OXYCONTIN PLAGUES STREETS OF ST. JOHN'S

Phamacies in St. John's are putting signs in their windows saying
they don't stock OxyContin to discourage would-be thieves from
breaking in.

Like Cape Breton, Newfoundland has seen an epidemic of prescription
drug abuse, and the narcotic painkiller has been blamed for seven
overdose deaths.

The provincial government has established a task force of health care
and justice officials to examine OxyContin abuse. Dr. Thomas Cantwell,
chief psychiatrist for the Health Care Corporation of St. John's, is a
member of the task force.

"It's difficult to know when it (OxyContin) became a problem, but it's
only on the market since the mid-1990s, so it's a relatively new drug.
Like any new drug it takes some time before people find that it's got
potential for abuse," Cantwell says.

Cantwell says that OxyContin abuse is spread across the major centers
of the province. "But I don't think the extent of OxyContin abuse in
this province is any greater than anywhere else. It's been highlighted
a lot more here. Unfortunately, it has become the drug of choice among
many of our population," he says.

OxyContin is a slow-release product usually prescribed as a
twice-a-day dose. It is available in various strengths, the highest
being 80 mg. The drug is made up of granules that are slowly (and
safely) absorbed into the bloodstream.

Addicts are bypassing the slow-release nature of the drug by either
crushing and snorting it, or by dissolving it in water and injecting
it. This raises concern over exchange of, or re-use of needles.

OxyContin is extremely powerful and highly addictive, Cantwell
explains. "To put it into context, it is one of the opiate drugs; so
is morphine. Society knows very well about morphine. OxyContin is
about two-and-a-half times as powerful as morphine and that's
significant," he says.

One of the reasons the OxyContin task force was created was the
overdose deaths. "There have been now, I believe, seven confirmed
deaths and that's quite high even when you look at all the other
narcotics and medications on the market. I think people are beginning
to worry: Is there something specific about this particular drug that
is causing so many deaths?" Cantwell says.

Cantwell says that it is difficult to quantify the number of
OxyContin-related admissions to psychiatric facilities. He has seen
people admitted who are trying to get off the drug, but he also sees
addicts turning up when the drug's availability on the street dries up.

Essentially, the addicts check themselves into hospital to get a fix.

"And then as soon as it becomes available on the street again, they
tend to sign themselves out and not follow through with treatment,"
Cantwell says.

He goes on to explain that the health care providers are beginning to
steer away from weaning addicts off the drug because weaning just
doesn't seem to work.

When asked where on the street the drug is coming from, Cantwell
states that it is coming from pharmacies and doctors. "The police tell
me there is very little of it coming into the province on the black
market. It's coming from legitimate sources, but it's also coming from
armed robberies of pharmacies, or break-ins into homes or pharmacies,"
he says.

A spate of pharmacy break-ins has generated concern among the police
and that has led to the signs in pharmacy windows.

On the street, the drug fetches high profits, selling for about a
dollar per milligram, making an 80-mg tablet worth $80. Cantwell
encountered one case of an older person with chronic pain who was
selling her OxyContin prescription, then buying another painkiller and
realizing a profit.

"We have to look at how it is being prescribed. Do we need more
education of physicians prescribing it?" Cantwell asks. He wonders how
young people with no documented evidence of chronic pain are being
prescribed OxyContin.

"There are doctors out there who, knowingly or unknowingly, are
writing prescriptions that they shouldn't be writing," he says.

Cantwell is very concerned that the drug is finding its way into
schools among young people. While he sees the media's interest in
OxyContin as beneficial, he thinks that heightened media coverage may
tempt some people to try the drug.

He also worries that the focus on OxyContin may shift attention from
other addictions, such as gambling, which has caused many deaths by
suicide.

"Addiction is the basic illness and it has many heads, drugs being
one. OxyContin is one of those many drugs that make up the drugs of
addiction," Cantwell says.

Darrin McGrath writes for The Chronicle Herald from his home in St.
John's.