OXYCONTIN USE ON RISE IN CITIES

Abuse Of Prescription Painkiller Especially Rampant Among Teens

Right after he graduated from high school, a friend introduced Mark
Smith to OxyContin as a way to get high. Three years later, Smith is
still a prisoner to the nation's most popular prescription
painkiller. More than once, his attempts to break his addiction alone
have drawn him to psychiatric wards in the chilling throes of withdrawal.

"It's a slow suicide," said Smith, 21, of Savage, who goes to a
Minneapolis methadone clinic daily in hopes of one day piecing his
life back together. "It's been a living hell on it, and coming off of
it. Like riding on the tail of a dragon."

Some months after barreling through her OxyContin prescription before
her scheduled refill, Heidi Fredericks, 35, would inject heroin to
slake her overpowering need. But the Rochester mom found that on the
street, OxyContin was not only the cheaper of the two drugs -- it was stronger.

OxyContin, the top-selling narcotic painkiller, has made major
inroads into the Twin Cities drug culture, especially among youths as
of late. Once nicknamed "Hillbilly heroin" because of its popularity
in Appalachia and other rural areas, the powerful opiate has been
linked in recent weeks to armed robberies at suburban pharmacies from
Arden Hills to Lakeville and the death in May of an Eagan teen.

A statewide poison control center notes a threefold increase in
related phone calls in as many years. Methadone clinics swell with
heroin users who say they use the two opium-derived drugs
interchangeably. Due to a growing street trade in recent months,
authorities are focusing on OxyContin dealers in undercover buy-busts.

A report released last week by the National Center on Addiction and
Substance Abuse at Columbia University said there are 15.1 million
abusers of prescription drugs and that 2.3 million of those are teens.

But unlike heroin, cocaine or methamphetamine, police say there are
no criminal kingpins to topple, no foreign drug cartels to target. To
the surprise and alarm of many parents, the latest youth drug is
readily available in their medicine cabinet.

Soaring Popularity, Soaring Problems

Manufactured by Purdue Pharma, OxyContin was approved by the U.S.
Food and Drug Administration in 1995 as a treatment for moderate to
severe pain lasting more than a few days. Within six years it had
become the most popular narcotic painkiller on the market, with
annual sales exceeding $1 billion. OxyContin today is just as likely
to be prescribed by a primary care physician as a cancer specialist
or pain clinic.

Considered twice as potent as morphine, the pills are made up of a
single compound -- oxycodone -- coated with a controlled-release
buffer to allow pain relief over an extended period of time. (Drugs
like Percodan and Percocet contain oxycodone in more limited amounts,
diluted by other active ingredients.)

"I think OxyContin is certainly a favorite among drug abusers just
because there's nothing else in it," said Chris Lintner, a pharmacist
with the Minnesota Poison Control System.

For effect, users have learned ways of dissolving the buffer to
absorb the oxycodone all at once. The drug is chewed and eaten,
crushed and snorted or dissolved in water and injected for a loose,
floating feeling and a euphoric, heroin-like high.

Experts first noticed OxyContin addiction in rural areas, where
loggers and other workers who perform heavy manual labor began
getting hooked on the drug. Soon, some elderly patients and the rural
poor found that selling their supply provided supplemental income,
while heroin users from urban areas discovered the pills to be
readily available from small-town doctors and pharmacies.

By 2000, authorities in rural Maine, Kentucky, Ohio, Pennsylvania,
Virginia and West Virginia were alarmed by the prevalence of
OxyContin addiction, which seemed to be spreading from the
Appalachian region to major cities. In a West Virginia drug clinic,
as many as half the patients were hooked.

Until recently, however, Twin Cities drug enforcement officials still
considered OxyContin abuse an East Coast problem. Local authorities
say its prevalence has grown in the past 12 to 18 months, joining a
series of prescription narcotics, like Percocet and Vicodin, that are
popular with young abusers. Experts say it has even made inroads at
"rave" parties, where teens once favored recreational drugs like
Ecstasy over narcotics.

"The majority of cases that we've got are still meth," said Sgt. John
Grant, the agent in charge of the Dakota County Drug Task Force. "But
we're seeing more and more OxyContin cases. It's becoming the drug of choice."

