POLICE FRET OVER SURGE IN 'HILLBILLY HEROIN' USE

OxyContin becomes Drug Of Choice For Area Abusers

Last summer, on a warm sunny day, a Bedford Township woman made what some
parents would consider a shocking wish.

Standing on the wooden porch of her well-adorned suburban home, the mother
of a family that once seemed inseparable watched her son's vehicle pull
into the driveway and whispered:

"Oh no, they let him go. God I want him to go to jail, just so he can quit."

She'd heard all the excuses, had all the hopes, only to have them turned
against her. Now when her 24-year-old son, Kevin L. Welch, tells her he's
giving up his drug habit, she doesn't bother saying she won't believe him
anymore.

"He used to tell us everything, but now the lies aren't going to stop. The
addiction won't stop," said Mrs. Welch, who asked that her first name be
withheld for this story.

Kevin's not addicted to cocaine or heroin, for years the choice of many
addicts. He's hooked on a new kind of drug -- one seen by many as safe,
even government approved. OxyContin, nicknamed "oxy," "the ox," or "O.C.,"
is a pain-killing, Pied Piper of a pill that can be illegally converted
into an energizing drug.

When crushed and snorted, or melted and "mainlined" via needle into a vein,
"it makes you want to do things, achieve things," Kevin said. "It keeps you
going."

"Across the board, OxyContin is becoming a drug of choice," said Lt. Dan
Schultz, in charge of the Toledo Metro Drug Task Force. "And this year,
we're seeing a tremendous increase in its illegal use."

Seizures of so-called "Schedule II" drugs -- the most tightly controlled
prescription narcotics -- that are being illegally sold in the Toledo area
nearly tripled from a 2003 total of 939 unit doses to 2,581 doses for the
year of 2004 through November alone. "That tremendous increase can pretty
much all be attributed to OxyContin," Lieutenant Schultz said.

For Kevin, life on the pill became wonderful -- full of energy and
excitement and bliss, he said. For a while.

But life had to stay wonderful. After weeks of taking several pills every
day without a prescription, Kevin stopped -- and soon a riptide of
withdrawal symptoms made his muscles clench like vice grips, thrust into
his stomach until he vomited.

"I can't remember the last time I got high from it," Kevin now says. At the
height of his addiction, he would melt three 80-milligram pills -- the
chemical equivalent of 48 Percocets; tiny, 5-mg pain killers seen by many
addicts as the epic high -- and shoot them into his vein. It took $120 a
day just to keep the pain away.

High costs

Enforcement officials say that the withdrawal symptoms of "Oxy" mimic
heroin, giving the drug the nickname: "hillbilly heroin" or "poor man's
heroin."

An ironic title, given the fact that the street price of OxyContin is twice
that of heroin. "There's nothing on the street more valuable than Oxy,"
Kevin said.

But for some, evidently, price is no object. Lt. Luke Davis -- who oversees
a multi-agency narcotics task force in southeast Michigan -- said OxyContin
is the most commonly abused prescription drug in Monroe and Lenawee counties.

"It just continues to get worse. It used to be the older people using, but
now it's getting into the younger generation, the high schools," he said.

Dr. Brian Kaminski, medical director of the emergency center at Toledo
Hospital, agreed based on the recent increases of people in their teens and
early twenties that he's seen walk into his emergency room saying they're
hooked on OxyContin.

Even Deputy Joe Lambert, a member of Monroe County sheriff's department and
until last year the liaison officer at Bedford Public schools, said
OxyContin snuck right under his highly sensitive nose -- into his own
family. A close relative of his who was raised under his roof and went
through the school system he once monitored became addicted to OxyContin.

"They seem perfectly normal," Deputy Lambert said. "I didn't notice until
it was too late."

He added that the dozen or so informants he talks with say "the majority of
their friends and people they see in school are doing this stuff."

One in five students in Lucas County has used OxyContin, according to a
survey of about 40,000 students done in April by the Alcohol and Drug
Addiction Services Board of Lucas County.

"Keep in mind, the survey excludes the hard-core users, the drop outs who
aren't around any more," said Jay Salvage, executive director of the board
through 2004. He said OxyContin was added to the survey questions this year
because the board saw it as an "emerging issue of concern."

"It's insidious. You don't see the signs until you're paying the bills,"
Mrs. Welch said.

Cause and effect

In November, Mrs. Welch's wish came true: Her son spent his first
Thanksgiving in jail. It was a long time coming: Kevin's addiction robbed
his family of every dime in their savings account, tens of thousands of
dollars in cash advances on their credit cards, and guns, power tools, a
leaf blower went missing from the garage.

