Pubdate: Fri 17 Oct 1997 Source: Hamilton Spectator Contact: Section: A1 / Front Author: Adrian Humphreys, Change Reporter Death from `hospital heroin': Dilaudid is cheap, easy to buy and can kill The street drug of ``last resort'' is believed to be the last drug ever for a young father of two found dead of an overdose in his Stoney Creek home. The prescription opiate Dilaudid, known on the street as ``hospital heroin,'' is being blamed by HamiltonWentworth police in the death of a man cremated yesterday after a small ceremony. The untimely death and the needle marks on his arm highlight the problem of prescription drugs slipping from the medical community's control and out into the streets. Once there, the pills are crushed, mixed with water and injected into the arms of desperate addicts. Dilaudid is cheap, easy to buy and can kill. Dilaudid hits the streets when doctors are sloppy, dishonest, are duped, or are using drugs themselves, says Dr. Anne White, a Hamilton physician and chair of the Ontario Medical Association's section on addiction. Addicts call them ``croakers'' doctors who are an easy touch for prescription painkillers. And when such a doc is found, word among addicts spreads quickly. Often the name of a croaker is swapped for half the pills an addict finagles. ``Every addict knows which doctors, and they flock to their doors,'' said White. Addicts can spend hours each week going to walkin clinics, emergency rooms and pharmacies. When they snare the drug, an addict often uses some and sells the rest, spending the money on cocaine or heroin. It's a dangerous deal. ``Dilaudid is a very, very powerful narcotic,'' says White. ``Intravenous injection can be very dangerous because the effect is so fast. If you do too much, you don't even have time to take the needle out of your arm before you're hit with it.'' With no time to even call out for help, overdose deaths come quietly. Opiates, as powerful depressants, slow the central nervous system. Too much can stop basic body functions, including breathing. Regan Anderson, director of the Hamilton Men's Detox Centre, regularly sees clients getting Dilaudid prescriptions they probably shouldn't. ``Dilaudid may not be the most appropriate medication for an individual because of an addiction history. Often a simple phone call can clear up the problem,'' Anderson said. ``There are those who know how to get a doctor to prescribe it. It is on the streets, it's highly marketable and it's easier to get than heroin.'' The College of Physicians and Surgeons of Ontario is aware of problems with the drug being prescribed. ``We warn doctors that patients are saying they're from out of town, that their luggage was lost with their pills or their prescription,'' said Jill Hefley, college spokeswoman. ``That's a common ruse patients use.'' It's one thing for a physician to be duped and another when inappropriate prescribing is intentional. A Kitchener doctor was recently found by the college's discipline committee to be wrongly doling out narcotics. Dr. Rosemary J. Arnold had her licence suspended for a year. She has appealed the decision. On Hamilton streets, opiate addicts talk about turning to Dilaudid when heroin can't be scored, said Stephen Buckle, a community outreach worker with the Hamilton AIDS Network who helps run the Van Needle Exchange program. Users sometimes supplement a Dilaudid injection with other drugs or a snort of liquor up the nose. Dilaudid becomes the ``drug of last resort'' for opiate addicts. ``Heroin is the usual opiate, but historically there isn't a lot of it in Hamilton,'' said Buckle. ``When they can't get heroin, when they can't make a trip into Toronto to get it, they turn to Dilaudid.'' Hamilton's lack of heroin and the fact that there wasn't a methadone treatment program in the city for more than a decade, has made Dilaudid abuse very much a Hamilton problem, said White. Methadone is a heroin replacement given in daily doses, allowing addicts to function normally without getting a euphoric high.