HILLBILLY HEROIN HEADS DOWNTOWN

If you were on Queen West this week, you may have noticed Jennifer, an
unlikely figure even by the loose standards of Skid Row. Snow was falling,
and a cold wind raked the street, but Jennifer was wearing a purple velvet
miniskirt, a nylon bomber jacket and a pair of teetering heels.

She had the desperate air that comes with being a 43-year-old prostitute
whose best-before date has long since passed, but for Jennifer, career
problems paled in comparison to the matter immediately at hand -- where she
was going to get the money for her next hit of OxyContin, her drug of choice.

Less than five years ago, she had a husband, a job and a house in the
suburbs. Now, thanks to her drug addiction, that's all gone, replaced by
her life on the street and the endless, grinding quest for a fix.

"It's got to happen soon," she said, as yet another car passed. "I'm
feeling rough. And I know what happens next. . . ."

Unless she came up with the money for some Oxycontin within a few hours,
she would begin suffering the agonies of withdrawal.

The combination of chills and pains is so unbearable one addict compared it
to "having a migraine while your hair is being burned off your head."

Jennifer hiked up her skirt and moved a step closer to the curb. "I wish I
could stop," she says. "But I can't . . . that's just the way it is."

Jennifer is far from alone in her struggle with OxyContin, a well-regarded
medicinal painkiller that has found a sinister second life as a street
drug. It's referred to as Oxy, OC, Killer and Hillbilly Heroin -- a name it
earned when it rose to popularity in rural Kentucky after going on the
market in 1996.

But Hillbilly Heroin has since moved downtown. According to a public-health
report released this month, OxyContin (and drugs related to it) were
responsible for 27 deaths in the city of Toronto in 2002 -- a sharp
increase over previous years, when it typically caused between one and
seven deaths.

The statistic is reflected in countless other major cities, where OxyContin
has rapidly become an addict staple. Dr. Kumar Gupta, a leading Toronto
addiction specialist who sits on the board of the Canadian Society of
Addiction medicine, says he encounters ever-rising numbers of OxyContin
addicts in his practice. Some are existing drug users who have discovered
OxyContin. Others are people who find themselves hooked after using
OxyContin as a prescription for pain -- like the 19-year-old high-school
student who became an addict after a car crash (or, to cite a recent
headline-making example, U.S. talk-show host Rush Limbaugh) -- or teens who
simply tried it once at a party and liked the blissful rush it offers.
"This drug is replacing heroin as the leading problem drug of abuse," says
Dr. Gupta.

One of the most troubling aspects of the OxyContin scourge, Dr. Gupta says,
is the fact that many addicts are supplied by doctors who are duped into
writing multiple prescriptions. One of his own patients, he says, got
prescriptions from eight doctors at once.

Dr. Gupta believes Ontario should set up a central prescription registry
like the one British Columbia instituted in 1996. The need for a registry
was highlighted this week when Ontario Provincial Police laid 58 charges of
"double-doctoring" and one count of fraud against a Barrie woman who
allegedly visited five doctors and six pharmacies to obtain more than 200
narcotic pills.

"The sad reality is that there are some physicians that dispense high
quantities of this drug to patients in a dangerously liberal fashion that
render the patients vulnerable to getting hooked," Dr. Gupta says.

Jennifer, the Parkdale prostitute, is a case in point. Crying, she related
her story this week as she waited for the trick that would pay for her next
Oxycontin fix. Until 2000, she says, her life was "normal." She worked as a
cashier in a lumber store, and was married to a man who installed
eavestroughs. She and her husband had a house, a Labrador retriever and a
Toyota Camry.

Then came her long, deadly dance with OxyContin. It began when she hurt her
back in a car accident and was given OxyContin to control the pain. Soon
she was taking twice as many pills as her initial prescription required.
When she asked for yet another increase, her doctor refused. So she went to
another doctor. Then she saw a third doctor, who knew nothing about the
other two.

For Jennifer, the three prescriptions weren't enough. She started buying
OxyContin from a friend at work, who had a connection at a pharmacy. Her
habit quickly escalated to the point where it was costing her several
hundred dollars a week. She drained her bank account, then her husband's.
She took cash advances on their credit cards until they were maxed out.

Unable to focus, she lost her job, She and her husband split. Jennifer
tried to kick OxyContin, but the pain of withdrawal was crucifying.
"Everything in me hurt," she says.

Jennifer moved into a cheap apartment downtown and collected welfare. Some
time in 2001 she found herself turning tricks on the street. "I'd like to
quit," she says. "I just don't see how. If you tried it, you'd see."

Countless other addicts have stories that differ only in the details.
"Addiction levels the field," says Betty Walker, manager of the Renascent
Centre's Munro House, a residential treatment program for addicted women.
"It can be anyone."

As an opiate-based pain-reliever, OxyContin is closely related to heroin,
and to the opium smoked by addicts in Victorian England. OxyContin is
designed by its makers to be a slow-release painkiller, but addicts quickly
learn how to short-circuit that feature by crushing the pills, so the
entire narcotic content is dumped into their system at once.

The sheer pull of the drug is illustrated by the experience of a woman
called Nancy, whose descent into OxyContin addiction began in 1999, when a
boyfriend gave her a painkiller pill in a bar. "Try it," he said. "You'll
like it."

She was amazed by the euphoria it produced. She felt herself buoyed in a
wave of bliss. "It was great," she says. "Who wouldn't want that feeling
again?"

For about six months, she "dabbled" in painkillers, buying Percocets from a
dealer who hung out in an east-end bar. Within six months, she was taking
one every day. Then it was two. In 2001, she moved up to OxyContin, which
provided a bigger hit: "One Oxy was worth five Percs," she says.

She bought the pills at a doughnut shop on Dundas. At first, she took three
or four 40-milligram pills a day, crushing them to defeat the time-release
feature. Within a few months, she was doing 15, by a new means -- injection.

When she injected the drug, it instantly reversed the painful effects of
impending withdrawal: "You go from freezing cold to warm and cozy," she
says. "You go from stomach cramps to feeling great. You stop sneezing. And
then in a little while it all starts again."

Dr. Mark Weiss, who works in addiction medicine at the Bellwoods Centre,
says the sharp public debate over OxyContin has obscured some key issues --
like the fact that OxyContin is really nothing new. "It's an opiate," he
says. "And opiates have been around for a long time."

But he says the mechanisms of addiction are only partly understood by
medical science, although there is general agreement on some fundamental
issues. "People are constantly describing this incredible feeling they had
when they first tried drugs," he says. "Every time they use, they're
chasing that initial high."

In a small East York bungalow, a woman named Darlene is still trying to
recapture the feeling she had when she tried OxyContin for the first time,
in 2002. "My mind and my body were separate," she says. "I loved the feeling."

At 40, Darlene is nearing the end of her rope. She used to be a head
cashier at the Toronto Dominion Bank, but is now unemployed, thanks to her
addiction. OxyContin wasn't her first run-in with substance abuse -- she
has used cocaine and alcohol heavily in the past. But OxyContin has been
her Waterloo. Since becoming addicted after taking the drug for back pain
three years ago, she's spent an estimated $40,000 on it.

In her kitchen, sitting in the window above the sink, she has a picture of
her brother, who committed suicide after years of substance abuse by taking
a massive overdose of OxyContin.

"I'm using the same thing that killed my brother," she says. "How stupid
does that make me? I know where all this goes, but I can't stop."