Mrs. Welch first noticed something was wrong when she and her husband came
back from the Florida Keys in May, 2003, and saw a $12,000 cash advance on
a family credit card.

"In all, I'd say he got us for 40 to 50 grand," said Mrs. Welch.

"Mom's terrified to let me back into her heart," said Kevin, sitting in a
cell at Lenawee County jail for stealing a friend's checkbook and forging
six checks to keep his habit going. "I've got the greatest parents. They've
always been there. They've given me everything -- and I've done a lot to
hurt them."

He'd spent a few days in lock-up before, once for possession of drug
paraphernalia, but Mrs. Welch believes the seven-month stint he's now on is
the only possible solution.

"A few days just aren't enough to scare them off this drug," she said.

It's one example of how the abuse of OxyContin, like any addictive drug,
translates into other areas of crime, enforcement officials say.

In November, an armed robbery at Yinger Pharmacy Shoppe in Monroe was
carried out by two men who demanded the drug specifically. Jim Yinger, the
owner, now refuses to carry OxyContin.

"My employee got the barrel of a .45 stuck in their face. How would you
feel? It's not worth it," Mr. Yinger said.

It's the third such pharmacy robbery in recent years, according to Monroe
County Prosecuting Attorney Michael Weipert. "OC" was the target in all three.

Tim Benedict, vice president and chief inspector for the Ohio State Board
of Pharmacy, said the armed robbery trend has been increasing statewide for
the past three years, with OxyContin the main target "the large majority of
the time."

But there are pettier crimes, as well.

"The people that started on it two years ago are starting to steal to keep
their habit going," Deputy Lambert said. "It's coming to a head -- half the
robberies and larcenies from cars in Bedford can be attributed to this drug."

While Ohio is in the top 10 states of OxyContin abuse, Drug Enforcement
Agency spokesman Dave Jacobson said "the Toledo area is at one of those
critical junctures in drug trends -- it's at a crossroads. Use is
increasing, and it's in danger of taking off. But it could also fade to the
side."

But he and other enforcement officials add that fighting illegal sales of
prescription drugs is more difficult than fighting other drugs. With
cocaine, shipments can be found and intercepted. But with OxyContin,
"people are selling it mostly off of legitimate scripts," Lieutenant Davis
said: Dozens of legit prescriptions creating dozens of potential sources.

That eventually trickles down to the street dealer, Lieutenant. Schultz
said: "It's pretty commonplace now to stop someone selling other drugs like
cocaine or heroin and he'll have some pills on him. A year ago that
wouldn't have happened."

The pill's prevalence and popularity is partly due to its accessibility,
Lieutenant Schultz added, with legal prescription holders selling a dozen
or so pills a month out of the 30, 60, and sometimes 90 they're prescribed
- -- at around $40 for a single 40 mg pill.

While Vicodin, another pain killer, remains the most widely abused
prescription drug on the market, "taking 20 Vicodin a day will tear your
stomach up," Kevin said. "And who wants silver when you can get gold and
platinum?"

Medical dilemmas

Part of the attraction of OxyContin, Mr. Salvage said, is due to the fact
that it's seen as safe, "government approved." Made in a controlled
environment, with no danger of being "stepped on" or cut for purity,
OxyContin is seen as a less dangerous, less addictive, more reliable "high"
than a bag of heroin or cocaine bought on a dark street corner.

"It's amazing how quickly the illicit drug industry can take a legal drug
and convert it," he said. "Never underestimate the creativity of these people."

And because of that, pharmacists say their job is getting harder. Never
mind the armed robberies, they have more commonplace concerns whenever a
customer walks in the door.

"Some come in and they limp, they cough. You know when the carnival's in
town," said Ernie Boyd, executive director of the Ohio Pharmacists Association.

Ohio pharmacy board officials say one big problem is tracking "pharmacy
shopping" -- abusers going to different pharmacies for the same
prescription several times in a row -- with stricter tracking methods in
neighboring states pushing some abusers into the Buckeye state.

All states surrounding Ohio have statewide oversight mechanisms:
centralized databases overseen by state pharmacy boards into which
prescription information is logged alongside patients' personal
information, thus making the practice difficult.

A bill sponsored by Ohio Rep. Thomas Raga, a Republican from suburban
Cincinnati that would set up and help fund such a system passed both
chambers Dec. 7 and now awaits Gov. Bob Taft's signature.

Still, Mr. Boyd said, pharmacists are getting more adept at spotting red
flags: Photocopied scripts, sloppy signatures for known doctors on stolen
prescription pads with stolen "DEA" identification numbers, and people with
insurance or from "out of town" paying in cash.

