'Hillbilly Heroin' Abuse Exploding
Decatur Police
consider OxyContin a 'Big Problem.'
An admission by talk radio celebrity Rush Limbaugh on Friday that he was
addicted to painkillers shocked many of his listeners, but it was no surprise to
area law officers who are witnessing an explosion of abuse.
"OxyContin and hydrocodone are very abused medications. It's a big problem,"
said Sgt. Faron White of the Decatur Police Department.
Limbaugh admitted his addiction after Florida officials said a drug
investigation in the state "overlapped" accusations made by Limbaugh's former
maid, who told The National Enquirer she had helped supply her employer with
massive amounts of OxyContin and hydrocodone. Limbaugh told his audience Friday
he was immediately admitting himself to a rehabilitation center.
The problem of painkiller abuse is not just big, it is also complex, according
to doctors. The same drugs that are increasingly targeted by law enforcement
have also allowed many pain-wracked patients to return to work and to a
fulfilling life.
Although hydrocodone has for years been the prescription drug of choice for
abusers willing to tap the Decatur black market, OxyContin - nicknamed
"hillbilly heroin" because of its initial abuse in rural areas - is catching up.
White said one reason OxyContin's popularity is increasing is the ease with
which it is abused. Manufactured as a time-release pill, addicts can crush the
water-soluble pills and inject them, chew them or snort them for a heroin-like
rush.
A rush that is sometimes fatal, especially when combined with alcohol or other
drugs. At least one Decatur teen died from an OxyContin overdose, White said,
and he has no doubt more deaths will come.
3 Primary Methods
White said abusers of prescription painkillers use three primary methods to
obtain the medications. One is "doctor shopping;" another involves forging
prescriptions. Less commonly, they rob pharmacies.
The doctor-shopping method is hardest to catch, White said, because "doctors are
probably the hardest to work" from a law enforcement perspective.
Typically, White said, the doctor-shopping method of acquiring OxyContin or
hydrocodone involves black-market professionals visiting numerous doctors and
convincing them their symptoms are best treated with one of the addictive drugs.
Inherent in any investigation is the assumption that the professional duped a
doctor - something most doctors do not like to admit, he said.
More advanced black marketers hire people to shop doctors for painkiller
prescriptions, a method that makes law-enforcement efforts even more difficult.
"They do it for a living. They can say the right thing to get a doctor to
prescribe the drugs," White said.
More Security
An increase in robberies of area pharmacies has Bendall's Pharmacy in Decatur
preparing to purchase a bank vault to hold all OxyContin and hydrocodone pills.
Tim Douthit, owner of Bendall's, said he is frequently amazed at the effort
people will expend to get OxyContin and hydrocodone.
"If I get suspicious, I'll ask them if it's a good prescription. Usually
they'll say, 'Yes,' and then I say I'm going to call the doctor. Most of them
will then say they'll come back later, or act like they are mad, take the
prescription and storm out," Douthit said.
"But I had one lady who said it was a good prescription. I started to call the
doctor, and she actually ran around behind the pharmacy counter, jerked the
piece of paper out of my hand and ran out the door," Douthit said.
Recalling a more successful scam, Douthit said people would bring in
official-looking prescriptions from a doctor who supposedly practiced in
Decatur.
On the prescription was a phone number, but the number was monitored by somebody
involved in the scam.
"I got duped by that one, but not for long. They were pretty much run out of
town," Douthit said.
Not Easily Duped
Dr. Eric Beck, board certified in pain management and medical director of
HealthSouth Rehabilitation Center in Huntsville, said doctors are not as easily
duped as police may think.
"Patients have to take regular urine drug tests to make sure not only that they
are taking the medication ( instead of selling it ), but also that they are not
taking anything else they shouldn't be," Beck said.
"If they come up short - if they say they lost it, or the dog ate it, or they
dropped it in the toilet - I normally just quit writing it, and they don't get
anymore," Beck said.
