OXYCONTIN IS TOP ADDICTIVE DRUG

62% of Methadone Clinic Clients Hooked on Prescription Painkiller

NASHVILLE - The prescription painkiller OxyContin has overtaken heroin and
other street drugs as the narcotic of choice for addicts seeking help at
Tennessee's methadone clinics.

And it can be more dangerous than other drugs.

"A lot of people are losing limbs, getting infections and even their heart
valves are getting infected," said Dr. Steven Ritchie, medical director of
state methadone clinics in Nashville and Memphis.

The problem is the drug was designed to be absorbed by the body over a
12-hour period, so some of the substances in it don't completely dissolve
when addicts inject it.

Buddy Stephens, director of the state Department of Health's methadone
clinic program, said about 21 percent of those admitted to state methadone
clinics in 2001 reported OxyContin was their drug of choice. The percentage
jumped to 51 percent in 2002, and last year it reached 62 percent, Stephens
said.

In Knoxville, more than 90 percent of the clinic's clients are addicted to
OxyContin.

Treatment costs about $12 a day and is covered by TennCare for those who
qualify, Stephens said.

The rise in the number of people seeking treatment has boosted TennCare's
costs from $2.4 million in 2002 to $3.5 million last year, according to
AdvoCare, a company contracted by the state to provide mental health
services and drug treatment.

There are also signs that OxyContin is gaining in popularity among all drug
users. Prescription painkillers like OxyContin now rank second to marijuana
as the most-abused drugs in the country, according to the Substance Abuse
and Mental Health Administration.

Addicts are drawn to it because they can get a 12-hour dose in one sitting
by crushing the tablets and snorting them or dissolving them and injecting
the solution, according to Leah Young, a spokeswoman for the Substance
Abuse and Mental Health Administration.

OxyContin was initially used primarily to treat pain in terminally ill
patients but has since become widely prescribed for back and joint
injuries, drug counselors said.

Most people begin their addiction with a valid prescription for the pain
medication, Stephens said. But when the prescription runs out and
withdrawal symptoms set in, people quickly seek other ways to get it on the
street, on the Internet or from a different doctor in a practice known as
"doctor shopping."

With the rise in OxyContin addiction, methadone clinic counselors say
they're also seeing younger and wealthier patients. Street prices of a
single tablet range from $30 to over $150, depending on the potency and
availability of the drug.

To satisfy their craving for the drug, addicts often show up at emergency
rooms with elaborate tales of upcoming surgeries, lost prescriptions,
doctors on vacation and piles of medical records, said Corey Slovis, who
leads the Department of Emergency Medicine at Vanderbilt Medical Center.

"They usually complain of severe, excruciating lower back pain and say
OxyContin was the only thing that worked before," said Slovis, who created
a rule last year prohibiting emergency room doctors from prescribing
OxyContin in most cases.

One or two people a week are admitted to the emergency room after
overdosing on the drug, he said. While the numbers are not at what he calls
the "epidemic" levels of other cities, Slovis said, virtually nobody came
in with an OxyContin overdose a few years ago.

"Physicians are finally learning they cannot leave people on the drug for
as long as they do," he said. "This is the most addictive thing we've seen
since heroin."

Dr. Robert Ripley, a Nashville cardiologist and a member of Tennessee's
board of medical examiners, said the state is creating a database to
monitor which doctors are prescribing narcotics and for whom.

"Doctors have to police themselves and apply limits on the health care they
provide," Ripley said. "The whole culture of how medical care is delivered
in this state has to change."

When deprived of OxyContin, addicts are often bedridden, with severe body
cramps and pain, nausea and vomiting, headaches, chills and drenching
sweats. That's why the addiction is treated with methadone.

But Stephens said demand for treatment is outpacing the ability of
methadone clinics to provide it.

"We have an insufficient number of clinics to meet the needs of our
residents," said Stephens, who regulates the seven privately owned
methadone clinics in the state.