Law officers expect a problem which started in the northern mountains to make its way into the coastal plain.

Abuse of Oxycontin, a high-powered pain medication, is on the rise. The narcotic is sometimes referred to as the Smoky Mountain High, or Appalachian High, because its abuse roots go back to the coalfields of the West Virginia, Pennsylvania, and Kentucky mountains.

"We will see it eventually," said Chief Deputy Phillip Little of the Bladen County Sheriff's Department. "It is just a matter of time."

"Safety" increases draw

Oxycontin is manufactured by the Perdue Pharmaceutical Co. The drug is supposed to be used by people with chronic pain, such as cancer patients and those recovering from major surgery.

The fact that the drug is legitimately manufactured makes it even more attractive to drug dealers and users.

"With heroin or crack or crystal methamphetamine," Little said, "the buyer might not know what was used to 'cut' the drug (a process in which dealers mix other ingredients with pure drug to make a saleable product.)"

"With most drugs, the purity could be such that it could cause an overdose," Little said. "A hit might not be enough to make you high-or it might be enough to kill you."

"With Oxycontin," Little said, "the dealer and the buyer take advantage of a major corporation's quality control systems. A 25 milligram pill is a 25 milligram pill when it is inspected, packed in a sterile container, and shipped to a pharmacy."

The drug sells for between 50 cents and $1 per milligram. Pills come in various sizes, from 10 to 160 milligrams each.

The quality control also makes Oxycontin attractive to teen users, Little said, who think the drug is safer to abuse because it is legitimately manufactured. That false sense of safety has led to an increase in teen deaths from Oxycontin overdose.

"There is no drug that's safe to abuse, period," Little said.

Illegal sales of the drug have skyrocketed in some areas, Little said, eliminating cocaine, heroin and crystal meth as preferred street drugs.

Little said abuse of the drug started in coal mining communities, where doctors regularly prescribed the drug to people with chronic back pain, cancer and respiratory ailments, as well as major injuries.

Recreational use has been reported since the 1990's, Little said, but widespread abuse is a fairly recent development.

"Law enforcement agencies across the nation have started reporting more and more overdoses from Oxycontin," Little said. "They just suddenly started showing up, where they had been only a minor amount of abuse before."

"Cocaine has to be imported, processed, and then delivered," Little said. "The risk there is tremendous. With Oxycontin, it could easily be in a medicine cabinet, or stolen from a pharmacy. Pills can be hidden much more easily than a kilo of cocaine, or a bale of marijuana."

"If a user is caught with the pills," Little said, "it's far easier to explain away than a bag of pot."

Used like cocaine

The drug can be swallowed in pill form, or crushed into a powder and used like cocaine or heroin.

It can even be prepared in such a way to allow smoking like crack cocaine.

When it is changed from its prescribed pill form, Little said, the drug can be even deadlier than heroin.

"When the drug is reduced to a different form," Little said, "there's no timed release. It's like taking the drug in its purest form, uncut. An overdose is very, very easy."

Oxycontin is known by a variety of street names, such as Killer, OC, Oxy, and Oxycotton. A person high on the drug is said to be "Oxidized," Little said.

Many times, Little said, the drug is obtained through burglaries or armed robberies of pharmacies and drug stores.

Others seeking the drug may target a person who has been prescribed the medicine, and break into their home.

Some users go "doctor shopping," Little said, seeking physicians who will readily prescribe the pills. Others steal prescription pads or otherwise forge orders for the pills.

"It's to the point some pharmacists are reluctant to stock Oxycontin," Little said. "Thieves are beginning to target stores where they know it's sold."

Serious after effects

The high is described as euphoric, Little said, similar to that from heroin. Addiction is rapid, and former addicts say withdrawal is "excruciatingly painful," Little said.

"Former users say withdrawal from Oxycontin is far more painful than other drugs," Little said.

So far only one arrest has been made for sale of the drug in Bladen County. A cancer patient was arrested by local narcotics officers for reselling his medication on the street.

"Oxycontin use isn't that widespread around here yet," Little said, "but we know it's coming, and when it gets here, we'll feel the effects."

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