Saturday, January 11, 2003
Steamboat Springs The allure of pain pills was enough to entice someone to break into a local pharmacy last week.
Lyon's Corner Drug and Soda Fountain reported $1,000 worth of medication was stolen during a break-in last week. OxyContin -- a prescription painkiller known for producing, when abused, a euphoric high similar to heroin -- was among the pilfered items. Lyon's and other area pharmacies regularly stock OxyContin, which is commonly prescribed to people recovering from surgery, as well as cancer and rheumatoid arthritis patients.
Pharmacy thefts of OxyContin are common in the East, where small-town communities struggle with widespread dependency and addiction to the drug. Locally, police have seen a slow rise in the recreational use of OxyContin.
While the drug is not dangerous when used correctly, it can have dangerous and even lethal consequences when abused.
"Unfortunately, people who are going to abuse the drug are going to get ahold of the drug," said Detective Bob DelValle of the Steamboat Springs Police Department.
Police do not know if the local OxyContin thief intended to personally use the drug or sell it on the street, he said.
The illegal sale of OxyContin promises huge profit margins. A 20-milligram tablet that sold for $2.35 in 2000 could illegally sell for $10 to $20, according to the U.S. Drug Enforcement Agency. A 100-tablet bottle of 80-milligram strength OxyContin that sold $750 in 2000 could net $5,000 to $8,000 on the street.
"We've had some contact with the drug," said an agent with the Grand, Routt and Moffat Narcotics Enforcement Team who wished to be unnamed. "It's out there."
Steamboat Mental Health Center substance abuse specialist Michael Toothaker agreed the problem exists locally but emphasized the drug is more often used responsibly, thanks to doctors and patients alike.
"The majority of these people who use this medication use it when they need it and get off it," Toothaker said. "There's only a handful of people who will really abuse it."
Toothaker has worked with five patients in the past year that struggled with OxyContin addiction.
"I've not got a large caseload," he said. "A couple of these people came to the community with the problem to begin with."
The detoxification process is similar to getting someone off heroine, he said. Dependency comes easily. Recovery can take a lifetime.
Toothaker said some patients still struggle with withdrawal symptoms after many years.
"It's a powerful pill," he said.
Oxycodone, a strong narcotic pain reliever similar to morphine, is the sole active ingredient in OxyContin. In their various strengths, OxyContin tablets deliver 10, 20, 40, 80 or 160 milligrams of oxycodone. In comparison, other commonly prescribed pain-relief medications, such as Percocet, provide 5 milligrams or less of oxycodone and are combined with other active ingredients like aspirin.
"It's not dangerous if used the right way," Wal-Mart pharmacist John Walters said.
High oxycodone levels allow people to take OxyContin less often than other painkillers to manage pain, Lyon's Drug pharmacist Wendy Lyon said. OxyContin comes in a controlled-release form that, when the tablets are swallowed whole as directed, provides up to 12 hours of pain relief, she said.
"It's very good for acute pain," Lyon said. "Because of the time release, it can keep most (patients') pain at bay."
The high oxycodone levels become deadly when people undermine the drug's ability to gradually release oxycodone. Abusers often chew the tablets or crush them to snort or inject intravenously, which rapidly releases the oxycodone.
It's dangerous for people to get such a large amount of oxycodone all at once, Lyon said. Taking too much of the drug can cause low blood pressure, slow heartbeat and trouble breathing. Combining OxyContin with other medication or alcohol, or overdosing on it, can lead to injury or death.
OxyContin addiction is increasing across the nation, Toothaker said, but noted that it may be part of a larger trend: "We're seeing a rise in all different kinds of addictions."
In fact, awareness of the drug's potential for abuse, rather than a spike in the actual number of cases, may be a factor in the apparent rise in OxyContin addiction.
"We're starting to spot it a little bit more," he said.
When OxyContin was released on the market in 1996, it became the first product capable of providing up to 12 hours of pain relief. Today, OxyContin is the No. 1 prescribed Schedule II narcotic in the United States, according to the DEA.
The Food and Drug Administration keeps a tight rein on the drug because of its propensity to cause dependence and abuse. Patients prescribed OxyContin are urged to protect their medications from theft and flush unused tablets down the toilet. Doctors must write a prescription every time a patient gets a refill of OxyContin.
People have tried to get around the no-refills rule by visiting two or three doctors to get several prescriptions at once, Toothaker said, but doctors in the Yampa Valley are alert to that ploy.
"Our medical community is pretty savvy," Toothaker said. "They are pretty cautious about pain medications and how they are distributed."
FDA spokeswoman Kathleen Kolar-Quinn said the organization doesn't take the misuse of OxyContin lightly. All OxyContin packaging carries a "black box warning," the strongest warning carried by FDA-approved drugs.
The FDA intends to continue monitoring the drug and encourages the public to address OxyContin concerns to the organization, she said.
"There are regulatory actions that can be taken," Kolar-Quinn said.
Despite its potential for abuse, OxyContin remains popular in the medical community as a preferable alternative to taking painkillers every few hours because of the effective, long-term pain relief it provides.
"The FDA still contends that dealing with pain with narcotics is still the best way to go," Toothaker said. "Until something else gets discovered, that's the way it's going to be."