Sunday, February 25, 2001

An Enquirer Special Report

The OxyContin Pipeline

Multistate network keeps Appalachia hooked, Cincinnati part of 'near-epidemic'

By Kristina Goetz
The Cincinnati Enquirer

        HAZARD, Ky. — A multistate “pipeline” that runs through Greater Cincinnati is funneling the powerful painkiller OxyContin to mountain communities in Eastern Kentucky, authorities say.

        The elaborate and illegal network stretches from Indiana to Virginia, investigators have discovered. It includes alleged drug suppliers in Cincinnati, Dayton, Middletown and Portsmouth.

        Using pharmacists and doctors in several states, suppliers are evading a computerized watchdog system in Kentucky and successfully slipping thousands of the pills into a corner of Appalachia where many residents are wrestling with OxyContin addictions, according to police and court records reviewed by The Cincinnati Enquirer.

[photo] Tiny Hazard, Ky., has been hit hard by a big-city problem: drug addiction.
(Glenn Hartong photo)
| ZOOM |
        As a result, a problem Gov. Paul Patton has described as a near-epidemic in the mining counties four hours southeast of Cincinnati is likely to worsen until the pipeline can be shut down, authorities say.

        “It's unlike anything I've ever seen,” said Dan Smoot, a Kentucky State Police detective and a 12-year veteran of drug investigations. “I don't think we've hit rock bottom yet.”

        This month, more than 200 people were arrested and indicted in Kentucky. They are accused of abusing or illegally distributing the drug, nicknamed Oxy or OC.

        It was the largest drug raid in Kentucky's history and offered investigators an understanding of how the pipeline works.

        They have focused on two aspects:

        • Residents of Ohio and other regional states outside Kentucky obtain prescriptions for the painkiller, by either legal or fraudulent means. They then resell the drugs in Eastern Kentucky.

        The pills — used primarily to alleviate cancer pain — are highly profitable. Obtained legally, consumers pay as little as 12.5 cents per milligram in Eastern Kentucky for OxyContin. Addicts, however, are paying as much as $1 per milligram — or $40 for a 40-milligram pill.

        • Kentuckians evade an electronic prescription tracking system by crossing into Ohio and other adjacent states to “doctor shop” or use out-of-state pharmacies.

        All prescriptions in Kentucky are tracked by a statewide database called the Kentucky All-Schedule Prescription Electronic Reporting system (KASPER).

        “That's how we stop the doctor-shopping here,” said Mr. Smoot, who works at the Kentucky State Police Post in Hazard. “But that's why everybody's going to Ohio.”

        The “shopping” is not limited to the Buckeye State. OxyContin suppliers and abusers also target towns and cities in neighboring Virginia, Tennessee and Indiana, federal and state investigators said.

        Yet that has not slowed the number of OxyContin prescriptions filled in Kentucky. Data from the state's Cabinet for Health Services shows there were 82,880 prescriptions for the drug were filled in 1999. Last year's total jumped to 156,660.

        National and regional experts say this part of the country seems especially vulnerable to the drug, one of medicine's newest, most promising pain fighters.

        In Eastern Kentucky, for instance, many residents have been injured in coal mines, timber harvesting or accidents. Others suffer from cancer, for which OxyContin is the most effective pain-management drug.

    In a single month, investigators say, it is possible for an OxyContin pusher to make more than $20,000.
    The street value of the pills in Kentucky is $1 or more per milligram. If one individual gets three prescriptions of Oxy (60 pills at 80 milligrams) from different doctors and sells them all, he could generate $14,400 in a month.
    In one extreme case, Kentucky State Police investigators say one father-son-daughter team visited as many as 52 doctors.
    OxyContin (oxycodone hydrochloride) is a narcotic pain reliever derived from opium in a patented time-release form, prescribed to relieve moderate to severe chronic pain.
    • Introduced: 1995.
    • Developer: Purdue Pharma, Stamford, Conn.
    • Revenue generated in 2000: $600 million
    • Cost to consumers: $1.25 per 10-milligram tablet to $14 for a 160-milligram tablet.
    • Length of time-release relief: 12 hours.
    • Common side effects: Constipation, nausea, sedation, dizziness, vomiting, headaches, dry mouth, sweating and weakness.
    • Appeal to addicts: Abusers either grind it and snort it, or inject it. The drug can produce a heroin-like high.
        Kentucky's death rate from cancer is the fourth-highest in the country. Records from the National Cancer Institute show almost 190 Kentuckians per 100,000 died of cancer in 1997, the most recent data available. The national rate was about 164 per 100,000.

        In Greater Cincinnati, police say, OxyContin has become the drug of choice for pharmaceutical abusers, making an unprecedented leap in popularity. Since it appeared on the illicit market about a year ago, Tristate police have confiscated more than 13,000 doses of OxyContin.

        Experts say that is one of the highest totals in a city the size of Cincinnati in the nation. However, there is no comprehensive federal data to support that because OxyContin abuse is so new.

        Even increased police investigations and the threat of federal prison have not slowed the OxyContin pipeline to Kentucky, authorities say.

