Pubdate: Sun, 17 Jun 2001 Source: San Jose Mercury News (CA) Copyright: 2001 San Jose Mercury News Contact: http://www.sjmercury.com/ Details: http://www.mapinc.org/media/390 Author: Allen G. Breed, Associated Press Bookmark: http://www.mapinc.org/find?186 (Oxycontin) ABUSE OF POWERFUL PAINKILLER HITTING HARD IN APPALACHIA Heroin-Like Medication Linked To Deaths GILBERT, W.Va. -- Kristen Rutledge had watched friends slowly kill themselves with OxyContin. Her own cousin, just 18, shot herself in the head when she couldn't get more of the drug. Girlfriends were prostituting themselves for another fix. Still, when someone offered her a yellowish 40 milligram pill, she took it, chopped it up and snorted it. It was the start of a three-day binge, and she was hooked. "When I got down to two, I started panicking," the 20-year-old said as she took a drag off her umpteenth cigarette. "I had to get out and buy some more." Over the next year, her habit grew to eight "40s" a day, she said. When her dad, Tim Rutledge, a former mayor, found out, she tricked him into giving her more money by saying she was being threatened by drug dealers. Many people in Appalachia call OxyContin "hillbilly heroin." Its abuse may not have started in the mountains, but it exploded here. Across the region, people have overdosed on the powerful prescription painkiller and robbed pharmacies and family members to feed their habits. "If this was an infectious disease, the Centers for Disease Control would be in here in white vans," said Tim Rutledge. "There's no doubt it's very much a plague." To cancer patients and chronic pain sufferers, OxyContin is a wonder drug. While most strong pain medicines last only about four hours and take an hour or so to work, Oxy gives a steady 12-hour release of pain medicine with fewer side effects. But to addicts who chew the pill or crush it to snort or inject, Oxy produces a one-shot, heroin-like high that can kill. Purdue Pharma, the drug's maker, is willing to concede that Oxy abuse has led to "somewhere between dozens and hundreds" of deaths in the past two years, says David Haddox, the firm's medical director. "I am sure it has caused some deaths," he said, "but my feeling is there is a magnification of this in the media." Purdue Pharma has taken steps to limit the damage. The company has stopped shipping its 160 milligram pills and has offered tamper-resistant prescription pads to doctors, among other things. Law enforcement officials insist the problems have not been overblown. Dealers have been charged with homicide in Virginia and Florida; doctors have been convicted of illegally dispensing OxyContin; Oxy-related burglary and armed robbery charges abound nationwide. Monday, the state of West Virginia sued the drug's makers, accusing them of pressuring and enticing doctors to overprescribe Oxy and of failing to adequately warn of potential abuse, charges the company denies. Michael Pratt, a prosecutor focusing on drug crimes in Kentucky, Tennessee and West Virginia, sees reasons why OxyContin hit Appalachia especially hard. The Appalachian economy has long been dependent on coal and timber. Those are industries that produce serious injuries, so there are large numbers of people on painkillers. In addition, OxyContin sells on the street for $1 a milligram -- up to $160 for the highest-dosage pill. In an area with chronic unemployment, that kind of money is hard to turn down. For years, prescription fraud for Valium and other drugs has been a problem. But, Pratt said, "Oxy rolls in. It's so powerful, it just lays waste." "This is a nuclear bomb," said Gregory Wood, a health-fraud investigator with the U.S. attorney's office in Roanoke, Va. "I was a cop in Detroit and saw crack come through the ghettos, and I've never seen anything like this." - --- MAP posted-by: Terry Liittschwager