prescribed medicines about to eclipse that of illicit
Pittsburgh Post-Gazette, March 01, 2007
After treating more than
2,000 people for OxyContin addiction since 2000, Dr. Neil
A. Capretto, Gateway Rehabilitation Center's medical
director, wasn't surprised by the findings of the United
Nations-affiliated International Narcotics Control Board
that abuse of prescription drugs is about to exceed the
use of illicit narcotics worldwide.
"There's just been a
growing, nonmedical, addictive use of prescription drugs,"
he said, particularly opioid drugs like OxyContin,
codeine, morphine, Percocet, Vicodin and Dilaudid. Opioids
possess some properties characteristic of opiate narcotics
like heroin and morphine but are not derived from the
"The good news is we're
treating pain better than we did 10 years ago," Dr.
Capretto said. "The bad news is there are more people
abusing and misusing [prescription drugs]. Unfortunately,
from our end, I'm really afraid it's going to get worse
before it gets better."
In a report yesterday, the
International Narcotics Control Board said abuse of
prescription drugs is about to exceed the use of illicit
street narcotics worldwide. The shift has spawned a lethal
new trade in counterfeit painkillers, sedatives and other
medicines potent enough to kill.
Prescription drug abuse
already has outstripped traditional illegal drugs like
heroin, cocaine and Ecstasy in parts of Europe, Africa and
South Asia, the board said in its annual report for 2006.
In the United States alone,
abuse of painkillers, stimulants, tranquilizers and other
prescription medications has gone beyond "practically all
illicit drugs with the exception of cannabis," with users
increasingly turning to them first, said the group, based
in Vienna, Austria.
Unregulated markets in many
countries make it easy for traffickers to peddle a wide
variety of counterfeit drugs using courier services, the
mail and the Internet.
"Gains over the past years
in international drug control may be seriously undermined
by this ominous development if it remains unchecked,"
Narcotics Control Board President Philip O. Emafo said.
The problem is compounded
in Western Pennsylvania, Dr. Capretto said, because it is
"one of the OxyContin epicenters of the world." The
powerful drug is prescribed here more than in other areas
because of the region's large elderly population and large
number of former industrial workers who suffered
Since 2000, Gateway has
experienced a 600 percent increase in admissions for
addictions to opioids, both prescription pills and heroin,
The prescription and heroin
addictions are often linked, Dr. Capretto noted, because
abuse of OxyContin has led many addicts to heroin for
economic reasons. While an 80-milligram OxyContin pill can
sell for up to $80 on the street, a stamp bag of heroin
has dropped to $10, even as purity levels have reached 90
"Someone spending hundreds
of dollars a day on OxyContin can buy heroin for
one-third, one-fourth that amount now," he said. "You have
suburban kids who never thought they'd stick a needle in
their arm shooting up.
Richard Goldberg, Allegheny
County deputy district attorney in charge of the narcotics
unit, agreed that OxyContin users are turning to heroin
because dealers of both drugs are reacting to market
forces of "supply and demand" in a price war.
Dr. Capretto said he's
treated OxyContin abusers who enlisted others to stand
outside of doctors' offices to buy partial prescriptions
from elderly patients.
"They'd buy half a
prescription for $200 and sell it for 10 times that much,"
He said he knows of high
school students from an upper-middle-class school district
who broke into a fellow student's home to steal his
father's OxyContin, prescribed for a car accident; of
addicts who go to real estate open houses to go through
medicine cabinets; and addicts who go from doctor to
doctor with fake medical records, knowing just how to act
and just what to say.
Mr. Goldberg said
prosecutions in Allegheny County involving prescription
drugs peaked about two years ago when they made up about
30 percent of nearly 6,000 drug cases. Now, that number
has dropped back to the 20 percent range where it was
previously, he said.
After an upswing involving
OxyContin prosecutions several years ago, the pendulum has
swung back to Vicodin, he said.
"Vicodin has been there and
will always be there. It's one drug doctors are more
comfortable in prescribing," he said.
The number of Americans
abusing prescription drugs went from 7.8 million in 1992
to 15.1 million in 2003, nearly doubling, the Narcotics
Control Board said. Among their prescription drugs of
choice: the painkillers oxycodone, sold under the trade
name OxyContin, and hydrocodone, sold as Vicodin and used
by 7.4 percent of college students in 2005.
Although the number of U.S.
high school and college students abusing illicit drugs
declined in 2006 for a fourth consecutive year, "the high
and increasing level of abuse of prescription drugs by
both adolescents and adults is a serious cause for
concern," it said.
exploiting intense demand for prescription drugs that can
give a "high" comparable to cocaine, heroin or
methamphetamine, the watchdog group said.
It singled out Scandinavia,
where demand for flunitrazepam -- a sedative sold as
Rohypnol and widely known as a "date rape drug" --
increasingly is being met by unauthorized production, and
North America, where widespread abuse of prescription
drugs, including the narcotic fentanyl -- 80 times as
potent as heroin -- has been blamed for a spike in deaths.
"The very high potency of
some of the synthetic narcotic drugs available as
prescription drugs presents, in fact, a higher overdose
risk than the abuse of illicit drugs," Dr. Emafo said.