office of Dr. Art VanZee, who was fresh off
an internal medicine residency at Vanderbilt University and had
decided to launch his medical career in a rural area with a paucity of
doctors and a wealth of community needs.

It was, from the beginning, a fortuitous match -- for my father, for
Lee County.

The first time I accompanied my dad to VanZee's office at the St.
Charles Health Clinic, there was the usual annoying wait. But once we
were in the good doctor's office, VanZee eased his lanky frame onto a
stool, looked straight into my father's eyes, and listened intently to
every complaint large and small.

I was impressed.

That feeling grew as medical concerns became more acute over time,
eventually positing my father in Richmond and Baltimore for his final
years. Even then, during annual summer visits back home, Dr. VanZee
would drive across the county with his children to spend a few hours
on a Saturday afternoon at my father's side.

In part, that was a tribute to my dad. In part, it was a testament to
a doctor who sees medicine as more than a score sheet on aches and
pains, but as a way to share in his patients' lives.

All of which leads me to say that I've been seeing a lot more of Art
VanZee lately than I'd like -- on the front page of Lee County's
``Powell Valley News,'' in The New York Times, and on CBS' ``Eye on
America'' feature last week.

Lee County, it turns out, is in the path of a horrific cyclone that is
spinning out of control through remote areas from Maine to the
Appalachian coal fields and is now beginning to touch down in more
populous areas.

The narcotic painkiller, OxyContin, released a few years back as a
wonder drug for individuals with chronic pain, has instead become a
force of destruction. OxyContin is spawning an epidemic of drug
addiction, crime, heartache and even death in regions that deserve no
new varieties of despair.

``It really has been disastrous for us,'' VanZee said in a telephone
conversation last week from the clinic in St. Charles. ``I've never
seen anything like this, the severity of the abuse and the number of
people involved.''

The New York Times recently quoted a Drug Enforcement Administration
official saying that no other prescription drug in the past 20 years
has been illegally abused by so many people so soon after it appeared.

The newspaper reported on aggressive marketing techniques by the
producer, Purdue Pharma, that have helped push OxyContrin sales to $1
billion -- more than Viagra -- in less than five years on the market.

Because of its time-release formula, OxyContin allows patients to take
fewer pills and get pain relief over a longer period of time than
earlier pain medications. That's all to the good.

But when the drug is crushed and snorted or injected, it produces a
powerful narcotic rush on the order of heroin. In the back seats of
cars and in the shadows of silent storefronts, hundreds, even
thousands of southwest Virginia and eastern Kentucky young people have
discovered that fact.

In a gathering that drew 800 people to Lee High School last month, a
longtime community worker lamented that, directly or indirectly, no
family or workplace in the county is untouched by OxyContin. She added
what, for me, were haunting words: ``It has changed us.''

VanZee tells how. In the past 18 or so months, he has been called
repeatedly in the night to treat young people who have overdosed. He
has seen teen-agers whose baby shots he administered sitting in jail
after stealing from their families or someone else. He has watched
foster care rolls double as young, addicted parents abandon their children.

He has become acutely aware of the pitiful void in detox clinics and
substance abuse services in his region.

And he has reached a conclusion. OxyContin needs to go. This is a
controversial position, given the massive drug profits involved. But
unlike heroin or cocaine, OxyContin is an opiate that can
unquestionably be contained at the source.

Purdue Pharma could withdraw the drug voluntarily, or the Food and
Drug Administration could force the company's hand. Nationwide,
advocates of a ban hope to raise 100,000 signatures of support before
officials of the company and the FDA meet sometime soon.

To be sure, some legitimate users of OxyContin would regret the loss.
But VanZee argues persuasively that a ban is justified because ``the
pain so far outweighs the amount of help.''

I hope federal officials, and any state ones in a position to help,
heed his plea. I've seen firsthand that this doctor's priorities lie
with his patients, which makes his word good enough for me.