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Kentucky's Pain

Three years into the war on OxyContin abuse, the casualties continue. But there's hope where it all began

Sep 16, 2004 | Newsweek

The sun was barely up when dozens of police fanned out across the leafy, green mountains of eastern Kentucky last month. Armed with sealed indictments and bulletproof vests, they rounded up 87 suspected drug dealers. There were coal miners, factory workers, a 19-year-old dragged from bed in her pajamas, a grandmother with pills spilling out of her pockets.

Police said undercover agents had caught each one selling drugs—many of them powerful prescription painkillers like OxyContin. For a big-city police department, that would be a major bust.

But to officials in Appalachia, it was just another week. In April, members of Operation UNITE, a new federal anti-drug task force, arrested 211 alleged drug dealers around the town of Hazard—the largest drug bust in Kentucky history.

They picked up another 35 in June and 69 in July. The area's drug problem is so bad that "the enforcement is pitifully easy," says Dan Smoot, UNITE's law-enforcement director.

Three years ago another giant drug bust in Hazard—200 suspected dealers in the spring of 2001—established eastern Kentucky as the ground zero of prescription-painkiller abuse. Designed to alleviate severe, chronic pain, OxyContin gained a street following for the heroinlike high it delivered when crushed. Although police launched a massive crackdown and OxyContin's maker, Purdue Pharma, targeted the region as part of a nationwide $230 million program of abuse prevention, education and law enforcement, the area hasn't been able to kick its habit. Purdue Pharma points to eastern Kentucky's tradition of self-medication—moonshine and marijuana have soothed cancer, mining injuries and emotional pain for years.

Locals acknowledge the history of substance abuse, but say OxyContin's potency and its handy distribution network—local pharmacies and the Internet—have made it more insidious than any other drug. They're wary of Purdue's help and complain that the company's Kentucky grants are a fraction of the $1.6 billion in net sales that OxyContin earned last year alone. Now with a generic version from another company hitting the market, they worry the problem will only get worse. To Hazard Mayor Bill Gorman, the struggle is like the war on terror. "It's just ongoing," he says wearily.

Eastern Kentucky isn't the only part of the country still wrestling with OxyContin abuse. By 2002, the Drug Enforcement Administration estimated that illegal OxyContin use had reached 23 states. The White House drug czar's office cites it as a problem in Appalachia, New England, the mid-Atlantic and the Southeast. Now the local officials who first spotted the epidemic hope to lead the way out.

An influx of new federal money is already having an impact. After reading an expose in the Lexington paper last year, Kentucky Rep. Hal Rogers used his seat on the House appropriations committee to acquire $16 million for UNITE (Unlawful Narcotics Investigations, Treatment and Education). The task force has hired 29 undercover agents, started a treatment hotline and set up drug courts and school programs. The street supply of OxyContin has dwindled—only 10 percent of the 6,600 pills seized by UNITE this year were Oxys—and prices have shot up from $80 to $120 for an 80-milligram tablet. That has prompted a shift to cheaper, more plentiful drugs like methadone and heroin, but "[Oxy] is still what everybody wants and seeks," says Smoot. Since its launch in January UNITE has seized $1.6 million worth of drugs. That gives residents hope.

UNITE is betting much of its money on drug courts, which let nonviolent offenders skip jail if they pass drug tests, get counseling and work or attend class. Twenty-year-old Jamie Farmer chose drug court after she was arrested for writing $40,000 of bad checks to cover the $800 a day she and her boyfriend spent on Oxy. "You go because you want out of jail," says Farmer. "But drug court made me change."

Though slow at first to react to abuse of its best-selling drug, Purdue Pharma has since beefed up its efforts. The company has spent millions working with pharmacists and law enforcement to prevent thefts, prescription fraud and doctor shopping. In Kentucky alone, Purdue has sponsored more than 250 lectures for doctors, donated $765,000 to local police and run an ad campaign to educate the public about prescription-drug abuse. It's also spent more than $150 million developing a more abuse-resistant form of the drug.

But for the people of eastern Kentucky, all that seems like too little, too late. "They have caused addiction—even deaths—of young people," says Rogers. "I do not want their help." Even those accepting Purdue's cash are skeptical. After the Richmond sheriff's office got a $25,000 grant from Purdue, the company flew police spokesman Willard Reardon to New York and picked him up in a limo to attend a training session at its Connecticut headquarters. "They were trying to win us over," Reardon says. "It's a Band-Aid on a huge problem." But Purdue spokesman James Heins counters that the company is trying harder to stop abuse than any other pharmaceutical maker. "We did not invent the prescription-drug abuse problem," he says. "What else would people have us do?" For towns like Hazard, there may be no easy answer.

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