South, Appalachia beset by painkiller abuse

[almaty 19]

GILBERT, West Virginia (AP) -- When his craving for painkillers got to be too much, Steve Dotson lay down and let his wife drive a car over his leg. It hurt, but he could dismiss the pain with thoughts of the medicated bliss that would follow.

Steve Dotson lived under this bridge when he was addicted to prescription painkillers.

Soon, he lost his house, the state took his children away and he was spending nights under a bridge, where he hoped to die.

"You get to where you don't even want them (pills) anymore. You just do them so you can get through the day," the 43-year-old southern West Virginia resident said.

Dotson is one of millions of Americans who has experienced the harm that can come from addiction to the prescription narcotic hydrocodone. Less regulated than similar prescription painkillers, drugs containing hydrocodone have quietly become the most widely prescribed -- and, perhaps, widely abused -- opiate painkillers on the market.

With 124 million prescriptions in 2005, drugs containing hydrocodone are the most popular of their type in the country, according to the U.S. Drug Enforcement Administration's Office of Diverson Control. These drugs are sold under hundreds of brand names and generic titles, and hydrocodone can be found in medication ranging from cough syrup to painkillers.

The most commonly prescribed product combines hydrocodone and acetaminophen, which is marketed under brand names such as Vicodin and Lortab.

The DEA reported in 2006 that legal retail distribution of drugs with hydrocodone had grown by roughly 66 percent nationwide since 2001.

Its illicit use had grown as well, and by 2005, hydrocodone was the most frequently encountered pharmaceutical of its kind in drug evidence submitted to the National Forensic Laboratory Information System. The Drug Abuse Warning Network has said hydrocodone products are linked to more emergency room visits than any other prescription painkiller.

The extent of prescription painkiller abuse in central Appalachia drew national attention about five years ago, when oxycodone was the drug of choice for many people. The drug, most commonly known under the brand name OxyContin, was so widely abused it earned the nickname "hillbilly heroin."

As OxyContin came under scrutiny, doctors were more careful about how they prescribed it. Many switched to hydrocodone products, which were already popular but didn't have the same stigma.

All 50 states saw increases in the distribution of hydrocodone between 2001 and 2005. But the trend was particularly significant in the South, where all the top 10 states in terms of increased distribution are located, according to the DEA. Four of the top five -- Tennessee, West Virginia, Kentucky and Alabama -- include parts of Appalachia.

Authorities say hydrocodone is so popular in this region partly because it's easy to acquire. Street drugs such as heroin are harder to come by in sparsely populated rural areas. Prescription painkillers can be found at every pharmacy and pain clinic, as well as ordered over the Internet.

"When I started in this field, the primary client was involved with alcohol," says David Bailey, a community resource specialist with the West Virginia Prevention Resource Center.

"I wish it were still alcohol. Not that that's not a very dangerous drug, but the addiction (to painkillers) seems to be much more intense, much more severe within a shorter period of time."

It is a mistake to focus on a single drug, said Dr. Peter Cohen, medical director of the Maryland Alcohol and Drug Abuse Administration. He pointed out that while hydrocodone abuse has grown slightly in Maryland since 2002, it is still far less commonly abused than street drugs such as heroin.

From 2005 to 2006, the number of people admitted to Maryland drug rehabilitation programs with hydrocodone addictions grew from 284 to 596, according to figures from the drug abuse administration. But the number of heroin addicts admitted to treatment in the same period stayed at nearly 16,000.

The problem is not hydrocodone or even opiates per se, Cohen said, but addiction itself.

"If you're an opiate addict, you're going to find something, based on what's available and what you prefer," he said.

The DEA is considering moving drugs containing hydrocodone from being classified as so-called Schedule III drugs to being Schedule II drugs. The reclassification would mean it would be harder to obtain refills. Doctors and pharmacies would also have to keep more stringent records about how many prescriptions are written and filled.

Dotson has been off drugs since a religious experience in 2001. He got a job and is a board member of Strong Through Our Plan, a local anti-drug group.

He is determined to stay off drugs, and recently chose to pull out his own tooth with pliers to avoid the temptation of receiving a prescription for a hydrocodone-based painkiller after the extraction.

On a recent day, Dotson pointed out the spot under the bridge where he lived and pointed to the spot in the Guyandotte River where he was baptized after getting clean. Not all of his friends were so lucky, he said.

"You've got three choices," he said. "You either die, go to prison or get saved. Mostly, people around here are dying." E-mail to a friend

[Sinergy 3]

hydrocodone wonderful s**t that is

Oh but i never asked anyone to phsycally harm me to get my hands on the pain candy

Edited August 21, 2007 by Ionescu

[Caladan 19]

I read once that the average drug addict is a middle-class, white, suburban housewife addicted to painkillers. I have no idea if that's accurate, but it wouldn't surprise me because painkillers are some potent sh!t.

[Sinergy 3]

I read once that the average drug addict is a middle-class, white, suburban housewife addicted to painkillers. I have no idea if that's accurate, but it wouldn't surprise me because painkillers are some potent sh!t.

They make the emotional boo-boos go bye bye (was addicted to vicodin when i was a teen, thats when i was messed up, im normal now )

[almaty 19]

there is a major shift ....people over 40..getting hooked..and hillybilly herion leading the way...

[Sinergy 3]

there is a major shift ....people over 40..getting hooked..and hillybilly herion leading the way...

hillbilly heroin??

[Caladan 19]

I read once that the average drug addict is a middle-class, white, suburban housewife addicted to painkillers. I have no idea if that's accurate, but it wouldn't surprise me because painkillers are some potent sh!t.

They make the emotional boo-boos go bye bye (was addicted to vicodin when i was a teen, thats when i was messed up, im normal now )

I had a prescription for some kind of synthetic opiate a couple years ago when I banged up my tailbone. I didn't get addicted, but man, those pills were fun.

[almaty 19]

I read once that the average drug addict is a middle-class, white, suburban housewife addicted to painkillers. I have no idea if that's accurate, but it wouldn't surprise me because painkillers are some potent sh!t.

They make the emotional boo-boos go bye bye (was addicted to vicodin when i was a teen, thats when i was messed up, im normal now )

I had a prescription for some kind of synthetic opiate a couple years ago when I banged up my tailbone. I didn't get addicted, but man, those pills were fun.

did you mix them with alcohol?

[Sinergy 3]

im still stuck on hillbilly heroin

[Caladan 19]

Only once. Opiate + glass of wine = suddenly too tired to breathe.

[peejay 327]

Only once. Opiate + glass of wine = suddenly too tired to breathe.

A word of advice...stick with beer...you'll get fat and sleepy before you OD.

And it tastes good!

[almaty 19]

Only once. Opiate + glass of wine = suddenly too tired to breathe.

i was curious, as allot of folks do drink and get totally smashed and unable to walk

[Caladan 19]

I hadn't realized how strong they were!