editorial comment Good idea! Let's put more people in prison! It's working so well elsewhere....

By Pat Reavy
Deseret Morning News

Abuse of the popular painkiller Oxycontin has caused problems for law enforcement and doctors for years. Now the rising popularity of two other drugs is causing added concern along the Wasatch Front.
The drugs are Palladone capsules, an extended-release pain medication more powerful than Oxycontin that has been on the market since September, and Carisoprodol, a muscle relaxant sold under the brand names Rela and Soma, and reportedly the 14th most abused street drug in the nation.
Law enforcers are not the only ones concerned about the emergence of more drugs with the potential of abuses. The medical community throughout the Mountain West is also worried, and some states are taking steps to curtail abuse.
According to R.K. "Mick" Markuson, executive director of the Idaho Board of Pharmacy, the biggest problem with Carisoprodol is that it is not scheduled.
Drugs are typically divided into five "schedules." Each category comes with a certain set of licensing requirements and other restrictions concerning production, possession and distribution of the drug.

"Because Carisoprodol is not a scheduled drug, abuse is underreported. However, Carisoprodol is increasingly being found in post-mortem drug tests done by the coroner," Markuson said during a recent lecture in Idaho.
Markuson made his comments to the Idaho Nurses Association Legislative Committee in support of a bill introduced in the Idaho Legislature that would add Carisoprodol to the list of Schedule IV substances. Oregon lawmakers have already passed a similar bill and legislators in Washington were considering it, he said.
Michael Crookston, medical director of the Day Spring chemical dependency program at LDS Hospital, agreed that unscheduled drugs are much easier for abusers to get.
"Of all the muscle relaxants, (Soma) is the most abused," he said. "It's the most dangerous drug. It should be a controlled substance. Virtually anyone in addiction treatment thinks it should be a controlled substance. I don't prescribe it."
Despite concerns within the medical community, Utah law enforcement officers hope efforts that kept other problems in check, namely the popular club drug Ecstasy, will also help prevent the prescription drug problem from getting out of hand. Although methamphetamine remains the biggest challenge for Drug Enforcement Administration agents in the state, resident agent-in-charge Barry Jamison said the abuse of prescription drugs is the fastest-growing problem.
"Certainly we have an Oxycontin problem. Ours is probably a little less than other areas. But the whole idea is to keep it under wraps," Jamison said.
Heavy media coverage plus strict enforcement by drug agents combined to keep the Ecstasy problem from exploding in Utah, and Jamison hopes to see similar effects in the agency's efforts to combat Oxycontin abuse.
Officials attribute the continued Oxycontin problem to the drug's easy accessibility, through the Internet and other sources.
"It's huge," said Crookston. "People I talk to don't describe any problem whatsoever finding Oxycontin. It's cheaper now than it has ever been. It's readily available."
Effective painkillers and muscle relaxants can be a godsend for those who legitimately need them, but Jamison said that the better the drugs work in the medical arena, the more they are highly sought after by abusers.
"These medications work very well. We are not against these medications. We are against the abuse of these medications," he said. "The better these medications are at suppressing pain, the more abuse potential they have."
Prescription drug abusers come from all walks of life, but many officials report being most concerned about rising abuse among juveniles. One high school-age patient told Crookston it was easier to obtain Lortab in one particular Salt Lake County high school than it was to get cigarettes.
A recent USA Today article cites two surveys that show Oxycontin has surpassed Ecstasy in popularity among American teens.
Prescription-drug-related incidents in high schools is indeed a growing area of concern, Salt Lake County Sheriff's Sgt. Shane Hudson said.
The sheriff's office helps monitor seven high schools in the county. There were approximately 100 drug- and alcohol-related arrests during the 2004-05 school year from all seven schools, Hudson said. Only one of those arrests, however, was for Oxycontin.
But Hudson said that doesn't count the many teens who consume drugs at houses where parents aren't home during the day.
"We hear things through the rumor mill and grapevine at school," he said. "The information we're hearing is that prescription drugs are becoming more popular among the kids."
Students who abuse prescription drugs get them most often from one of two sources — either by stealing the pills from their parents' medicine cabinet or ordering them through the Internet, Hudson said.
Doctors such as Crookston agree that Internet sales of narcotics are skyrocketing, as is students' knowledge of the prescription drugs.
"Virtually every high school kid knows what Lortab is," he said, recalling one patient who was spending up to $2,000 on the Internet to purchase Lortab and Soma.
In February, South Jordan police announced they had arrested a 17-year-old boy who allegedly bought anti-convulsant via the Internet from a company in India with the alleged intent of selling them to other students.
The teen allegedly gave some of the pills to friends, who later suffered serious health problems. He eventually pleaded guilty in juvenile court to drug-related charges and was fined and put on probation.
That arrest led police to an even bigger drug operation and the arrests of six people, including one who was shot by police after he allegedly tried to run them over with his car.
Part of the allure of prescription drugs in preference to alcohol or other drugs is that they are much "cleaner," officials say. But once a person is hooked on prescription drugs, the abuse can often progress into something much bigger, such as illicit street drugs.
Once taking Oxycontin pills straight fails to have the desired effect, abusers often start crushing the pills open and snorting them for a bigger high. When that high no longer satisfies an abuser, or once an abuser can no longer afford the fairly expensive pills, Crookston said it is a natural progression to move on to the less expensive heroin.
"I had one (patient) who never smoked or drank but got hooked on oxy," he said. "People who never dreamed they would be a heroin addict . . . started with prescription drugs."
The allure of profit from the prescription-drug trade can also be great, Crookston said. At up to $40 per pill, people who obtain their pills legally can make a little extra income by selling off a couple of extra pills on the street.
What many teens and some adults tend to forget is that selling "extra" pills is a felony offense, Crookston said.
That makes it vital for doctors to be careful and alert when prescribing the powerful medications, Crookston said, especially in light of the fact that abusers often become experts at lying to their doctor — or multiple doctors — about illnesses and pain to obtain more drugs.
Even as law enforcers watch abusers, they also keep a close eye on the doctors who prescribe the medication.
In May, the licenses of a Salt Lake doctor and his assistant were suspended following an investigation of insurance fraud and a drug distribution scheme. The doctor allegedly prescribed nearly 74,000 tablets during the past 12 to 16 months, more than 24 times the average amount for other doctors.



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E-mail: preavy@desnews.com

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