DRUG OVERDOSE DEATHS IN SOUTHWEST VIRGINIA ECLIPSE REST OF STATE

LEBANON -- Drug overdose deaths in Southwest Virginia have eclipsed the
rest of the state in the past decade, with prescription painkillers like
methadone beating out cocaine and other illegal drugs, a state Health
Department study concluded.

The deaths tripled between 1993 and 2003, jumping from 66 to 217, the study
by the department's Office of the Chief Medical Examiner reported. More
than 90 percent -- an estimated 211 -- involved prescription drugs.

"Our counties are hard-hit," said Dr. John Dreyzehner, director of the
Cumberland Plateau Health District, which includes Russell and Tazewell
counties. "To me, that's alarming."

Some counties had overdose death rates that beat out Richmond's by 300 to
600 percent.

Russell County had the highest death rate for its population -- 14 deaths
in 2003, for an average of 48.5 per 100,000 people.

Lee County came in third with eight deaths. Wise County ranked fifth, with
12, and Tazewell County was sixth, with the same number of deaths.

"These deaths represent only the tip of the iceberg," Dreyzehner said.
"There are parents, spouses, siblings and especially children devastated by
these losses."

Dreyzehner proposed the study after Dr. William Massello, the state's
deputy chief medical examiner, pointed out a steep increase in drug-related
deaths.

"The drugs involved in the Southwest Virginia deaths may not be the ones
many people think about," Dreyzehner said. "All these drugs are dangerous.
Any of them can kill you if they're used improperly."

It wasn't clear Wednesday how many of the deaths resulted from illegal
prescription drug use. A little more than one-fourth of those who overdosed
- -- 26.8 percent -- were known to be using their own prescriptions, the
study found.

"Some of this may be purely accidental," Dreyzehner said. "But some of
these overdose victims were not using their own prescriptions."

Nearly half of the deaths -- about 44 percent -- involved methadone, which
doctors around the region began prescribing after fears arose about the
addictive nature of oxycodone-based painkillers like OxyContin.

Most of those overdose victims used methadone in the pill form prescribed
for chronic pain, not the liquid form generally used to help wean drug
addicts off opiates like heroin or OxyContin, the study found.

The average drug user, based on the report, was a 37-year-old man with a
history of drug abuse and treatment for pain, chronic illness or mental
problems. Nearly one-fourth worked in jobs such as construction or coal mining.

"I'm coming to the opinion that the culture of disability in our region is
a factor in this drug use," Dreyzehner said. "When people are disabled,
they have time on their hands, they frequently need medical care, and they
frequently have access to medical care.

"With disability often go poverty and lack of political opportunity. Some
people will turn to drugs to fill what may be missing pieces of their lives."

The average drug user, particularly on methadone, overdosed on a
combination of two or three drugs, the study found. Valium, oxycodone and
Xanax were among the most common.

Dreyzehner said that tendency might stem from the slow-acting nature of
methadone. Pain victims looking for immediate relief or addicts seeking a
quick high try to speed up the process.

"Methadone in particular seems to have the ability to sneak up on people
who use it improperly," he said.

The statistics don't offer an answer to the problem, just a warning,
Dreyzehner said.

"Society doesn't have all the answers," he said. "At some point, people
make decisions. But if we can educate people, we can try to stem the tide."