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OxyContin puts Appalachians in death grip
The Associated Press
Published Sunday, June 24, 2001 12:17 AM CDT
GILBERT, W.Va. (AP) � Kristen Rutledge had watched friends slowly kill themselves with OxyContin. Her own cousin, just 18, shot herself in the head, when she couldn�t get more of the drug. Girlfriends were prostituting themselves for another fix.
Still, when someone offered her a yellowish 40 milligram pill, she took it, chopped it up and snorted it. It was the start of a three-day binge, and she was hooked.
�It�s not like any other drug I�ve ever done,� the 20-year-old says.
Over the next year, her habit grew until she was taking up to eight �40s� a day, she says. When her dad, a county school board member and former mayor, found out, she tricked him into giving her money by saying she was being threatened by drug dealers.
The cash drain contributed to Tim Rutledge�s loss of his grocery franchise. But Kristen didn�t care.
�When I got down to two, I started panicking,� she says. �I had to get out and buy some more.�
Many in Appalachia call OxyContin �Hillbilly heroin.� Its abuse may not have started in the mountains, but it exploded here.
Across the region, people have overdosed on the painkiller and robbed pharmacies and family members to feed their habits.
�If this was an infectious disease, the Centers for Disease Control would be in here in white vans,� says Tim Rutledge. �There�s no doubt it�s very much a plague.�
To cancer patients and chronic pain sufferers, OxyContin is a wonder drug that can return them to a semblance of normal life.
Dr. Michael Levy, director of pain management at the Fox Chase Cancer Center in Philadelphia, calls Oxy �close to an ideal opiate.� While most strong pain medicines last only about four hours and take an hour or so to work, patients on Oxy get a steady 12-hour release of pain medicine with fewer side effects and less risk of liver damage.
�This product is better than anyone thought it would be when it was released five years ago,� he says. �This is a drug we need to protect, because it really helps patients.�
But to addicts who chew the pill or crush it to snort or inject, Oxy produces a one-shot, heroin-like high that can kill.
Purdue Pharma, the drug�s maker, is willing to concede that Oxy abuse has led to �somewhere between dozens and hundreds� of deaths in the past two years, says David Haddox, Purdue Pharma�s medical director.
#Five Kentucky residents and the estates of two others claim in a lawsuit that deceptive marketing and overprescription of the painkiller led to problems with addiction, crime and death.
The lawsuit, filed in Clay County, seeks $3 million for a substance abuse center and other unspecified damages.
Named in the suit are Purdue Pharma; Abbott Laboratories; Dr. Ali Sawaf, a Harlan urologist charged in February with illegally prescribing the drug; and Pineville Community Hospital.
Among its allegations, the lawsuit contends Purdue Pharma used coercive and inappropriate tactics to market its drug. Similar lawsuits have been filed in Virginia and West Virginia.
The Kentucky lawsuit names five living plaintiffs and the estates of two others it claims died of OxyContin overdoses. It seeks class-action certification which would allow others to join the suit later.
Purdue Pharma said its promotion of OxyContin has been legal and responsible and that it has worked with police and others to cut abuse of the drug.
#�I am sure it has caused some deaths,� Haddox says, �but my feeling is there is a magnification of this in the media.�
Purdue Pharma has taken steps to limit the damage. The company has stopped shipping its 160 milligram pills and has suspended shipment of 40s to Mexico because too many were finding their way back across the border.
The firm has offered tamper-resistant prescription pads in Maine and other states, and it expects to help pay for a federal pilot program to track narcotics prescriptions in Florida, Mississippi, Ohio, Virginia and West Virginia. Purdue Pharma sent a representative to Gilbert in January to address concerns; and it is running public service announcements on local radio to warn against abuse.
Law enforcement officials insist the problems have not been overblown. At least one dealer in Virginia has been charged with murder. Manslaughter charges were filed in a Florida Oxy death. Several Virginia doctors have been convicted of illegally dispensing the drug. Breaking and entering and armed robbery charges related to Oxy have been filed from Maine to Mississippi.
Michael Pratt, a prosecutor focusing on drug crimes in Kentucky, Tennessee and West Virginia, sees reasons why the drug hit Appalachia especially hard.
The Appalachian economy has been dependent on coal and timber, industries that produce serious injuries, so there are large numbers of people on painkillers.
�A lot of places, you got a headache, you�ll tough it out,� Pratt says. �Down here it�s like, �Well, my grandfather�s got some drugs. I�ll take that and it�ll go away.� And it just escalates.�
In addition, OxyContin sells on the street for $1 a milligram � up to $160 for the highest-dosage pill. In an area with chronic unemployment, that kind of money is hard to turn down.
