A Prescription for Tragedy

May 14, 2007— -- Jan Spector, a 58-year-old Atlanta resident, has experienced persistent migraines since receiving a head injury in 1992.

Though he found himself on a revolving menu of pain medications over the years, he says that he "pretty much had everything on an even keel" before he was prescribed OxyContin in the fall of 2006.

"By December, I felt like it had turned my life upside down," he told ABC News. "I felt like what the Oxy did for me was that it overrode some of the other pain relievers that had been working OK. I imagine that it might have worked better at a higher dose, but I was not willing to do that."

Rather than begin a downward spiral of self-medication, Spector sought medical help and rehabilitation.

Unfortunately, many others who have been introduced to the drug are more eager to up their doses themselves. And some doctors who deal with pain fear that OxyContin possesses the potential for both dependency and addiction for many legitimate users -- as well as those seeking a quick high.

Pain Pills on the Street

Like a growing number of pain medications, OxyContin is a drug with two vastly different faces.

In the clinical setting, it is the trade name for the drug oxycodone, a long-acting pain reliever that many chronic pain sufferers view as a godsend.

On the street, however, the drug goes by many other names, including "Oxy," "O.C.," and "killer." Along with ecstasy, Vicodin and inhalants, OxyContin was one of only four drugs to show a continued increase in use throughout 2005, according to the annual "Monitoring the Future" report funded by the National Institute on Drug Abuse.

Over the years, researchers found that OxyContin use increased sharply from 4 percent in 2002 to 5.5 percent in 2005 -- a nearly 40 percent jump in three years.

The most recent figures provided by the researchers show that OxyContin abuse in this age group dropped back to 4.3 percent in 2006. But the news wasn't all good; in this same year, 8th- and 10th-grade students, who had not previously been showing much increase in their OxyContin use, reached their highest levels of OxyContin abuse observed so far.

A Drug Destined for Abuse?

So how does a drug that is often prescribed for cancer patients or those with chronic back pain become the prescription of choice for those looking for a high?

Some experts say the time-release drug, by its very design, provides an uncommonly high incentive for abuse.

"The primary reasons why Oxycontin became a widely abused drug are because the company heavily promoted it for inappropriate indications, and because the sustained release mechanism could be easily bypassed," says Michael Katz, clinical associate professor of pharmacy practice and science at the University of Arizona in Tucson.

"This means that a single tablet, once crushed or otherwise altered, could then be dissolved and injected or snorted," he explained. "No other sustained-release [drugs have] such a by-passable mechanism and are, therefore, inherently less subject to improper use."

And those looking for a quick and significant high were more than willing to alter the pill in order to take advantage of 12 hours worth of pain medication in one massive hit.

"Addicts will crush and inject it; they'll do anything," says Dr. Joseph Shurman, chair of the Pain Clinic at Scripps Memorial Hospital La Jolla. "Several companies are trying to work on a tamper-proof version, but it is difficult."

But aside from the buzz factor, the attribute that perhaps most directly led to the widespread abuse of the drug was its increasing availability.

According to data from Drug Topics, a news magazine for pharmacists, retail U.S. sales of OxyContin totalled $9.6 billion from 2000 through 2006. Moreover, it was one of the 25 top-selling drugs from 2000 to 2005, and it captured the 11th spot in 2003.

Widespread use and popularity of the drug led to increased opportunities for those with prescriptions to sell their pills -- usually for five to 10 times their normal price -- to casual users.

"Some people used this appropriately, but because of high demand, it fell into the substance abuse market because it is now worth a lot of money," says Dr. Joel Saper, founder and director of the Michigan Head Pain and Neurological Institute in Ann Arbor.

Legitimate Users Affected

While many individuals and families suffer because of the inappropriate use of OxyContin, others who need it for legitimate pain treatment may suffer from the stigma and fear that surrounds the drug.

According to the National Institute on Drug Abuse, most people who take OxyContin as prescribed do not become addicted.

"Overall, this situation has added to the overall tone of opioid fear in this country which makes getting patients under good medical control difficult," says Dr. Michael Joseph, clinical associate director of the Children's Hospital of Los Angeles Comfort and Pain Management Program.

And it's not just the patients who have become fearful.

"Now many doctors are even afraid to prescribe it," Shurman says. "The sad part about this is that for patients, it's led to this massive chilling effect."

He says many patients who might benefit from the drug are either scared to take it, fearing addiction, or are worried about the stigma of taking a drug so widely known for its abuse. But avoiding the drug comes with risks of its own.

"The risk of suicide in these patients is very high; a lot of these pain patients have depression."

Fruit of an Impatient Culture

And some say the true problem is not the drug itself, but a general culture of overmedication and liberal prescribing habits.

"We have become an impatient culture," says Phil Bryant, associate chair for community rehabilitation programs at the University of Pennsylvania Health System.

"We want instant meals, instant responses, and instant pain relief. Instead of resolving the underlying medical or emotional issue, we often mask it with pain medications. When this becomes habitual, the individual often develops both a physiologic addiction and emotional dependence," Bryant said.

It's a dependence that headache sufferer Spector feels he narrowly avoided by seeking medical help. And he says patients and doctors alike must be more wary about OxyContin.

"I think doctors have been persuaded that it's a lot less problematic than it is," Spector says. "I don't think it's the type of drug you want out in the public."