Police say the street market is still largely driven by individual
users, who are selling OxyContin at $1 a milligram -- or $20 to $40
for a pill -- in order to fund their own OxyContin use.

According to the drug task force, in 2003, when OxyContin was
separated from other prescription drugs for counting purposes, there
were 47 pills seized. In 2004, that number had doubled to 94, and
already in 2005, 86 pills have been seized.

"We're seizing more OxyContin through search warrants and buy-busts.
Not just the kids, but the adults, too," Grant said. "All of a sudden
we're getting people who are saying, 'Hey, I can deliver 50 to 100
units of OxyContin.' It's actually becoming the target."

Authorities and medical experts say typical users might be teenagers
or someone in their early 20s who began using the drug
recreationally. While study findings vary, experts say addiction
among prescription users who take the drug as directed is relatively uncommon.

"It's intended to be used by people in pain under a doctor's
supervision, for people in a specific type of pain," said Jim Heins,
spokesman for Stamford, Conn.-based Purdue Pharma.

Heins noted that the company has worked with several states to
establish prescription drug monitoring programs. "In patients taking
it as directed, the incidence of addiction is low."

A Youth Problem

But its popularity among young people is clearly growing. A national
survey conducted recently by the Partnership for a Drug Free America
found that teens, for the first time, are now more likely to abuse
prescription painkillers than illicit drugs. The survey found that 18
percent of students in seventh through 12th grades had tried Vicodin
to get high and 10 percent had abused OxyContin, while 9 percent had
used cocaine, crack cocaine or Ecstasy.

Shana Hunsucker, 18, of St. Paul first heard about OxyContin eight
months ago through a friend. Since then, she said, the drug has grown
into a popular new draw within St. Paul's youth drug culture. She saw
a friend descend so far into addiction he sold his belongings, stole
from his roommates and was forced from his home.

"Most people are buying it from people who are stealing it from their
parents," said Hunsucker, who believes the pills are easier for young
people to acquire than methamphetamine.

Brian Sturgeon, an investigator with the Dakota County Drug Task
Force, said that many older abusers are getting the drug legally from
their physicians, or buying or stealing it from people who have prescriptions.

"Sometimes they will have five, 10 different doctors issue
prescriptions," Sturgeon said of users' practice of "doctor
shopping." "Sometimes the smaller dealers will steal it from
relatives or (through) burglaries."

As its popularity increases, so do consequences. In the metro area
last year, there were 475 hospital emergency department reports
involving oxycodone, according to the Hazelden Foundation, which runs
addiction programs in the Twin Cities.

"Kids are really of the mistaken belief that if it's a pill, it's
somehow safe," said Carol Falkowski, who monitors drug abuse trends
in the Twin Cities for Hazelden and the National Institute on Drug
Abuse. She notes that about 5 million school-age children take pills
daily for behavior disorders. "They learn at a young age that pills
are a relatively safe proposition, because so many of their friends take them."

"But really, with prescription narcotics, even one-time use in a high
dose can be fatal," Falkowski said. "And it's not as if these pills
come in their original packaging (on the street). Kids don't really
know what they're getting."

Daniel Kaschner believes his son didn't know. Christopher Kaschner,
17, was found dead in his bedroom by his twin brother on the
afternoon of May 1. The Eagan teen had stopped by a friend's house
that Friday evening and taken a number of pills from an OxyContin
bottle that had been left out on the kitchen table by the friend's
father, a cancer sufferer, Kaschner said.

Christopher slipped into bed early Saturday night, complaining of a
headache. His brother went to his door that night to invite him
outside for a cigarette, but decided not to bother him after hearing
him snoring unusually loudly. Kaschner now knows that sound was a
likely sign of respiratory distress. During an OxyContin overdose,
the part of the brain that controls breathing is impaired, drawing
the victim into a light coma.

Kaschner and his wife, Vicky, who left early Sunday morning on
vacation, received the news of their son's death later that day at their hotel.

