`PAIN KILLER' A GRIM TALE OF ADDICTION, DEATH

PAIN KILLER: A Wonder Drug's Trail of Addiction and Death By Barry Meier.
Rodale. 336 pages, $24.95.

In "Pain Killer," award-winning investigative journalist Barry Meier
has created a grim, gritty saga that flows like an episode of "Quincy."

OxyContin (known as "Oxy" on the street) was hailed as a miracle
remedy for chronic pain, especially that associated with terminal
illness. The reason for its primacy over earlier pills was that its
one drug -- oxocodone, a morphine derivative -- was packed in a time
release seal of acrylic paste. Pain relief slowly leeched out over a
12 hour span, giving pain sufferers that most blessed of experiences
- -- a full night's sleep.

The pill's creator, a small company called Purdue Frederick, was able
to convince itself and even the FDA that Oxys would have no street
potential, because there was no initial rush. How wrong they were, and
how they fought against the rapid deterioration of that assumption, is
the essence of "Pain Killer."

Meier focuses on Pennington Gap, in southwestern Virginia. It is one
of the anomalies of Oxy that it hit the rural communities first. The
beautiful people, the Rush Limbaughs, came onto the Oxy scene way
late, after appalling damage had been done in America's heartland.

It was alleged that Purdue targeted rural areas based on their large
stake in Medicaid. With a guaranteed pay-down of government dollars
for the kind of lifelong pain engendered by occupations like
coal-mining, a place like Pennington Gap was the ideal
proving-ground.

Purdue, in a zealous campaign considered "conservative" by the
cutthroat standard of pharmaceutical competition, courted rural
doctors with all-expense paid conferences to glamorous sites, glutting
them with statistics about OxyContin's efficacy delivered by plausible
medical experts. But as the campaign reached fever pitch, local reps
began touting the drug for occasional and even mild pain.

Many medical practices in southern Appalachia are manned by folks who
came in with Vista or student internships, and came back. One such
dedicated physician, Dr. Art Van Zee, was alerted early on to the
dangers of Oxy, seeing children he'd known since birth succumbing to
addiction. Someone had figured out -- as Meier states, "it was child's
play" -- how to pop the un-poppable pill.

Van Zee and a consortium of concerned citizens approached Purdue and
were given the runaround.

Purdue refused to acknowledge the pill's negative effects, reiterating
that OxyContin was a God-send for pain sufferers.

When "acknowledgement" came it was in the form of subtle bribery --
offers to fund drug rehab programs with big bucks, which the folk of
Pennington Gap honorably refused.

The battle between rural communities and the medical/pharmaceutical
establishment -- the frustrations, the tactics, the human wreckage
before the denouement -- is at the heart of this fascinating forensic
mystery. Many Americans, certainly we who live in this part of the
country, have been touched by OxyContin's wildfire spread as a
destructive, even murderous, street drug. "Pain Killer" puts flesh on
the skeleton, revealing the people behind the headlines.

Barbara Bamberger Scott is a writer who lives in Dobson.