Mr. Benedict, who oversees complaints against pharmacists, said the cases
of actual pharmacists or doctors selling for profit -- "script mills" or
"candymen" -- is rare. But cracking down on an offender can be difficult.

"You don't indict a doctor for one bad prescription. You need 40 to 50
cases," he said.

Alan Gardner, a former ProMedica Health System physician and operator of a
private pain management practice in Defiance, was indicted in November on
two felony counts of aggravated trafficking and two counts of corrupting
another with drugs -- specifically, OxyContin -- relating to juveniles. Dr.
Gardner pleaded not guilty.

Some doctors are becoming increasingly hesitant to prescribe the drug, even
for conditions the drug was meant to treat: Serious, chronic,
round-the-clock pain.

And that's a problem for Connecticut-based Purdue Pharma L.P., maker of the
drug.

"Unfortunately, you've got criminal activity dictating legitimate
practice," said James Heins, public affairs director for Purdue.

Mr. Heins is quick to point out that OxyContin is a highly regulated
narcotic, and ever since Purdue became aware of the problem of its
illegitimate use in 2000, the company "stepped up" efforts to fight it.
Tamper-proof prescription pads with serial numbers were distributed to
doctors, funding was provided for an education campaign against juvenile
abuse, and Purdue is working on a pill that is rendered ineffective when
crushed.

But Rogelio Guevara, a chief inspector for the DEA, called some of those
efforts "public relations damage control" in a letter included in a General
Accounting Office report on OxyContin abuse. In that 2003 report, DEA and
FDA officials expressed concerns that Purdue initially had been misleading
and overly aggressive in its marketing of the drug.

As for Purdue's recent efforts, "it may hurt sales," joked Dr. James D.
Chlovechok, medical director of the Ohio Sports Medicine Institute in
Cambridge, Ohio.

"Once word gets around that you prescribe it, the abusers start showing
up," he said. "It's a lot of work to try to treat real pain, because you
try to sort the real from the unreal."

Dr. Chlovechok remembers being visited by a whole family -- sisters with
different married names coming from different counties, all asking for
OxyContin for all sorts of problems.

"Then one day I saw their names in a relative's obituary, and I knew why
they were coming to me," he said.

Solutions

Ross Chaban, vice president of clinical services at Substance Abuse
Services, Inc. -- the only methadone clinic in Lucas County -- said the
increase in patients seeking treatment for OxyContin addiction this past
year has been unprecedented.

Those admitted for Oxycodone abuse -- the active ingredient in OxyContin --
jumped 142 percent, from 19 patients in 2002-2003 to 46 patients in
2003-2004. In comparison, the heroin addicts SASI treated jumped 21
percent, from 131 to 159, in that time period.

Before that, Mr. Chaban said SASI saw only two or three patients abusing
Oxycodone, "half a dozen at the most."

One female patient at SASI who asked to remain anonymous has been on
methadone for two years in an attempt to combat OxyContin. Hit by a car
seven years ago and with broken bones in her face and hip, she went through
three surgeries and was placed on OxyContin for four years. In the end, the
105-pound woman was up to whopping 360 mg a day.

When she was finally cut off cold by a new doctor, "the symptoms made me
feel worse than when I got hit by that car," she said.

She bought OxyContin on the street for several years -- to the tune of
$2,000 a month -- before she checked into SASI. Looking at her two young
kids and staying away from other users kept her off it, she said.

Paul Barko, her counselor at SASI, said that's crucial for those with
contacts in the drug culture. But Mr. Salvage, whose board oversees SASI,
said the main challenge with prescription drug abusers is getting them to
see their habits as dangerous in the first place.

"A lot of times people will stigmatize or condemn alcohol and heroin users
- -- but it's hard to do that with prescription drug users," he said. "They
and those around them don't see themselves as addicts."

Mr. Jacobson agreed that "the American mentality doesn't have a strong and
healthy enough fear of these drugs that they should have."

Kevin Welch said he's looking forward to the day he'll get out of jail, but
added that "I'm gonna be scared to see how I react to that little bit of
freedom. I would like to think this is the bottom, that this will reach me,
but there's no guarantee I'm not going to go back."

Mrs. Welch gets a little angry when she glances at a letter sent from her
son in jail. "Oh, here comes the guilt again," she said.

"This used to be a house overflowing with friends," she said, tearing up as
she looks at the pool, tree house, and playground set in her backyard.

"As long as they're alive, you want to believe there's hope. But I just
don't know if there is."