        The drug has a firm grip on many of its addicts. Abusers often grind it and snort it, or it's injected. The narcotic produces a heroin-like high when it is abused.

        “The need for the drug outweighs the fear of prison,” Mr. Smoot said. “You can't grow it and you can't make it. If I could have an OxyContin tree, I'd be in business.”

Tristate connection
        Details of the multistate pipeline began to emerge after the Feb. 6 raid in Eastern Kentucky. After an 8-month investigation, federal agents and local police arrested 207 people, ranging in age from 20 to 65.

        Fifty-two people were arrested on federal charges and 155 on state violations, all drug-related. Those arrested included upper-middle and mid-level drug dealers, along with street dealers and abusers.

        The investigation focused on Perry, Pike, Harlan and Clay counties.

        One Cincinnati-area man and his nephew from Hazard, Ky., were arrested and indicted on drug charges in the raid.

        Investigators say Willie Baker, 61, of Newtown, took to Hazard his own prescription pills and those of his relatives after his nephew, Gary Baker, 38, had found a buyer in Eastern Kentucky. Investigators did not know how or why the elder Mr. Baker had an OxyContin prescription.

        “He had an avenue to get rid of them (pills) down here,” Mr. Smoot said. “We bought from them a month prior (to the raid) and then his nephew called and said he had plenty and did we want more.”

        That's when, undercover agents say, they bought $1,000 worth of pills from Willie Baker and found 90 more 80-milligram pills in his pockets.

        Three other Ohio men also face drug charges stemming from the February raid.

        One is Todd Morris, 31, of Middletown. The other two, authorities say, are father and son — James and Joseph Miller, of Dayton, Ohio.

A region's drug of choice
        Federal agents and regional police were drawn to Eastern Kentucky last summer after complaints about the presence of OxyContin dealers and abusers began to surface in Hazard. The city of about 5,400 is the seat of Perry County government.

        So great was the community's concern that in October, 400 residents attended a Hazard church meeting to talk about the evils of OxyContin. Lives were being destroyed, they said. Teens were stealing from parents. Adults were breaking into homes.

        “The community is standing up and saying, "We are here. We will not give up,' ” said the Rev. Ronnie “Butch” Pennington of Petrey Memorial Baptist Church.

        The centerpiece of the community's anger: drug transactions in Perry County Park.

        So many drug deals were observed and so many syringes were littering nearby streets that residents began to call the area “Pillville.”

        In that park — with its ball fields, swimming pool, playground and tennis courts nestled against Kentucky's highest mountain peaks — undercover officers conducted surveillance and scored their first buys.

        Officers discovered that the elaborate OxyContin pipeline had quickly moved a new illegal drug into the region. Just three years earlier, several large busts had virtually wiped out a cocaine distribution system in those same counties.

        The February raid is just the first step to ridding the region of OC.

        “We do anticipate further arrests,” said Roger West, assistant U.S. attorney.

Stopping the flow
        Kentucky officials say the very device that created the need for the multistate pipeline — the commonwealth's computerized KASPER system — may be the solution to shutting down the OxyContin flow.

        Kentucky's KASPER prescription tracking database acts as a protective bubble. It allows law enforcement and medical personnel to track every prescription written and filled in the state. Authorities use the data to target doctors who prescribe drugs incorrectly and the patients who abuse them.

        KASPER was created in 1998. Its founding came two years after the U.S. Drug Enforcement Administration reported that Kentucky was second in the nation in codeine consumption and 13th in in Oxycodone (Percodan, Percocet, Tylox) consumption.

        Sheriffs, state police and school superintendents testified about the severity of prescription drug abuse to Attorney General Ben Chandler's Prescription Drug Abuse Task Force in 1996.

        Kentucky is one of 17 states, including neighboring Indiana, with similar systems.

        But because the 17 systems aren't linked, those determined to obtain drugs illegally can cross Kentucky's border undetected, said Kathy Keough, executive director of the National Association of State Controlled Substance Authorities, based in suburban Boston.

        Authorities know that Kentucky's drug traffickers and abusers are aware of the computerized watchdog. That's why they try to fill prescriptions in such border towns as Cincinnati; Big Stone Gap, Va.; and Austin, Ind.

        The increase in the use and movement of OxyContin has Kentucky officials lobbying other states to use a system similar to KASPER so information can be shared.

        “The system we put in place is absolutely critical to solving this problem,” Mr. Chandler said. “We don't want to be exporting the problem just because we have a good monitoring system.”

        Other states seem willing to listen.

        Virginia Attorney General Mark Earley is so concerned about the problem in the region that he has invited attorneys general from seven states — Ohio, Kentucky, Indiana, West Virginia, Maryland, Tennessee and Pennsylvania — to a March 1 meeting in Richmond, Va.

        Also invited are officials from Purdue Pharma L.C., the Stamford, Conn.-based company that makes OxyContin. A member of Kentucky Gov. Patton's newly-formed task force charged to attack the proliferation of OxyContin will attend.

        “We need to work together to solve this problem,” Mr. Chandler said.

The faces of OxyContin
Altered Oxy in the works


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