"I wish people were made more aware about how lethal this drug is. I
don't think doctors tell you to keep it away from children. They
should say, 'Lock it up,' " Kaschner said. "I'm not saying that it's
bad. But I think it needs to be controlled much more than it is.
Doctors are writing out more and more prescriptions for back pain.
That puts it on the streets."

Kaschner believes his son, who sometimes swallowed several ibuprofen
at a time to help him sleep, took four to six OxyContin pills under
the mistaken impression they would help his headache. Since his son's
overdose, he has learned that regular users build up a gradual
tolerance to painkiller narcotics over time. A cancer patient might
find comfort taking the same dosage that would be fatal to someone else.

"For somebody who is young and not used to narcotics, three pills
might be enough to cause toxicity, or even death," said Dr. Carson
Harris, a toxicologist at Regions Hospital in St. Paul. Harris
estimates the hospital's emergency room treats at least six or seven
cases of OxyContin overdose a year, with summer and fall being the peak months.

"Chris was a good kid. He had a big heart," said Kaschner, recalling
how his son posted poems on the Internet and hoped to study
electronics at a local community college. "He wasn't your 'sit
downstairs in the dark' druggie. You think of two things when you
think of accidental overdose. I've had people ask me, 'Was it a
suicide?' No. No, ifs, ands or buts about it."

OxyContin And Heroin

Gregory Carlson directs a Minneapolis methadone program that serves
600 narcotic addicts daily, most of them heroin users.

"Almost everybody that we've admitted in the past two years has used
OxyContin when they could get it," said Carlson, director of
addiction medicine at Hennepin Faculty Associates, a unit of the
Hennepin County Medical Center.

OxyContin, said Carlson, helps heroin users stave off the difficult
symptoms of withdrawal while providing a high of similar, if not
greater, intensity.

"There's nothing on the street that you can get as high with, that
would also suppress withdrawal as long," he said. "And those are the
two things addicts are looking for."

But if many heroin users are turning to OxyContin as an alternative,
some OxyContin users are also turning to heroin.

It's a familiar story for Mark Smith, who was just out of Burnsville
High School when a friend brought him OxyContin pills pilfered from
his mother's medicine cabinet. Smith, a social drinker in high
school, had never considered himself a hard-core drug user.

"From the moment I started, I was on a three-month binge," said
Smith, who turned to heroin when the pills weren't available. "I
couldn't get out of bed unless I had it. It's bad news."

Heidi Fredericks was in training to become a department store manager
when her doctor put her on OxyContin for chronic back pain in 2002.

"He said there's a new drug, OxyContin, and he put me on eight 80-
milligram tablets a day," she said.

Fredericks said the prescription was far too strong -- so strong, in
fact, some pharmacists refused to fill it. Fredericks, who watched
her career crumble while spending the past three years in and out of
addiction centers, blames her doctor for getting her hooked.

"It's like being in a coma, a waking coma. You don't sleep. You don't
eat," said Fredericks, who also injected heroin at the height of her
OxyContin addiction. On OxyContin, days blurred together and she lost
all sense of the passage of time. She remembers being asked to leave
a grocery store after shopping for six hours; to her, it had felt
more like minutes.

Both Fredericks and Smith said as their tolerance grew, their
OxyContin use provided little of the initial euphoria. Instead, they
craved it as a way to avoid the powerful sickness that accompanies
withdrawal from the drug.

They are both enrolled in treatment programs in hopes of defeating
their addictions.

"I think there is this moral model that addicts are these weird
people trying to get high all the time," said Carlson. "That's not
the case. They're normal people trying to feel normal. When you ask
an addict to give up his drug, you're not asking him not to get high.
You're asking him to tolerate the symptoms of withdrawal."

[Sidebar]

About OxyContin

Authorities and teens say OxyContin abuse has grown in the past 12 to
18 months. Considered twice as potent as morphine, the painkiller
fetches $1 per milligram on the street, or between $20 and $40 a
pill. The pills are swallowed, snorted or injected for a euphoric,
heroin- like high. National surveys show 10 percent of teens have
abused OxyContin to get high. The U.S. Food and Drug Administration
approved OxyContin for moderate-to-severe pain in 1995, and within
six years it had become the most popular narcotic painkiller on the
market, with annual sales exceeding $1 billion.