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OxyContin, known as 'hillbilly heroin,' is abused on the Hi-Line

So, what is OxyContin?

According to the Food and Drug Administration, OxyContin is a long-lasting version of oxycodone, a narcotic considered important therapy for many patients suffering long-term moderate to severe pain from cancer or other illnesses. When swallowed whole, the tablet provides 12 hours of pain relief.

Unfortunately, oxycodone products are also illicitly abused, by adults and youth alike. If chewed, snorted or injected, OxyContin produces a quick, and potentially lethal, high. It has been linked to hundreds of deaths.

Abuse of OxyContin reportedly originated in rural areas, causing it to be referred to sometimes as "hillbilly heroin." OxyContin produces opiate-like effects and is sometimes used as a substitute for heroin. Illicit uses of OxyContin include crushing the tablet and ingesting or snorting it. Most people who abuse this drug do so to gain euphoric effects, relieve pain, or avoid heroin withdrawal symptoms. Those who take the drug repeatedly can develop a tolerance or resistance to the drug's effects.

Most people who are prescribed OxyContin will not become addicted, although they may become dependent on the drug and will experience withdrawal symptoms when use is stopped.

Prevalence estimates

According to the National Survey on Drug Use and Health, about 1.9 million people age 12 or older used OxyContin nonmedically at least once during 2002.

For the first time, a questionnaire about OxyContin was included in the 2002 Monitoring the Future study. During 2002, 1.3 percent of eighth-graders, 3 percent of 10th-graders and 4 percent of 12th-graders reported using OxyContin within the past year.

According to the November 2002 Pulse Check: Trends in Drug Abuse, OxyContin diversion and abuse were reported as emerging in 13 of the 20 Pulse Check sites, including Baltimore, Billings, Boston, Chicago, Columbia, S.C., Denver, Detroit, Memphis, Miami, New Orleans, Philadelphia, Portland, Ore., and Seattle.

Purdue Pharma introduced OxyContin, an opiate agonist, in 1995. Pharmaceuticals such as OxyContin can be diverted for illegal use in many ways. The most popular form is known as "doctor shopping," where individuals, who may or may not have legitimate illnesses requiring a doctor's prescription for controlled substances, visit many doctors to acquire large amounts of controlled substances. Other diversion methods include pharmacy diversion and improper prescribing practices by physicians.

According to our local Tri-Agency Task Force, OxyContin is readily available. Due to its street value, usage has, for the most part, been limited to adults.

So where does it come from? Prescriptions. While most physicians are following the recommendations released by the FDA, reserving OxyContin just for patients with serious, chronic pain, others are not.

According to the Drug Enforcement Administration, retail prices for oxycodone from 1996 to 2000 ranged from $1.30 for 10 milligrams to $14 for 160 milligrams. Illicit prices for oxycodone ranged from $5 to $12 for 10 milligrams to $60 to $100 per 160 milligrams.

The Drug Enforcement Administration also reported that during 2000, there were 432 OxyContin theft and loss incidents, with the majority of incidents from employee pilferage. OxyContin thefts and loss incidents increased to 905 during 2002, with the majority of incidents from night break-ins, armed robberies, and employee pilferage. As of June 2003, there were 399 OxyContin theft and loss incidents, with 205,192 lost dosage units. Since 2000, there have been about 1.37 million dosage units lost.

Oxycodone is a Schedule II drug under the Controlled Substances Act. Schedule II substances have a high potential for abuse, as well as a currently accepted medical use in treatment in the United States with severe restrictions. Use of them may lead to severe psychological or physical dependence.

Many states have launched efforts to curb the illegal use of OxyContin. Louisiana, Maine, Virginia, Kentucky, Pennsylvania and Tennessee have enacted legislation to deal with this issue. California and 16 other states, not including Montana, have established prescription-monitoring programs. Many more states are working to establish legislation and prescription-monitoring programs to deal with diverted pharmaceuticals.

"We're hoping ... people will consider this a serious drug for serious pain," said Dr. Cynthia McCormick, the FDA's chief of addictive products.

It is not for mild pain or for temporary pain, such as after dental or surgical procedures. Physicians and other practitioners can help by monitoring claims of lost prescriptions and patients who claim to be from out-of-town asking for the drug by name, and by educating patients about its illicit appeal. It only takes one practitioner in a region such as ours to greatly impact OxyContin's illicit availability and associated consequences.

OxyContin will bear the FDA's strongest type of warning - a black box calling OxyContin as potentially addictive as morphine and explaining that chewing, snorting or injecting it can kill, McCormick said. Many drug abusers don't read warning labels, FDA officials said. But the hope is that if doctors give OxyContin just to patients with serious, chronic pain, it will become harder for abusers to get leftover tablets.

The drug's manufacturer is shipping special pads to doctors that make it tougher to forge prescriptions. The company is also starting a youth education program aimed at telling young people about the dangers of prescription drugs. Company officials said that it is the first company in the country to do that.

Additionally, drug task forces nationwide and locally are working more hand-in-hand with physicians to curb OxyContin's illicit use and distribution.

And finally, adults can help by ensuring that prescription drugs are not accessible to children or other adults in their home, the homes of relatives, and the homes of friends. A parent's best defense, however, is taking the time to talk to children and young adults about the harm associated with illicit use of prescription and illegal drugs.

For more information on this topic, contact the HELP Committee and Boys & Girls Club of the Hi-Line, 265-6206.


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