One of medicine's newest, most promising pain fighters has become the drug of choice for pharmaceutical abusers in the Tristate, making a leap in popularity unlike anything police have seen in years.

        OxyContin, a potent narcotic, has been hailed as a miracle drug for people with chronic pain and cancer. But police around Greater Cincinnati have given it a more sinister nickname: “the heroin of the Midwest.”

Cincinnati Police Sgt. Kerry Rowland says OxyContin is the street "drug of choice" (Glenn Hartong photo) | ZOOM |

        “It's like the purest form of heroin I've ever done,” said Rob Ramundo, a former Cincinnatian whose addiction to the drug led to a spree of drugstore robberies last year — and to prison. “Absolutely it was just as addictive.”

        Since it popped up on the illicit market about a year ago, Tristate police have confiscated more than 13,000 doses of OxyContin.

        That's amazing for a drug that was almost unheard of on the illegal market in 1999, authorities said. Only oxycodone, its sister drug, and the popular painkiller Vicodin were taken off the streets in larger amounts last year.

        Arrests related to OxyContin are soaring. Last year, of 140 arrests by the Cincinnati Police Division's Pharmaceutical Diversion Squad for illegal possession or trafficking in pharmaceuticals, 32 were for OxyContin.

        “It's the prescription drug of choice (for abuse) from Greater Cincinnati to rural Ohio,” said Sgt. Kerry Rowland, diversion squad commander.

        What is happening in the Tristate is unfolding across the nation. From tiny towns in Maine to the hollows of Kentucky to the suburbs of New Orleans, reports of theft and abuse are rampant.

        “They'll kick a bag of cocaine out of the way to get to "Oxy,'” said Detective Roger Hall of the Harlan County Sheriff's Department in Kentucky. “We did a drug roundup back in September. We arrested 76 people, and 45 were trafficking in OxyContin.”
       

Pill is unique
        The appeal of OxyContin, introduced in 1995, lies within a patented substance that bonds with its main ingredient, oxycodone, a widely used compound derived from opium.

        The bonding agent can actually measure the level of oxycodone in the blood, then release more or less pain-killer over a 12-hour period.

        Cancer patients, in particular, praise the drug because it gives them enough relief from pain that they can resume nearly normal lives.

        “It's the best,” said Roberta, 57, of West Chester. “I can't drive but, other than that, I'm totally functional. My quality of life has improved so much, and there are no side effects.”

        It is because the drug works so well that Roberta asked that her last name not be published. Around the nation, legal users of OxyContin have been accosted in drugstore parking lots and had their homes burglarized by users and dealers desperate for the drug. Roberta said she does not want criminals to know she has OxyContin in her home.

        OxyContin's potency — and the fact it is considered safer than street drugs because it is lab-produced — are what make it appeal to criminals and abusers. Its time-release properties mean more oxycodone — up to 160 milligrams — can be packed into each pill.

        It's also an expensive high.

        Pills are sold on the street for up to $1 per milligram, so a 40-mg tablet — the most commonly prescribed — fetches up to $40. (In a prescription, that pill would cost about $4).

        Abusers crush the pills and sniff them, or extract the oxycodone, then inject it. That defeats the pill's time-release substance, unleashing all the oxycodone for an intense — and highly addictive — rush.
       

Why it's big here
        Drug experts say Cincinnati's location, and its reputation as a “pill town” with a large medical and pharmaceutical community, are part of the reason for the drug's rapid rise here.

        “Cincinnati is a long way from the supply centers for drugs such as heroin or cocaine,” said Dr. Don E. Nelson, associate director of the Drug and Poison Information Center in Corryville,

        Those drugs often are “cut” — or diluted — significantly before reaching the streets here, so hard-core drug abusers turn to prescription drugs. Also, because Cincinnati has numerous hospitals and doctors' offices, abusers have more opportunities for theft and fraud, officials said.

        Local authorities have not seen any fatal overdoses yet involving OxyContin, and abusers, they say, don't fit into common stereotypes.

        “OxyContin can appeal to anyone — teen to senior citizen” said Sgt. Tom McGrath, coordinator of the countywide Drug Abuse Resistance Task Force (DART). “You can find it anywhere — Over-the-Rhine to West Chester.”
       

