PRESCRIPTION DRUGS LEADING KILLER

WILKESBORO -- Donna Reeves was worried about her daughter Casey's drug
use.

"I told her, 'I don't want to get that phone call (that) somebody's
found my daughter dead,'" Reeves said.

"Mom, I know my limits," Casey told her.

But one Saturday, Casey stayed in bed uncharacteristically late. Her
father had gone out of town to a charity event and her mother was upstairs.

"I was the one who had to make that phone call to her daddy and tell
him that his daughter was dead, because I'm the one who found her,"
Reeves said.

Casey Reeves, 20, was one of 18 people who died in Wilkes County in
2006 of a prescription-drug overdose.

Back then, authorities had already noticed a spike in
prescription-drug overdose deaths in Wilkes and other Northwest North
Carolina counties. Things are worse now.

Someone has died of an accidental prescription-drug overdose almost
every week so far this year in Wilkes County, according to
authorities. That puts Wilkes County on pace to have double the 26
prescription-drug overdose deaths it had last year.

The deaths in 2008 already ranked Wilkes County as having one of the
nation's highest per-capita death rates from prescription-drug overdoses.

Drugs of choice such are opiate-derived painkillers as Oxycodone,
which includes such forms as OxyContin, Percocet and Percodan, as well
as Hydrocodone, sold under trademarks including Vicodin.

"Prescription drugs right now are the No. 1 problem," Wilkes Sheriff
Dane Mastin said. "Not cocaine. Not meth. It's generating lots of
break-ins, home invasions."

In the neighborhood

It's a trend shared by other rural counties in Northwest North
Carolina. There were more than 22 deaths per 100,000 people in parts
of the mountains and foothills in 2006-2007, compared with 10 deaths
per 100,000 in the rest of the state, according to the N.C. State
Center for Health Statistics.

In Surry County, Sheriff Graham Atkinson said that prescription-drug
overdoses are one of the most serious drug problems they have.

People have died smoking rolled-up morphine patches. "You'll find them
dead sitting there with it in their hand like a cigar," he said.

He's infuriated about thieves who target elderly people who have
legally prescribed medication for legitimate use.

"We've had older folks tell us they hide their medicine in their
underwear to keep their grandkids from stealing it," he said.

In Wilkes County, Sheriff Mastin said the trend is getting worse in
part because the bad economy, job losses and other problems are
driving more people to seek escape in narcotics.

It's a complex issue as to why the situation is worse in rural areas,
but authorities say that part of the problem is that there are already
a lot of legitimately prescribed painkillers out there for people who
work hard at chicken plants, on farms and at other manual labor.

People steal or buy leftover medication.

It's not as easy to obtain heroin here as it would be in a
metropolitan area, and opiate-based painkillers become a recreational
drug they were never meant to be.

How they get it

More than 30 law-enforcement officers from Burke, Wilkes, Surry,
Guilford, Yadkin, Ashe, Watauga and Stokes counties, as well as agents
from the State Bureau of Investigation and other agencies, attended a
recent seminar at Wilkes Community College about what to look for and
how to fight prescription-drug abuse.

"I'm fairly passionate about this because I have been on the other
side of the table with the finger in my face (from the victim's
family) saying, 'What are you going to do?'" Mastin told the assembled
officers. "Education is one of the best tools we've got."

Experts from Purdue Pharma, which manufactures OxyContin and other
drugs, told seminar participants they should tell people to dispose of
prescription medications rather than saving the unused pills.

"This is where kids are getting this stuff: out of your medicine
cabinet, out of your friend's medicine cabinet, out of grandma's
medicine cabinet," said Landon Gibbs, a Purdue Pharma expert in
prescription-drug diversion.

It's also dangerous to share medications, experts warn, since people
react so differently to powerful drugs, especially if they're already
taking other substances or drinking alcohol.

Wilkes County and its Substance Abuse Task Force have been working on
the problem for years, and are preparing to introduce a major
educational effort about the dangers of prescription-drug abuse.

They're hoping to discourage people from doctor shopping -- the
practice of visiting multiple doctors to obtain multiple prescriptions
- -- and going door-to-door to persuade doctors to sign up for the
controlled substance reporting system available in North Carolina
since 2007, said Fred Brason II, the task-force chairman.

Doctors could access a database and see what narcotics a patient has
already been provided.

The task force is also working with Wilkes Regional Medical Center to
develop a policy to discourage the use of narcotics in the emergency
room, Brason said. People complaining of a headache or other
nonobvious problem would be provided non-narcotic medications until
they can visit a primary care physician.

"Anybody coming in will be treated for what they need. It's just not
going to be the easy place (to obtain narcotics) anymore," Brason said.

Hugh Chatham Memorial Hospital in Elkin adopted a similar policy
earlier this year after noticing an unusually large number of people
from Wilkes County coming over to use the Surry County hospital.

A task force in Surry County has recently finished a study about its
DWI rate, and plans to start a similar look at its prescription-drug
problem, Atkinson said.

Brason is the director of Project Lazarus, a pilot program set to
begin this summer to provide anti-overdose kits to at-risk patients
who are starting methadone treatment to try to kick opioid addictions.
The kits include the drug naloxone (known as Narcan), which reverses
opiate overdose by blocking the brain's opioid receptors.

One never knows

Wilkes is working with the federal Drug Enforcement Agency to schedule
drug turn-in days in the near future.

Authorities and residents alike say they want to spread the word about
how dangerous and scary the misuse of prescription drugs can be.

"One pill with the wrong person and they're gone," Brason
said.

Reeves says that her daughter, Casey, was a good young person from a
good family. A former cheerleader at North Wilkes High School, Casey
joined the National Guard early-entry program at 17 and wanted to pay
her own way through school and become a teacher.

Those dreams started to die when Casey started using Oxycodone and
other drugs. But she was proud to be kicking the drugs on her own.
Mother and daughter cried together as they talked about it.

Casey had been clean for a few weeks when she slipped up. Her mother
said she thinks that her body may not have been able to tolerate the
dose she used to take.

"If one person can hear this and it makes them change their mind about
doing drugs or if it helps one family member, then maybe her death
won't be in vain," Reeves said. "It's unbelievable how bad this is. I
think some people think it only happens to other people. Everybody
thinks 'It can't happen to me.'"