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."
The 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 very big, 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 U.S. District Court in East St. Louis sentenced Hays
to 51 months in federal prison for stealing 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 at the 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 was working 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. Beginning 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 which was 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, elderly people 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 newspapers 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."
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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 suffer from 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 will show Purdue Pharma misled federal regulators about Oxycontin's dangerously addictive
nature.
Then the company pushed the drug's sale through a marketing campaign aimed at convincing 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
head of the DEA blamed Purdue Pharma's "aggressive marketing practices" for
making ! Oxycontin readily available.
Purdue
Pharma gave its sales representatives incentives to sell big quantities of Oxycontin, and the sales teams encouraged physicians to prescribe the drug by taking them on expense-paid trips, then-DEA administrator Asa Hutchinson told members of Congress.
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
off 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 gets 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, as well as 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 bottle of Oxycontin in response to complaints that Oxycontin
was being 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 wasn'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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