A prescription painkiller with a heroin-like high is quickly becoming the new street drug of choice.
Oxycontin is an opiate-based narcotic prescribed by doctors to relieve the severe pain of terminal cancer, osteoarthritis and other ailments. It’s a strong medication and is unique among painkillers in this class, like Percocet and Vicodin, because it slowly releases the main ingredient oxycodone over a 12-hour period.
Known on the street as “Oxy” and “O.C.,” the tablets are crushed to break up its time-release properties and then snorted as a powder or boiled to a liquid and injected.
“It’s the hottest street drug that we have,” said Detective Chris Cain of the Columbus Division of Police narcotics bureau. “People smoking crack for years have peaked. They’re now switching over to heroin or an alternative high like Oxycontin.”
The Ohio State Pharmacy Board has started to flag overdose deaths from oxycodone, Oxycontin’s active narcotic ingredient, and are aware of at least two of these deaths in Ohio.
“The problem is once they develop the addiction to the opiate in it, it just keeps going, going and going – just like heroin,” Cain said.
Investigators say that Oxy has created a growing epidemic of addiction and a surge of criminal behavior in Columbus and southern Ohio.
“We’re getting burglaries in pharmacies,” Cain said. “We’re going to see pharmacists getting guns shoved in their face, and that’s going to be the sad part of it.”
Oxy goes for about $1 per milligram on the street; a 20mg pill fetches about $20. The drug is supplied as 20mg, 40mg, 80mg and, in rare cases, 160mg tablets, and retails for the equivalent of about 12 cents per milligram.
Addicts paying street prices spend $50 up to $400 per day to keep their habit going, though, every situation is different.
Pharmacists are aware of the Oxy trend: Doctors’ offices have reported burglaries of prescription pads, which can be forged in an effort to obtain the drug, and some patients have attempted to increase the quantity written on their legal prescription.
Oxycontin is in the most strictly controlled class of pharmaceuticals because of its high abuse potential. Prescriptions have no refills and doctors are required by law to write the quantity in letters next to numerals: (30) thirty, for example.
“We’ve seen patients try to change a 10 to 100 for some prescriptions,” said Gary Mangini, planning services manager at Ohio State Student Health Services pharmacy. “If it seems like a large quantity, we’ll call the doctor.”
Altering a prescription is a felony.
Patients are faking pain symptoms to doctors in an effort to obtain Oxy prescriptions, and people are shopping for doctors who prescribe Oxy liberally.
Dr. John F. Lilly, a surgeon from the southern Ohio town of Portsmouth, surrendered his medical license Jan. 31 and pleaded guilty to writing illegal prescriptions for narcotic painkillers, including Oxycontin, according to Scioto County prosecutor’s office.
Lilly was initially charged with 46 counts of aggravated drug trafficking, carrying a concealed weapon and engaging in a pattern of corrupt activity. As a result of his plea agreement, he was sentenced to three years in prison, fined $20,000 and ordered to forfeit $500,000 in cash and possessions that law enforcement said was a result of his corrupt activity.
Portsmouth police, who investigated Lilly for six months, reported lines that extended outside Lilly’s office and onto the sidewalk.
The National Association of Drug Diversion Investigators said that southern Ohio, including Columbus, is one of five areas in the country with heavy Oxycontin abuse. The others are in Virginia, West Virginia, Baltimore and Maine.
Oxy abuse came to Columbus via southern Ohio about three months ago, and is quickly becoming popular, said Cain.
“We’re going to see it in crack houses, running hand-in-hand with crack,” Cain said.
As a pharmaceutical, Oxy is attracting new and inexperienced drug abusers who don’t understand the power of this drug and its addictiveness.
“Because it comes in pill form, out of a bottle, some people see it as safe and clean, not tainted,” Cain said. “But heroin users know the power of this drug.”
Most of these new users are young, 16 to 25 years old, who are drinking alcohol with Oxy to increase its effects. The combination of the two drugs can be fatal.
Oxy’s many different tablet strengths can cause overdose and confusion.
“Someone thinks, ‘hey, I can do x-amount of Oxys,’ not knowing there’s a big gap in strengths; they take a bunch of 80s and boom, that’s it,” Cain said.
Controlling the sale of Oxycontin at the retail level is difficult because it is an effective drug for people who really need it, Mangini said.
Patients usually take Oxycontin for chronic pain or post-surgery pain on an acute basis. Because of its 12-hour, slow-release formula, patients need to take this drug only twice daily and don’t need to get up several times during the night for pain relief, like with other oxycodone drugs. Tablet strength, up to 160 mg per dose, is determined by the patient’s doctor.
Oxycontin has made its manufacturer, Purdue Pharma of Stamford, Conn., a fortune. Last year Oxycontin sales rose 77 percent to $957 million, making it a bigger seller than Viagra, research firm IMS Health reported.
Some pharmacies have stopped carrying Oxycontin and posted signs in their windows saying “We have no Oxycontin.”
For their part, Purdue Pharma says they have issued literature to further educate doctors about how to prescribe Oxycontin and are speaking at law enforcement seminars on the issue.
The manufacturer, prescribing doctors and pharmacists are in the business of treating terminal cancer patients and others with chronic pain.
“It’s a good drug for people with severe pain, people who really need it,” Mangini said.
The Columbus police are preparing for an Oxy battle.
“As far as a street level pharmaceutical, this is the most popular in many years,” Cain said. “What a mess we have with this, really.”