Pratt says, �we�ve never come upon something that kills people so much. I mean, if it killed them, they really had to work at it. Oxy rolls in. It�s so powerful, it just lays waste.�
�This is a nuclear bomb,� adds Gregory Wood, a health fraud investigator with the U.S. attorney�s office in Roanoke, Va. �I was a cop in Detroit and saw crack come through the ghettos, and I�ve never seen anything like this.�
Neither had the tiny town of Gilbert.
Like many coal towns, Gilbert, pop. 417, winds like a centipede along the riverbank, pushing leg-like hollows out into the hills near the Kentucky line.
OxyContin found its way here about five years ago. What started as a gentle rain soon turned into a flash flood.
Police Chief Greg Cline blames the drug for at least four deaths in town, and state police Sgt. J.J. Miller put the number at about a dozen in the county.
A mental health counselor tells of a man who was having his teeth pulled two at a time, because each visit meant a new Oxy prescription.
Kristen Rutledge has known people to shoot themselves for a prescription.
�It seems like if you�re around people who are doing it, you catch it,� says Judy Compton, manager of the Compton Inn.
She knows all too well. Her sister caught it, too.
Jeanie Compton was spoiled. Her mother gave her a red convertible BMW before she could even drive, and a trailer home to live in. When she wanted to get married at age 15, her mother drove her across the Tug River.
Now it�s all gone. The BMW? Traded for OxyContin. The trailer? Sold for a few thousand dollars� worth of pills. The husband? Found slumped over in the bathroom with a needle nearby, dead of a suspected Oxy overdose.
Jeanie�s troubles began around 1991, when her adoring father died suddenly at age 50. She started experimenting with drugs. Along came Oxy.
At one point, Joyce Compton says her daughter was raiding the family�s motel for televisions, microwaves, mattresses, to supply her habit. Judy Compton stopped letting her come to her house.
�She�d get up to leave and my stuff would fall out of her pantlegs,� she says.
On more than one occasion, Judy has found her little sister slumped in a chair, her head lolled over.
Jeanie Compton just turned 23. She spent her birthday in jail, where she was serving time for violating home confinement to seek Oxy. Back home, wearing a monitoring anklet, she says she�s ready to get serious about kicking Oxy.
�I�ve said I�m either going to end up in jail or dead,� she says.
Locals have a nickname for the road: Pill Hollow.
�On one occasion I timed them, and in 30 minutes we had 45 cars coming to one house,� says Clyde Lester. Of the 20 or so homes wedged into the mountains around him, he says four were occupied by dealers.
People are starting to lock their doors, and establishing community watches. Isolation, long an obstacle for Appalachia, has become something people miss.
�A lot of those troubles that used to be in the cities have really come home to plague this community,� says the Rev. Denny May, whose 19-year-old daughter, Shanda, killed herself in 1999 shortly after getting into Oxy.
When Pastor Clayton Cline asked his Baisden Community Church congregation who had been affected by OxyContin, he says, �Almost every one raised their hands.�
One was his own. About a year and a half ago, his daughter became addicted to OxyContin after her husband received a prescription for an accidental gunshot. For the past six months, Cline�s daughter and son-in-law have been attending a church-based methadone program in Georgia.
Debbie Trent sits in a middle school auditorium. A mental health counselor from Gilbert, she she is a member of a drug-awareness group called STOP � Strong Through Our Plan.
Cindy, a 38-year-old recovering addict and mother of two, tells how she took 320 milligrams of Oxy in the morning before she had the strength to take her boys to school. Friends thought she had cancer. For two hours, people talk about the problem.
Kristen Rutledge has tattoos she doesn�t remember getting. She went through physical problems � not menstruating for months, constipated for weeks. She stopped writing in her journal.
When she finally decided to quit Oxy, she did it cold turkey. The withdrawal lasted three days, the same as her first Oxy binge.
�I�d rather have died,� she says, drawing her knees up to her chest. �I was vomiting. I could hear things and see things. I had pain all over my body, all over me � my head all the way down to my calf.�
Her habit cost her father tens of thousands of dollars. OxyContin is still costing Tim Rutledge: Now, he�s giving the cash-strapped police department money for undercover drug buys and taking out full-page newspaper ads warning others about drugs.
Kristen says she�s been clean for a month. But she�s not kidding herself. �I�m still addicted,� she says. �I�m just not using.�
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