Pubdate: Mon, 29 Mar 2004 Source: Knoxville News-Sentinel (TN) Copyright: 2004 The Knoxville News-Sentinel Co. Contact: http://www.knoxnews.com/ Details: http://www.mapinc.org/media/226 Author: Associated Press Bookmark: http://www.mapinc.org/oxycontin.htm (Oxycontin/Oxycodone) OXYCONTIN IS TOP ADDICTIVE DRUG 62% of Methadone Clinic Clients Hooked on Prescription Painkiller NASHVILLE - The prescription painkiller OxyContin has overtaken heroin and other street drugs as the narcotic of choice for addicts seeking help at Tennessee's methadone clinics. And it can be more dangerous than other drugs. "A lot of people are losing limbs, getting infections and even their heart valves are getting infected," said Dr. Steven Ritchie, medical director of state methadone clinics in Nashville and Memphis. The problem is the drug was designed to be absorbed by the body over a 12-hour period, so some of the substances in it don't completely dissolve when addicts inject it. Buddy Stephens, director of the state Department of Health's methadone clinic program, said about 21 percent of those admitted to state methadone clinics in 2001 reported OxyContin was their drug of choice. The percentage jumped to 51 percent in 2002, and last year it reached 62 percent, Stephens said. In Knoxville, more than 90 percent of the clinic's clients are addicted to OxyContin. Treatment costs about $12 a day and is covered by TennCare for those who qualify, Stephens said. The rise in the number of people seeking treatment has boosted TennCare's costs from $2.4 million in 2002 to $3.5 million last year, according to AdvoCare, a company contracted by the state to provide mental health services and drug treatment. There are also signs that OxyContin is gaining in popularity among all drug users. Prescription painkillers like OxyContin now rank second to marijuana as the most-abused drugs in the country, according to the Substance Abuse and Mental Health Administration. Addicts are drawn to it because they can get a 12-hour dose in one sitting by crushing the tablets and snorting them or dissolving them and injecting the solution, according to Leah Young, a spokeswoman for the Substance Abuse and Mental Health Administration. OxyContin was initially used primarily to treat pain in terminally ill patients but has since become widely prescribed for back and joint injuries, drug counselors said. Most people begin their addiction with a valid prescription for the pain medication, Stephens said. But when the prescription runs out and withdrawal symptoms set in, people quickly seek other ways to get it on the street, on the Internet or from a different doctor in a practice known as "doctor shopping." With the rise in OxyContin addiction, methadone clinic counselors say they're also seeing younger and wealthier patients. Street prices of a single tablet range from $30 to over $150, depending on the potency and availability of the drug. To satisfy their craving for the drug, addicts often show up at emergency rooms with elaborate tales of upcoming surgeries, lost prescriptions, doctors on vacation and piles of medical records, said Corey Slovis, who leads the Department of Emergency Medicine at Vanderbilt Medical Center. "They usually complain of severe, excruciating lower back pain and say OxyContin was the only thing that worked before," said Slovis, who created a rule last year prohibiting emergency room doctors from prescribing OxyContin in most cases. One or two people a week are admitted to the emergency room after overdosing on the drug, he said. While the numbers are not at what he calls the "epidemic" levels of other cities, Slovis said, virtually nobody came in with an OxyContin overdose a few years ago. "Physicians are finally learning they cannot leave people on the drug for as long as they do," he said. "This is the most addictive thing we've seen since heroin." Dr. Robert Ripley, a Nashville cardiologist and a member of Tennessee's board of medical examiners, said the state is creating a database to monitor which doctors are prescribing narcotics and for whom. "Doctors have to police themselves and apply limits on the health care they provide," Ripley said. "The whole culture of how medical care is delivered in this state has to change." When deprived of OxyContin, addicts are often bedridden, with severe body cramps and pain, nausea and vomiting, headaches, chills and drenching sweats. That's why the addiction is treated with methadone. But Stephens said demand for treatment is outpacing the ability of methadone clinics to provide it. "We have an insufficient number of clinics to meet the needs of our residents," said Stephens, who regulates the seven privately owned methadone clinics in the state. - --- MAP posted-by: Terry Liittschwager