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Oxycontin Addiction: Hillbilly Heroin

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Only an addict can describe the euphoria that comes from that first outlaw hit of Oxycontin.
Only an addict can describe the sheer torture of trying to quit the narcotic painkiller known as “Hillbilly Heroin.” Jon Riley Hays, M.D., knows about both.
Hays, formerly a family practice physician in the Southern Illinois town of Herrin, first took Oxycontin three years ago when a patient turned in a bottle containing some leftover pills.
Hays, 42, at the time had been suffering excruciating back pain from a car accident, preventing a decent night of sleep. The much weaker painkillers he had been given weren’t doing the trick.
Hays knew that ingesting the Oxycontin was wrong. But he also believed the claims of sales representatives that Oxycontin is safe and nonaddictive.

Oxycontin: the addictive cycle begins

Within a few minutes of consuming that first Oxycontin tablet, Hays said, “I felt like Superman. I could work all day, be happy, go home, play with the kids. Do everything that I wanted to do. I just felt like a million bucks.”
Addiction advanced rapidly. Within six weeks, he was stealing Oxycontin from patients, crushing up the pills to mix in a saline solution, loading it into a hypodermic needle, and plunging it into his arm. He also bought Oxycontin from local pharmacies under false names.

Trying to get out

Terrified of what he had fallen into, Hays tried to wean himself off Oxycontin on the weekends while keeping his addiction a secret from his wife and two small children. It was a prescription for utter misery.
“You’re bedridden,” Hays said. “Your bones feel like they’re on fire, and they’re melting flesh.”
The worst moment occurred when his daughter, who was 4 years old at the time, walked into the bathroom of his house just as he was about to shoot up some Oxycontin, Hays said.
“Her eyes get huge, of course,” Hays recalled. “And she asks me, `Dad, what are you doing?'”
Hays shut his eyes for a moment.
“Addicts are very clever people — clever to get it, clever with excuses,” he said. “I said, `Dad’s sick, and he’s giving himself a shot of vitamins.'”
Eventually, through professional treatment, Hays got off Oxycontin. But not before the Drug Enforcement Administration caught up with him. In May 2002, a judge in the U.S. District Court in East St. Louis sentenced Hays to 51 months in federal prison to steal the drug.

The consequences

Today Hays — once a student brilliant enough to earn full-ride scholarships to the University of Illinois and the university’s college of medicine, a man whose lifelong ambition was to be a small-town doctor — is an inmate U.S. Penitentiary in Marion.
A few weeks before he entered prison, in early July 2002, Hays sat down with a Belleville News-Democrat reporter to recount his path to and from Oxycontin.
Just because you’re a physician, you don’t automatically become immune to addiction,” Hays said. “Maybe you’re a little more highly educated. But! as in my case, yeah, I knew I was addicted. I knew the warning signs for everything, but it didn’t prevent it.”
Hays met the reporter at a restaurant in Herrin owned by his nephew. Hays worked at the restaurant as a busboy — the only job he could find after losing his state medical license.
The former physician sat outside the restaurant on a white wicker chair, gazing down the street on a hot June afternoon as still and quiet as a Norman Rockwell painting. He thought about how so much — his house, his medical career, the total disruption of his family — could be squandered in such a brief time.
“A young health professional usually doesn’t wake up one morning and say, ‘I want to become an addict.’ Not one with two kids. Not one with a career. It just doesn’t happen that way,” Hays said.
He paused and thought about what he would say next.
These drugs are so addictive and powerful,” he said, “that it is an incredibly strong-willed person who can take them for a long period of time and not become addicted to them.”

Chasing the Oxycontin high

People always have chased the euphoria that comes from opiates and the perverse social cachet their abuse confers. In the early 1990s, on the East and West coasts, heroin became the chic drug of choice because it had re-emerged in a more powerful form than the heroin of two decades before.
The old stuff had to be cut up, mixed in a solution, and injected. The new heroin, the most popular of known as “black tar,” was strong enough to be snorted, providing a speedy, if sometimes fatal, wallop.
The new heroin slashed through Generation X like a vast scythe, felling hundreds of young men and women in their teens and 20s and flooding emergency rooms with thousands more.
A similar high could be obtained by abusing a wide range of opiate-based prescription painkillers with names like Percodan, Vicodin, Demerol, and Dilaudid.
But along came Oxycontin, and it upped the ante in ways no one could have predicted, etching a swath of death and addiction, crime and litigation across America, especially in Maine, West Virginia and Kentucky — places with big rural populations full of sick, older adults and those recovering from accidents in mines and on farms.
And now Oxycontin has torn into the metro-east. Consider:
* Hospital emergency rooms in the St. Louis area — which includes St. Clair and Madison counties — reported a 41 percent increase in admissions overdoses for Oxycontin and other narcotic painkillers between 2001 and 2002, according to the federal Drug Abuse Warning Network.
* Last week, the Southwest Illinois Treatment Center opened a treatment center at an office park in Fairview Heights. The center provides methadone-based outpatient treatment for up to 200 clients per year addicted to Oxycontin and other opiate-based drugs.
* The Simmons Law Firm, based in East Alton and St. Louis, has signed at least 550 clients from Madison County in response to newspaper ads published in June and July. The clients claim they became addicted to Oxycontin and suffered catastrophic health problems after taking the painkiller in the prescribed manner.
“We were absolutely overwhelmed. Not only were we overwhelmed with the numbers, but we were overwhelmed with the consistency of every single story,” said Jeff Cooper, a lawyer with the Simmons firm. “And it’s amazing once you start looking into it to find that these folks are just having their lives ruined by something that’s supposed to heal them.”
Oxycontin is the most popular narcotic painkiller in America, ringing up more than $1 billion in sales and filling nearly 6 million prescriptions in 2002.
Introduced in 1995, it was heralded as a godsend for people who have cancer, severe arthritis, and other forms of chronic, extreme pain.
Oxycontin’s success stems from a concentrated dose of oxycodone, a form of synthetic morphine. A slow-release mechanism in the pill provides 12 hours of soothing, numbing relief throughout the day, eliminating the need for multiple doses.
But like all opiate-based drugs, Oxycontin can be powerfully addictive because the body quickly builds up a tolerance to it.
Heroin addicts soon gravitated to Oxycontin, said Clifford Bernstein, medical director of the Waismann Institute, a Beverly Hills, Calif., drug treatment center where Oxycontin now accounts for most admissions.
“These heroin people love Oxycontin. You can take a pill and chew it,” said Bernstein, whose center uses a revolutionary technique of putting patients under anesthesia and cleansing their bodies with special drugs during withdrawal.
Oxycontin provides “the perfect high,” Bernstein said.
“It’s a high that doesn’t make you lose control, and people don’t know that you’re on the stuff,” he said. “And it doesn’t give you a hangover. So it’s like the perfect high, you know.”
It’s no coincidence that another nickname for Oxycontin is “Killer.” Nationwide, it’s been linked to at least 400 deaths by overdose, and possibly hundreds more.

