Police fret over surge in 'hillbilly heroin' use

1/2/2005

Last summer, on a warm sunny day, a Bedford Township woman made what some parents would consider a shocking wish.

Standing on the wooden porch of her well-adorned suburban home, the mother of a family that once seemed inseparable watched her son s vehicle pull into the driveway and whispered:

Oh no, they let him go. God I want him to go to jail, just so he can quit.

She d heard all the excuses, had all the hopes, only to have them turned against her. Now when her 24-year-old son, Kevin L. Welch, tells her he s giving up his drug habit, she doesn t bother saying she won t believe him anymore.

He used to tell us everything, but now the lies aren t going to stop. The addiction won t stop, said Mrs. Welch, who asked that her first name be withheld for this story.

Kevin s not addicted to cocaine or heroin, for years the choice of many addicts. He s hooked on a new kind of drug one seen by many as safe, even government approved. OxyContin, nicknamed oxy, the ox, or O.C., is a pain-killing, Pied Piper of a pill that can be illegally converted into an energizing drug.

When crushed and snorted, or melted and mainlined via needle into a vein, it makes you want to do things, achieve things, Kevin said. It keeps you going.

Across the board, OxyContin is becoming a drug of choice, said Lt. Dan Schultz, in charge of the Toledo Metro Drug Task Force. And this year, we re seeing a tremendous increase in its illegal use.

Seizures of so-called Schedule II drugs the most tightly controlled prescription narcotics that are being illegally sold in the Toledo area nearly tripled from a 2003 total of 939 unit doses to 2,581 doses for the year of 2004 through November alone. That tremendous increase can pretty much all be attributed to OxyContin, Lieutenant Schultz said.

For Kevin, life on the pill became wonderful full of energy and excitement and bliss, he said. For a while.

But life had to stay wonderful. After weeks of taking several pills every day without a prescription, Kevin stopped and soon a riptide of withdrawal symptoms made his muscles clench like vice grips, thrust into his stomach until he vomited.

I can t remember the last time I got high from it, Kevin now says. At the height of his addiction, he would melt three 80-milligram pills the chemical equivalent of 48 Percocets; tiny, 5-mg pain killers seen by many addicts as the epic high and shoot them into his vein. It took $120 a day just to keep the pain away.

Enforcement officials say that the withdrawal symptoms of Oxy mimic heroin, giving the drug the nickname: hillbilly heroin or poor man s heroin.

An ironic title, given the fact that the street price of OxyContin is twice that of heroin. There s nothing on the street more valuable than Oxy, Kevin said.

But for some, evidently, price is no object. Lt. Luke Davis who oversees a multi-agency narcotics task force in southeast Michigan said OxyContin is the most commonly abused prescription drug in Monroe and Lenawee counties.

It just continues to get worse. It used to be the older people using, but now it s getting into the younger generation, the high schools, he said.

Dr. Brian Kaminski, medical director of the emergency center at Toledo Hospital, agreed based on the recent increases of people in their teens and early twenties that he s seen walk into his emergency room saying they re hooked on OxyContin.

Even Deputy Joe Lambert, a member of Monroe County sheriff s department and until last year the liaison officer at Bedford Public schools, said OxyContin snuck right under his highly sensitive nose into his own family. A close relative of his who was raised under his roof and went through the school system he once monitored became addicted to OxyContin.

They seem perfectly normal, Deputy Lambert said. I didn t notice until it was too late.

He added that the dozen or so informants he talks with say the majority of their friends and people they see in school are doing this stuff.

One in five students in Lucas County has used OxyContin, according to a survey of about 40,000 students done in April by the Alcohol and Drug Addiction Services Board of Lucas County.

Keep in mind, the survey excludes the hard-core users, the drop outs who aren t around any more, said Jay Salvage, executive director of the board through 2004. He said OxyContin was added to the survey questions this year because the board saw it as an emerging issue of concern.

It s insidious. You don t see the signs until you re paying the bills, Mrs. Welch said.

In November, Mrs. Welch s wish came true: Her son spent his first Thanksgiving in jail. It was a long time coming: Kevin s addiction robbed his family of every dime in their savings account, tens of thousands of dollars in cash advances on their credit cards, and guns, power tools, a leaf blower went missing from the garage.