Beck was skeptical about law enforcement suggestions that doctors are slow to
cooperate.
"I call the police on a routine basis, and we rarely hear anything back from
them. We don't know what happens after we call," Beck said.
Abuse Vs. Benefits
The potential for OxyContin abuse should be weighed against the medication's
tremendous benefits, according to Beck.
"I have patients come in that haven't worked for years. They're placed on these
medications and suddenly they are gainfully employed. I've had many say to me
they have not missed a day of work since they started taking the medication.
That's pretty reinforcing to me," Beck said.
Limbaugh's name came up in connection with a type of drug ring White hopes does
not exist in Decatur: A ring allegedly dependent upon a corrupt pharmacist.
White said he believes area pharmacists are honest, and are fairly good at
spotting forged prescriptions. But the huge profits possible in distributing
black-market painkillers are a temptation, he said.
"Pharmacists know what to look for - altered prescriptions, copied prescriptions
or people calling in to say they're from a doctor's office. Doctors know what
to look for, too, but these folks are professionals," White said.
Monetary Lure
The extent of the monetary lure becomes clear from an affidavit filed in Florida
to obtain a search warrant. Florida officials said last week that they are
investigating an allegation Limbaugh illegally purchased black-market OxyContin
and hydrocodone.
The documents released by law-enforcement officials do not mention Limbaugh, but
officials said the two investigations are connected.
On Feb. 10, the Palm Beach County Sheriff's Office seized 5,000 hydrocodone
pills in numerous Ziploc bags from a pharmacist allegedly delivering them to a
black-market distributor.
When they searched the pharmacist's home, they discovered a bedside trunk
containing $806,000.
Complex Problem
The problem faced by regulators is complex. OxyContin can be deadly when
abused, but it is an effective drug in alleviating pain, especially for patients
with cancer, back pain and arthritis.
The active ingredient in OxyContin is oxycodone, a substance found in many pain
medications.
Most other pain medications, however, contain small amounts of oxycodone.
OxyContin's time-release formula contains a significantly greater amount of
oxycodone.
This same time-release formula, however, is critical both to the drug's
effectiveness and to suppressing abuse of the drug, according to Beck.
"The time-release prevents the patient from getting an immediate rush from the
drug. The abuse potential for short-acting narcotics is much higher than
long-acting narcotics like OxyContin. You get more euphoria from the
short-acting drugs, and you have to keep taking it to keep getting the effect.
"It's like Pavlov's dog. You take the pill and you get the euphoria, so you get
conditioned to that response. With time-release formulas you get a slow
release, which decreases the drug-effect pairing, so there is less likelihood of
becoming dependent," Beck said.
In 2001, at the urging of the Federal Drug Administration, OxyContin's
manufacturer added the FDA's strongest type of warning to OxyContin packaging -
a black box saying OxyContin is potentially as addictive as morphine.
While the use of oxycodone in pain relievers is not new, most other medications
combine the opiate with Tylenol or aspirin.
Those analgesics can be fatal when ingested in large doses, a fact that has left
OxyContin as a more popular alternative.
Beck said publicity about OxyContin abuse unfairly stigmatizes legitimate users.
"They call these patients 'addicted,' but they are not. Addiction is where you
go out and do illegal things to get medication.
"Yes, these people are physically dependent upon the medication. But if you
take a blood pressure pill on a daily basis, you are physically dependent on
that," Beck said. "These people have legitimate needs for adequate pain
control."
Newshawk: Chip
Webpage:
http://www.decaturdaily.com/decaturdaily/news/031012/drug.shtml
Pubdate: Sun, 12 Oct 2003
Source: Decatur Daily (AL)
Copyright: 2003 The Decatur Daily
Contact:
editor@decaturdaily.com
Website:
http://www.decaturdaily.com/decaturdaily/index.shtml
Details:
http://www.mapinc.org/media/696
Author: Eric Fleischauer
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