Pubdate: Sun, 20 May 2001
Source: Herald, The (WA)
Copyright: 2001 The Daily Herald Co.
Contact:  http://www.heraldnet.com/
Details: http://www.mapinc.org/media/190
Author: Angie Wagner, Associated Press
Bookmark: http://www.mapinc.org/find?186 (Oxycontin)

A PRESCRIPTION FOR DRUG ABUSE

LAS VEGAS -- Thanksgiving and Christmas came and went, and Jan hardly 
noticed. She slept a lot, trying to get off the prescription painkillers 
that consumed her days. She crashed her car for the third time, and once 
passed out at work for three hours.

"I knew I was in trouble," she said. "I didn't see how I was going to survive."

At 48, Jan now has a good job as a bookkeeper at a beauty salon and has 
been married 14 years. She's also a recovering prescription drug addict, 
one of an estimated 4 million in the United States and part of what the 
head of the National Institute on Drug Abuse calls "a dangerous new drug 
abuse trend."

Patients take drugs to relieve pain, calm stress or get to sleep -- then 
sometimes can't stop. So they turn to a network of suppliers, from friends 
to co-workers to underground sellers. Or they visit multiple doctors to get 
the same prescription. Some even break into drugstores or forge 
prescriptions on stolen prescription pads.

The newest concern is OxyContin, a synthetic morphine used to treat severe 
cancer pain that has become the illicit drug of choice in some parts of the 
country. State law enforcement chiefs are so worried that they announced a 
national task force last week to fight Oxy abuse.

For Jan, who spoke on condition that her last name not be used, the 
problems started 12 years ago when a psychiatrist prescribed the sedative 
Xanax for her severe panic attacks. She liked the way they made her feel -- 
calm, in control, self-confident.

"I absolutely loved them. They solved everything," she said.

Soon she built up a tolerance and needed more. So she got Xanax 
prescriptions from four doctors and took the prescriptions to different 
pharmacies. No one ever questioned her, she said: "It was easy."

Taking up to 20 pills a day, she tried to give them up but turned to 
alcohol to combat the withdrawal. When she couldn't get out of bed, her 
husband, Peter, figured she had the flu.

"I didn't know at all. I'm not a particularly suspicious type," he said.

Finally, after five years, she knew it had to stop.

She told her psychiatrist and checked into a detoxification center for 14 
days. She continued with outpatient treatment, but fighting her addiction 
took her away from her construction company payroll job, and the company 
replaced her. Though she could have returned in a different position, "I 
was too embarrassed to go back."

So she took college classes and got a new job doing payroll at a casino. 
After three years, she stopped treatment, thinking she was cured.

She wasn't.

"You sit back and go, 'How did this happen to me? How did I do this again?' 
she said. "It just escalated."

State attorneys general said last week they will study several state 
efforts to fight prescription drug abuse and make recommendations to their 
legislatures.

A potential model includes a Kentucky database that doctors, pharmacists, 
police, prosecutors and others can use to figure out whether a person is 
filling multiple prescriptions for the same drug at different locations.

A similar system used in Nevada since 1997 scans prescriptions and flags 
the names of patients who "doctor shop" to get multiple prescriptions for 
controlled substances. The information is given to the patients' doctors 
and pharmacies, and they can decide whether to ask the patients if they 
need help, said Keith Macdonald, executive secretary for the Nevada State 
Board of Pharmacy.

Only the program administrator and another worker have direct access to the 
Nevada database, because it's used to prevent drug abuse, not for 
enforcement, Macdonald said. Authorities investigating patients who may be 
illegally selling drugs are given information only by request.

A computer scans 2 million controlled-substance prescriptions each year. In 
1998, 162 patients were flagged and half of them decreased the number of 
prescriptions they were getting in the next year.

A year later, with an additional worker, the system identified 475 patients 
and the system tracked a 41 percent decrease in those patients' prescriptions.

"We have calls from patients who say, 'I never realized how bad I was,' " 
Macdonald said.

On the Net:

Substance Abuse and Mental Health Services Administration: www.samhsa.gov

National Institute on Drug Abuse: www.drugabuse.gov
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