Mrs. Welch first noticed something was wrong when she and her husband came back from the Florida Keys in May, 2003, and saw a $12,000 cash advance on a family credit card.

In all, I d say he got us for 40 to 50 grand, said Mrs. Welch.

Mom s terrified to let me back into her heart, said Kevin, sitting in a cell at Lenawee County jail for stealing a friend s checkbook and forging six checks to keep his habit going. I ve got the greatest parents. They ve always been there. They ve given me everything and I ve done a lot to hurt them.

He d spent a few days in lock-up before, once for possession of drug paraphernalia, but Mrs. Welch believes the seven-month stint he s now on is the only possible solution.

A few days just aren t enough to scare them off this drug, she said.

It s one example of how the abuse of OxyContin, like any addictive drug, translates into other areas of crime, enforcement officials say.

In November, an armed robbery at Yinger Pharmacy Shoppe in Monroe was carried out by two men who demanded the drug specifically. Jim Yinger, the owner, now refuses to carry OxyContin.

My employee got the barrel of a .45 stuck in their face. How would you feel? It s not worth it, Mr. Yinger said.

It s the third such pharmacy robbery in recent years, according to Monroe County Prosecuting Attorney Michael Weipert. OC was the target in all three.

Tim Benedict, vice president and chief inspector for the Ohio State Board of Pharmacy, said the armed robbery trend has been increasing statewide for the past three years, with OxyContin the main target the large majority of the time.

But there are pettier crimes, as well.

The people that started on it two years ago are starting to steal to keep their habit going, Deputy Lambert said. It s coming to a head half the robberies and larcenies from cars in Bedford can be attributed to this drug.

While Ohio is in the top 10 states of OxyContin abuse, Drug Enforcement Agency spokesman Dave Jacobson said the Toledo area is at one of those critical junctures in drug trends it s at a crossroads. Use is increasing, and it s in danger of taking off. But it could also fade to the side.

But he and other enforcement officials add that fighting illegal sales of prescription drugs is more difficult than fighting other drugs. With cocaine, shipments can be found and intercepted. But with OxyContin, people are selling it mostly off of legitimate scripts, Lieutenant Davis said: Dozens of legit prescriptions creating dozens of potential sources.

That eventually trickles down to the street dealer, Lieutenant. Schultz said: It s pretty commonplace now to stop someone selling other drugs like cocaine or heroin and he ll have some pills on him. A year ago that wouldn t have happened.

The pill s prevalence and popularity is partly due to its accessibility, Lieutenant Schultz added, with legal prescription holders selling a dozen or so pills a month out of the 30, 60, and sometimes 90 they re prescribed at around $40 for a single 40 mg pill.

While Vicodin, another pain killer, remains the most widely abused prescription drug on the market, taking 20 Vicodin a day will tear your stomach up, Kevin said. And who wants silver when you can get gold and platinum?

Part of the attraction of OxyContin, Mr. Salvage said, is due to the fact that it s seen as safe, government approved. Made in a controlled environment, with no danger of being stepped on or cut for purity, OxyContin is seen as a less dangerous, less addictive, more reliable high than a bag of heroin or cocaine bought on a dark street corner.

It s amazing how quickly the illicit drug industry can take a legal drug and convert it, he said. Never underestimate the creativity of these people.

And because of that, pharmacists say their job is getting harder. Never mind the armed robberies, they have more commonplace concerns whenever a customer walks in the door.

Some come in and they limp, they cough. You know when the carnival s in town, said Ernie Boyd, executive director of the Ohio Pharmacists Association.

Ohio pharmacy board officials say one big problem is tracking pharmacy shopping abusers going to different pharmacies for the same prescription several times in a row with stricter tracking methods in neighboring states pushing some abusers into the Buckeye state.

All states surrounding Ohio have statewide oversight mechanisms: centralized databases overseen by state pharmacy boards into which prescription information is logged alongside patients personal information, thus making the practice difficult.

A bill sponsored by Ohio Rep. Thomas Raga, a Republican from suburban Cincinnati that would set up and help fund such a system passed both chambers Dec. 7 and now awaits Gov. Bob Taft s signature.

Still, Mr. Boyd said, pharmacists are getting more adept at spotting red flags: Photocopied scripts, sloppy signatures for known doctors on stolen prescription pads with stolen DEA identification numbers, and people with insurance or from out of town paying in cash.