No escape for addict
        Mr. Ramundo knows well the dark side of OxyContin.

        The Cincinnati native is serving a four-year term at the Chillicothe Correctional Institution for robbing six pharmacies in suburban Hamilton County and Clermont County last spring.

Rob Ramundo

        OxyContin was the only thing he demanded.

        “It produced the same feelings heroin did,” said Mr. Ramundo, 29, once a successful photographer for a Chicago-based men's magazine.

        Mr. Ramundo said he tried OxyContin because the quality of heroin he could find in Cincinnati was poor. If abused, OxyContin is as addictive as heroin, he said.

        And like quitting heroin, quitting OxyContin was hellish, he said.

        “You feel the same withdrawal symptoms ... the worst flu you ever had. You sweat. You vomit. You can't control your bowels and you shake and you wish you would die. The only relief is more.”

        When he ran out of money, he began holding up drugstores.

        “Because of my history (with heroin), mom and pop would not give me any money,” he said.
       

Ruses, thefts feed habit
        While robbery sprees like Mr. Ramundo's are uncommon, people addicted to OxyContin, or those who simply want to cash in on the hot market for it, will go to extraordinary lengths to obtain it.

        Sgt. McGrath said some abusers try “doctor shopping” — visiting a number of physicians and complaining of pain to collect several prescriptions. Others alter their prescriptions, or steal the drug from relatives or friends.

        Evidence abounds of OxyContin's infiltration in the Tristate:

        • On Monday, the Butler County grand jury indicted two Kentucky men on aggravated trafficking in drugs and weapons charges. They were arrested Jan. 28 in Fairfield after the Butler County sheriff's drug and vice unit purchased 600 tablets of OxyContin. It was the largest bust involving OxyContin in Butler County.

        • DART recovered 1,200 OxyContin tablets last year that had been diverted from a mail-order pharmaceutical company.

        • Agents arrested a Madisonville medical assistant in December, accusing her of taking prescription blanks and filling them out for OxyContin for herself.

        • Police are still seeking a man in his early 20s who robbed an Amelia pharmacy of an undetermined amount of OxyContin on Jan. 12.

        Mr. McGrath said authorities are taking measures to quell the problem. DART has sent advisories. It also has featured the drug in its monthly newsletter, distributed to health-care professionals, describing common methods abusers are using to forge or alter prescriptions, he said.
       

Drug has defenders
        Those who dispense the drug for patients with chronic pain say there's nothing else quite like it on the market.

Dr. Rebecca Bechhold (left) confers with nurse Maddy Mendelhall about the use of Oxycontin at Hospice of Cincinnati. (Michael Snyder photo) | ZOOM |

        Dr. Rebecca Bechhold, medical director of Hospice of Cincinnati and an oncologist, is one of OxyContin's biggest advocates. She sees the changes it brings in patients every day.

        “I probably prescribe more of it than any other (doctor) in this area,” she said.

        The drug's patented formula means it needs to be taken only once or twice a day. Patients also experience few side effects.

        “It is a narcotic and it is very similar to morphine,” Dr. Bechhold said. “But it does not have the side effects of morphine,” such as hallucinations.

        Dr. J. David Haddox, medical director of Purdue Pharma, the Stamford. Conn.-based developer of the drug, said OxyContin is getting a bad rap in the media, with too much attention focused on its abuse rather than its pain-relieving abilities.

        “We have to make sure physicians and law enforcement and pharmacists ... are aware, and make sure we do all we can to minimize drug abuse,” he said. “At the same time, we need to do all we can to make the drug available to patients who have legitimate needs.”

        Purdue Pharma conducts seminars and distributes literature about the drug's benefits, and its dangers if abused, he said.

        Sitting in prison in Chillicothe, Rob Ramundo prays he can turn his life around. Prison and law enforcement officials said he has a good chance at rehabilitation based on a strong and supportive family and his will to straighten out his life.

        Still, he's plagued with regret over “the pain I've caused my family,” he said.

        “That's the hardest part of all of this. They still support me, but when I get out, there will be a trust issue.

        “Put it this way: OxyContin can consume your life. It's nothing to play with. It's fire.”

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