PLENTY OF 'HILLBILLY HEROIN' IN C.B.

Island Doctors Prescribe a Lot More Oxycodone Than MDs Elsewhere

Sydney - An addictive narcotic linked to escalating crime was
prescribed more often in Cape Breton than anywhere else in the
province last year.

A new study tendered Wednesday at the Nova Scotia Police Commission
inquiry into an in-custody death shows more than 432,000 of the
roughly one million oxycodone pills prescribed in the province were
swallowed by Cape Bretoners.

The generic drug - the so-called "hillbilly heroin," a cheaper
substitute known for its highly addictive buzz - is sold under the
names Oxycontin, Supeudol and Oxy-IR.

Cape Breton Regional Police blame the drug for a number of violent and
desperate acts committed in the area by addicts in recent months.

Those include an armed holdup at a Lawtons drugstore and several break
and enters into the homes of cancer patients, who use the prescribed
narcotic for pain control.

Colleen Conway, director of the provincially funded prescription drug
monitoring program, told the commission there were 653 patients from
the island's 138,000 residents who were written 3,430 prescriptions,
each containing an average of 126 pills, last year.

By comparison, only 545 patients under the Capital district health
authority - which oversees health care for a population three times
greater in the metro Halifax area - were written 2,509
prescriptions.

Across the province, more than 8,400 prescriptions for Oxys were
prescribed to 1,726 patients, almost triple the number prescribed by
doctors and dentists in 2000.

James Guy Bailey, a Sydney Mines bodybuilder, died from a drug
overdose in 2000 while in Cape Breton police custody.

But it wasn't Oxycontin that killed him. Instead, it was Bromazetam,
an anti-anxiety drug in the benzodiazepine family of drugs that the
province doesn't monitor, along with the antidepressant Paxil, also
not monitored.

"Since Bailey's death, we would love to be able to monitor those . . .
(but) again it's a lack of resources currently," Ms. Conway said.

"It would be to the benefit of the health of all Nova Scotians to
monitor benzodiazepines."

Ms. Conway said the program has a budget of $300,000 and staff must
manually enter information from paper forms after prescriptions are
filled.

Besides narcotics, the program monitors the use of other drugs like
codeine, testosterone and Ritalin for suspected abuse. Doctors and
dentists suspected of over-prescribing are referred to their
respective colleges for investigation. There were fewer than five
referred last year and fewer than 10 in 2001.

She said any suspected substance abuse by patients - who might
double-doctor for pills, steal prescription pads, or change doses or
dates on legitimate prescriptions - is reported back to the family
doctor. But that information isn't shared with other unsuspecting physicians.

"It would be better if we had electronic prescriptions," she said,
noting their outdated system doesn't let doctors and dentists check
for recent prescriptions.

"Although it's not live, it's almost as good."

The Bailey inquiry has been told by several drug pushers and users -
and by police officers - that prescription drugs sold on the street
are either stolen or obtained by people who fake symptoms to get the
pills from their family doctor or an emergency ward physician.

Drug enforcement officer Const. Greg Gouthro said the last four armed
robberies in the industrial Cape Breton area were Oxy-related.

One Oxy costs up to $50 per pill on the street.

Users either swallow the pill, crush and snort it, or mix the pill's
contents with water and inject it.

"Our recommendation to the doctors who are prescribing Oxys would be
to prescribe only a week's supply at a time" to at least lower the
quantity of pills getting on the street, Const. Gouthro said.

"If a patient is supposed to have one Oxy per day, then give them only
seven. . . . Make it that they have to go back for them each time."

Jean McKenna, lawyer for the commission, said more work obviously
needs to be done by the Health Department to monitor drugs like oxycodone.

"There's a problem, we know it's getting on the streets, we know it's
being prescribed in large numbers," she said.

"It may be perfectly legitimate, there may be more chronic pain here,
maybe for some physicians the oxycodone is their drug of choice for
treating pain . . . but it's always in their discretion."

[sidebar]

2002 OXYCODONE USE

District Health Authority Residents Patients Prescriptions

Cape Breton 138,000 653 3,430

Capital 400,700 545 2,509

South Shore 60,000 86 576

Colchester East Hants 73,400 113 525

Guysborough Antigonish Strait 49,300 68 351

Pictou 49,700 81 319

Annapolis Valley 82,300 85 317

Cumberland 34,300 52 192

South West Nova 66,200 43 191

Total 945,500 1,726 8140