The Potent Perils Of a Miracle Drug

By Timothy Roche

For a woman dying of cancer, Terry Sanborn didn't seem to suffer. She and her unemployed husband Stephen lived on Medicaid and $512 a month in Social Security in a quiet blue-collar cul-de-sac in tiny Bangor, Maine. But they managed to pay $78,000 in cash for that roomy house at the bottom of Hershey Avenue, with a swing set in the backyard. They forked over an additional $17,000 for a Ford Econoline van. Not until drug agents raided the place did neighbors know how they were able to afford it all.

The Sanborns were accused of dealing OxyContin, the morphine-like drug prescribed for Terry's pain. In any given week, her husband reportedly told investigators, the couple supplemented their Social Security by selling drug addicts $8,000 worth of the tiny white tablets that are chewed or smashed to remove the time-release coating, then snorted or injected, generating a high as intoxicating as that of heroin. So popular and addictive is OxyContin these days that it has stirred up a blizzard of a crime wave through the towns of Calais and Bangor, say drug counselors and police investigators. People are using bogus prescriptions to obtain the drug, or they are smuggling the pills across the nearby Canadian border. "Three months ago, we had needles show up outside the middle school," says local drug counselor Carrie McDonald.

Not just in rural Maine: OxyContin is quietly becoming a dangerously popular drug in other pockets of the nation. In the New Orleans suburb of St. Bernard Parish, police say OxyContin abuse is an "epidemic." Officers are making as many arrests for the "killers," as it is known there, as for crack cocaine. The town has had five documented overdoses, but police captain John Doran believes the number may be higher. "We're a suburb, so you see a lot of middle-class families--folks who'd never dream of taking a needleful of heroin," he says. The same is true in Pulaski, Va. (pop. 10,000), where OxyContin has overtaken cocaine and marijuana. Property crime is up 50%, says police chief Eric Montgomery. Four overdoses have been confirmed so far by police, who suspect more than have been reported. More alarming, says U.S. Attorney Bob Crouch, is a recent survey of students in southwestern Virginia indicating that 20% of high school kids and 10% of middle school kids know about OxyContin and how to obtain it.

With abuse of OxyContin on the rise, police in at least three states are reporting a record number of pharmacies being broken into. The homes of people with legitimate OxyContin prescriptions are being robbed in invasions targeting the pills. These patients are often tracked down by relatives who know what is inside their medicine chests or by their small-town neighbors who hear small-town talk about their prescriptions. Thieves are even accosting customers in drugstore parking lots, on a hunch that they might be carrying the sought-after drug, say Bangor authorities. OxyContin rings get prescriptions from sloppy or questionable doctors and use the usual means of forging them, either by photocopying the form or by using a pen to change a prescription for 10 tablets, for example, to 100. The truly inventive ones ask their doctors for another drug, then take the prescription form home, soak the ink off with chemicals and write themselves a new prescription.

Not everyone agrees that OxyContin is problematic. Dr. David Haddox, senior medical director for Purdue Pharma, the drug's manufacturer, insists doctors are not overprescribing. But the company has a lot to lose if the controversy lingers and doctors take their patients off it. Last April the Wall Street Journal reported that OxyContin sales increased 95% in one year, generating $600 million in sales for Purdue Pharma. Indeed, the drug, introduced in 1995, has been hailed as a miracle; it eases chronic pain because its dissolvable coating allows a measured dose of the opiate oxycodone to be released into the bloodstream (see PERSONAL TIME: YOUR HEALTH). However, abusers quickly found that by smashing the pills, they can get all the drug's potency in a rush of euphoria.

Facing pressure from prosecutors, investigators and drug counselors, OxyContin's manufacturer has begun working with doctors to minimize forged prescriptions. In Maine the problems have caused a quandary for doctors. In 1999 the legislature passed new medical rules requiring doctors to treat pain more aggressively. Now Maine is the second largest consumer of OxyContin among all the states, and had 35 deaths from overdoses last year. "We haven't had a drug problem like this in the high schools in Maine until now," says U.S. Attorney Jay McCloskey, who is waging a war against the doctors who so readily write OxyContin prescriptions. "We've had people tell us if a doctor had just asked them to roll up their sleeve for a blood-pressure test, they would have seen the track marks."

--Reported by Elisabeth Kauffman/Nashville