Mr. Benedict, who oversees complaints against pharmacists, said the cases of actual pharmacists or doctors selling for profit script mills or candymen is rare. But cracking down on an offender can be difficult.

You don t indict a doctor for one bad prescription. You need 40 to 50 cases, he said.

Alan Gardner, a former ProMedica Health System physician and operator of a private pain management practice in Defiance, was indicted in November on two felony counts of aggravated trafficking and two counts of corrupting another with drugs specifically, OxyContin relating to juveniles. Dr. Gardner pleaded not guilty.

Some doctors are becoming increasingly hesitant to prescribe the drug, even for conditions the drug was meant to treat: Serious, chronic, round-the-clock pain.

And that s a problem for Connecticut-based Purdue Pharma L.P., maker of the drug.

Unfortunately, you ve got criminal activity dictating legitimate practice, said James Heins, public affairs director for Purdue.

Mr. Heins is quick to point out that OxyContin is a highly regulated narcotic, and ever since Purdue became aware of the problem of its illegitimate use in 2000, the company stepped up efforts to fight it. Tamper-proof prescription pads with serial numbers were distributed to doctors, funding was provided for an education campaign against juvenile abuse, and Purdue is working on a pill that is rendered ineffective when crushed.

But Rogelio Guevara, a chief inspector for the DEA, called some of those efforts public relations damage control in a letter included in a General Accounting Office report on OxyContin abuse. In that 2003 report, DEA and FDA officials expressed concerns that Purdue initially had been misleading and overly aggressive in its marketing of the drug.

As for Purdue s recent efforts, it may hurt sales, joked Dr. James D. Chlovechok, medical director of the Ohio Sports Medicine Institute in Cambridge, Ohio.

Once word gets around that you prescribe it, the abusers start showing up, he said. It s a lot of work to try to treat real pain, because you try to sort the real from the unreal.

Dr. Chlovechok remembers being visited by a whole family sisters with different married names coming from different counties, all asking for OxyContin for all sorts of problems.

Then one day I saw their names in a relative s obituary, and I knew why they were coming to me, he said.

Ross Chaban, vice president of clinical services at Substance Abuse Services, Inc. the only methadone clinic in Lucas County said the increase in patients seeking treatment for OxyContin addiction this past year has been unprecedented.

Those admitted for Oxycodone abuse the active ingredient in OxyContin jumped 142 percent, from 19 patients in 2002-2003 to 46 patients in 2003-2004. In comparison, the heroin addicts SASI treated jumped 21 percent, from 131 to 159, in that time period.

Before that, Mr. Chaban said SASI saw only two or three patients abusing Oxycodone, half a dozen at the most.

One female patient at SASI who asked to remain anonymous has been on methadone for two years in an attempt to combat OxyContin. Hit by a car seven years ago and with broken bones in her face and hip, she went through three surgeries and was placed on OxyContin for four years. In the end, the 105-pound woman was up to whopping 360 mg a day.

When she was finally cut off cold by a new doctor, the symptoms made me feel worse than when I got hit by that car, she said.

She bought OxyContin on the street for several years to the tune of $2,000 a month before she checked into SASI. Looking at her two young kids and staying away from other users kept her off it, she said.

Paul Barko, her counselor at SASI, said that s crucial for those with contacts in the drug culture. But Mr. Salvage, whose board oversees SASI, said the main challenge with prescription drug abusers is getting them to see their habits as dangerous in the first place.

A lot of times people will stigmatize or condemn alcohol and heroin users but it s hard to do that with prescription drug users, he said. They and those around them don t see themselves as addicts.

Mr. Jacobson agreed that the American mentality doesn t have a strong and healthy enough fear of these drugs that they should have.

Kevin Welch said he s looking forward to the day he ll get out of jail, but added that I m gonna be scared to see how I react to that little bit of freedom. I would like to think this is the bottom, that this will reach me, but there s no guarantee I m not going to go back.

Mrs. Welch gets a little angry when she glances at a letter sent from her son in jail. Oh, here comes the guilt again, she said.

This used to be a house overflowing with friends, she said, tearing up as she looks at the pool, tree house, and playground set in her backyard.

As long as they re alive, you want to believe there s hope. But I just don t know if there is.

Contact Tad Vezner at: tvezner@theblade.com or 419-724-6050.