The legal fallout

Cooper said his firm plans to file the first set of personal injury lawsuits by the end of this month against Oxycontin’s maker, Purdue Pharma, of Stamford, Conn., and its distributor, and Abbott Laboratories of Abbott Park, Conn.
Cooper blamed the high addiction levels on Purdue Pharma. Citing a pair of whistleblower lawsuits that have been filed within the past month in Connecticut and Florida, Cooper said the evidence would show Purdue Pharma misled federal regulators about Oxycontin’s dangerously addictive nature.
Then the company pushed the drug’s sale through a marketing campaign to convince physicians to prescribe the painkiller for even minor pain, Cooper said.
Cooper is far from alone in making this claim.
In December 2001, while testifying before a congressional subcommittee, the DEA head blamed Purdue Pharma‘s “aggressive marketing practices” for making! Oxycontin is readily available.
Purdue Pharma gave its sales representatives incentives to sell large quantities of Oxycontin. The sales teams encouraged physicians to prescribe the drug by taking them on expense-paid trips, then-DEA administrator Asa Hutchinson told Congress members.
Purdue Pharma strenuously denied Hutchinson’s allegations at the time.
But Hays corroborated assertions that the company aggressively marketed the painkiller. During his days as a physician, Hays said, Purdue Pharma drug reps freely gave out vouchers for Oxycontin that allowed patients to buy them at deep discounts.
“And these drug reps from Purdue Pharmaceuticals said, ‘Hey, this drug is very long-acting, and it’s not addictive,'” said Hays, who, with his wife, Darla, in September 2002 filed a lawsuit in U.S. District Court in East St. Louis alleging negligence, fraud, and breach of warranty against Purdue Pharma and Abbott Laboratories.
Hays is seeking $300,000 in lost wages and more than $50,000 in punitive damages. In May, a federal judge remanded the Hays case to St. Clair County Circuit Court.
Cooper said what he’s found with Oxycontin plaintiffs is they start by taking one Oxycontin pill, “then they take two a day, and then all of a sudden they need three and four and five a day. It’s just amazing.”
The average addict, Cooper said, is a person between the ages of 35 and 40 who get hurt at work or playing a softball game and is prescribed Oxycontin.
“And if you follow the timeline, about a year and a half or two years later, they’ve lost their job, they’ve lost their kids, they’ve lost their family, they’ve lost everything,” Cooper said. “And these are people with no history of addiction, no criminal history.”
James Heins, a spokesman for Purdue Pharma, denied the charges made by Cooper and charges made by plaintiffs in 300 lawsuits filed nationwide over Oxycontin.
“These allegations are baseless,” Heins wrote in an e-mail to the News-Democrat.
Heins pointed out that almost 50 of these lawsuits have been dismissed. What’s more, Heins wrote, Oxycontin is a Schedule II controlled substance whose active ingredient, oxycodone, has been available in the United States for more than 70 years and is used in almost 60 different pain medications.
“The package insert has always carried clear warnings regarding the product’s abuse potential,” he wrote.
Nonetheless, in late 2001 the Food and Drug Administration ordered Purdue Pharma to affix the strongest type of warning, called a “black box warning,” on each Oxycontin bottle in response to complaints that Oxycontin was improperly prescribed.
How much blame Purdue Pharma must bear for the abuse of Oxycontin, its blockbuster star, remains an issue of debate among drug treatment professionals.
It’s a powerful drug,” said Reeve Sams, regional manager for National Specialty Clinics, the Nashville, Tenn.-based chain of 17 clinics that owns the recently opened Southwest Illinois Treatment Center in Fairview Heights.
But Sams declined to put the onus on Oxycontin or its maker.
“And if Oxycontin weren’t there, it would be something else,” Sams said. “So that’s why I hate specifically to pick on Oxycontin.”
Sams acknowledged, though, that at his firm’s clinic in West Virginia, “85 percent of our admissions were Oxycontin addictions.”
Bernstein, the Waismann Institute, medical director, blamed Purdue Pharma for overselling Oxycontin’s benefits while downplaying its dangers.
“It’s marketed as a long-lasting drug, but really it’s a short-acting drug wrapped in a coating of something that’s supposed to dissolve slowly,” Bernstein said. “You get a good euphoria from the Oxycontin. I don’t believe, personally, for one minute that the Purdue Pharma people didn’t know that.”
Copyright (c) 2003 The Belleville News-Democrat

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