EASTERN KENTUCKY NARCOTIC SWEEP

Drug Arrests Show Part Of Epidemic

Doctor Charged Isn't Sole Source Of Painkiller, Authorities Say

Convicted of felony tax fraud in Michigan and ordered to undergo treatment
for a gambling problem, Dr. Ali H. Sawaf nonetheless had little trouble
getting a medical license in Kentucky in 1998.

Now he sits in the Harlan County Jail, the only health professional so far
charged in a sweeping investigation into illegal use of the highly
addictive painkiller OxyContin.

More than 200 people have been indicted as part of ongoing federal, state
and local investigations into alleged widespread trafficking in the
synthetic morphine, which is similar in its effect to heroin. Federal
prosecutors say 59 people have died from overdoses in the past 13 months in
Eastern Kentucky.

Most of those charged so far are street-level dealers or users, but Joseph
Famularo, U.S. attorney for Kentucky's eastern district, said more charges
are possible as investigators try to determine the source of the drug,
which can be obtained from a pharmacy only with a doctor's prescription.

Harlan County Sheriff Steve Duff, whose office arrested Sawaf last week
after an investigation of his local urology clinic, said the problem is
more widespread than just one alleged supplier of the drug.

He said people who deal in the drug "doctor shop" in other towns or other
states. For a time, he said, some local people were traveling to Virginia
to a doctor known as the "Candyman."

That doctor was later prosecuted by federal officials, Duff said.

Mark Caverly, diversion group supervisor for the U.S. Drug Enforcement
Administration in Louisville, said the problem has become so widespread in
Eastern Kentucky that some physicians have posted signs in their office
stating, "No OxyContin."

"This appears to be the drug of choice right now," said Caverly, who tracks
pharmaceuticals for the DEA. "This has been coming up real strong in the
past 18 months."

THE RAPID spread of the drug -- and the 59 deaths -- shocked some veteran
law enforcement authorities.

"It was well beyond anything I imagined," said Famularo, who announced the
indictments Tuesday. "It truly was an epidemic like some sort of locust
plague rolling through southeastern Kentucky."

Duff said Harlan County, where about a dozen people have died from
overdoses, has been having trouble with the drug for more than a year.

"I've been asking for help since 1999," he said. "It's terrible up here,
and it's escalating."

Duff said his office in September conducted a drug raid resulting in 66
arrests and "90 percent" of those arrested were for crimes involving
Oxy-Contin.

Duff said that Sawaf was writing so many prescriptions for OxyContin that
Harlan County pharmacists refused to fill them, prompting Sawaf to complain
to him.

Sawaf, being held in jail on a $650,000 cash bond, could not be reached for
comment. He's been charged with multiple felonies, including six counts of
illegally prescribing drugs.

Michael A. Mone, executive director of the Kentucky Pharmacy board, said he
had received a complaint in recent months from a Kentucky doctor he
declined to identify who said that local pharmacists were refusing to fill
his prescriptions for OxyContin. Mone said he wasn't able to offer much
help to the doctor.

"Pharmacists have a right not to dispense drugs not in the best interest of
the patient," Mone said. "I'm convinced my pharmacists did a good job."

Mone said he's not aware of any pharmacists charged in the investigations
that resulted in 52 federal and 155 state charges. Lloyd Vest, general
counsel for the Kentucky Medical Licensure Board, said he isn't aware of
any doctors other than Sawaf who are charged.

Sawaf was granted a license by the Kentucky licensure board in September
1998 despite his legal problems in Michigan, according to board records.
The records showed he had a felony tax conviction and his medical license
had been temporarily suspended in Michigan.

Sawaf's criminal case was resolved when he pleaded guilty, was placed on
probation for 60 months and ordered to stop gambling and attend gambling
addiction treatment.

Vest, the Kentucky licensure board lawyer, said the board could have
refused Sawaf a license based on the offenses, but records show the board
decided to grant him a Kentucky medical license.

"It's at the discretion of the board," he said.

Vest said the board hasn't taken any action against Sawaf since his arrest
last week, but an inquiry panel will take up the matter when it meets Feb. 22.

The epidemic of OxyContin abuse is causing many problems in southeastern
Kentucky, including in Harlan County, Duff said.

He said thefts and burglaries are up and those arrested more and more are
stealing to support OxyContin addiction.

Harlan Jailer Denny Pace said he's seeing an increased number of inmates
arriving who are using and are addicted to the drug.

"I have a huge problem with my inmates taking these "oxies,' " Pace said.

He said inmates undergo a medical screening. If they report using
OxyContin, they must receive medical treatment for problems, including
possible withdrawal.

"A NUMBER of people booked into the jail list that they take that drug,"
Pace said. "It is rampant."

Duff said he believes one reason the drug is so popular in Eastern Kentucky
is the relatively "easy access" and the fact that other drugs -- such as
marijuana, cocaine and methamphetamine -- are not as easily accessible in
the mountains.

Famularo said he hopes the charges announced Tuesday will stem the abuse of
OxyContin but can't guarantee it, given the apparent scope of the problem.

"You never really know in our business," he said. "You got to stay in there
and do what you can do."

Officials in Kentucky had a new, powerful tool to track OxyContin
prescriptions as part of the investigation into abuse of the narcotic
painkiller.

Called KASPER (Kentucky All Schedule Prescription Electronic Reporting), it
is a giant, computer database of all controlled drugs dispensed by Kentucky
pharmacists.

Dr. Rice Leach, Kentucky's public health commissioner, said KASPER grew out
of a task force he headed charged with finding a better way to track
controlled drugs -- such as narcotic painkillers.

Authorized by the 1998 General Assembly, KASPER was up and running last
year and contains information dating to Jan. 1, 1999, said Danna Droz,
branch manager for the state Drug Enforcement and Professional Practice Branch.

Information is provided to law enforcement officials who certify it is
needed for a specific, criminal investigation, Droz said. Physicians and
pharmacists also may obtain information if it is needed for treatment of a
specific patient, Droz said.

Using KASPER, police can determine whether one individual is having
multiple prescriptions filled for the same narcotic from different doctors,
Droz said. Before KASPER, if police suspected a problem, they had to visit
every pharmacy or physician they believed a suspect may have used.

"Law enforcement tells us it's a Godsend, it's the best thing that ever
happened to drug investigations," Droz said.

Physicians or pharmacists could also use it to determine whether a patient
was obtaining the same drug elsewhere -- or obtaining other drugs that
might conflict with a new prescription, Droz said.

Any pharmacist or physician who dispenses controlled drugs must report them
to KASPER, Droz said.

Most pharmacies report by computer, Droz said.

It's a big improvement over what state drug officials had before, she said.

"We had no database before," Droz said. "We had nothing."