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Warning: This Drug Can Kill You

OxyContin was supposed to be a miracle prescription for chronic pain. Now it is rapidly becoming a street drug of choice—and of death

By Nancy Guerin

Kevin Dively will never forget the first time he met his best friend, Jesse Gifford. Dively was 12 years old when he moved next door to Gifford on Route 405 in Greenville.

“Jesse was two years younger than me,” says Dively. “I was riding around on my four-wheeler when I saw this punk-ass kid standing on the seat of his dirt bike. I knew I liked him right off the bat.”

From that day forward, Kevin, Jesse and Jason, Kevin’s older brother, formed a friendship that they all thought would last a lifetime. As they got older, their interests turned from dirt bikes, skateboards and four-wheelers to music. By the time Gifford was 16, the three of them formed their first rock band, called the Boogie Woogie Bums. They later became known as the Derogatories, a punk band, and started playing the local bar scene in Albany. Soon they branched out of the area and traveled the country, learning what it was like to scrape by on a sometimes-working musician’s salary.

Just as Kevin proudly remembers the many funny, frightening and unforgettable stories of their life on the road and in Albany, he also sadly remembers the last night that he saw his 23-year-old best friend alive, back on July 13.

“We met up at the Blues Festival this summer at the plaza,” Dively explains. “As soon as I saw him, I knew he was kind of messed up, but I wasn’t sure exactly what he was on.”

Dively says that Jesse later admitted to him that he was high on the drug OxyContin, a prescription painkiller.

“I remember he had tried OxyContin before, but he said he was really freaked out by how strong it was so he threw it away except for a few pills,” says Dively. “But that night he had the tablet broken up into pieces. He was taking little bits of it throughout the night. And before he left the bar I was told that he took another tablet whole.”

Dively says he thinks Gifford got the pills from some guy who worked as a pharmaceutical distributor.

After the Blues Festival, they all went out to Smitty’s Tavern on Washington Avenue. Dively says it was a great night because the guys in the band decided, after a two-year hiatus, to get back together.

“We came up with a few ground rules that night,” says Dively. “For one, no more partying, we were going to be serious about our music. I know this made Jesse really happy because the band meant everything to him. Jesse was the kind of guy who did everything to extremes, so when it came to music he would go over the top. If he had a date he would break it to play music. The band always came first.”

But the next morning, when Dively was eating breakfast at Quintessence and reminiscing about the night before, he received a phone call.

“It was Jesse’s girlfriend and she just said that he was not breathing,” recalls Dively. “We all flew over to his apartment as fast as we could. When we arrived, there were two cops at the front door. They wouldn’t let us in. They just asked what kind of drugs was Jesse on. When I told them OxyContin, the cops’ reply was, ‘Oxy what?’”

“I had no idea that this could kill him, and I don’t think that Jesse did either,” says Dively. “I don’t think Jesse wanted to die. I just don’t think he knew the power of the drug that he was taking. And I don’t think that other people know how dangerous this drug is as well.”

While the coroner’s report has not yet been released confirming the actual cause of Gifford’s death, his parents, Randy and Yvonne, are convinced that the senseless loss of their son’s life was the result of an overdose from the drug OxyContin.

Shattered lives: Randy Gifford holds a photo of his son Jesse. Photo by Joe Putrock.

“I never even heard of this drug before,” said Randy Gifford, Jesse’s father. “I don’t know why more people are not warned about it. Since my son’s death, many people have come forth and told me stories of people that they know that have died from this or that are addicted to the drug.”

While Jesse’s story may sound strange to the people who have never heard of OxyContin, the abuse of this prescription painkiller has been creeping its way into cities and suburbs across the eastern United States for the last five years. Abuse of the drug was first reported in remote communities in Appalachia and rural Maine, but many are saying that this pill is quickly becoming the drug of choice for young people in the Albany area.

“When I spoke to the coroner about Jesse’s death,” says Dively, “he told me this was the third overdose from this drug he has seen recently. People have no idea how addictive this drug is and how deadly it is. People just think it’s another party drug, but they are dying from it.”

OxyContin, OX, Oxy, killer, hillbilly heroin and poor-man’s heroin are just a few of the many street names that people call the drug. First introduced in 1996 by Purdue Pharma L.P., the drug was thought of as a miracle pill for those suffering from chronic pain.

Treating addiction: Dr. Bruce Maslack, specialist at St. Mary’s Hospital. Photo by Joe Putrock.

“This was the first drug of this kind,” says Dr. Bruce Maslack, an addiction specialist at St. Mary’s Hospital in Amsterdam, “that could give people the long-lasting pain relief that they needed, without the groggy effects that they would obtain from other, stronger painkillers because of the drug’s time-release mechanism that allows patients to get the medicine in small doses over a long period of time.”

But the drug that was once praised for its potent ability to help manage pain is quickly gaining the reputation as the country’s most pernicious street drug.

According to Maslack, the high that most people chase is from OxyContin’s most active ingredient, oxycodone, an opioid or synthetic opiate, which is found in other pain-relief drugs like Percodan and Tylox. However, OxyContin contains a much higher concentration of oxycodone than other prescribed medicines. Where painkillers such as Tylox may contain 5 milligrams of oxycodone, OxyContin can include between 10 and 80 milligrams, depending on the dosage.

Maslack says that when used properly, the pill is swallowed whole. It can alleviate discomfort for up to 12 hours, the longest-lasting pain relief medicine on the market to date. Doctors prescribe the drug for severe or chronic pain often associated with cancer or back injuries. But those who are taking the drug for recreational purposes are crushing it up to eliminate its time-release capsule. Maslack adds that by doing this, users receive a full dose of the drug at once, giving them a euphoric high very similar to that found in other opiates like heroin and morphine. Abusers chew, sniff or shoot up the drug.

“For pain-medication purposes, chronic-pain problems, this drug is a very effective way to deliver the medicine,” says Maslack. “The problem is that you can easily defeat the sustained release by chewing up or grinding up the time tablet. Then all bets are off to how much you are getting at once.”

This, he explains, is why most people are overdosing from the drug. “The user is getting all that was supposed to be delivered in a 12-hour period at once, because you have sort of beat the system,” says Maslack. “The question then becomes, are you tolerant enough so that you don’t have respiratory depression, the common way that people die from it.”

OxyContin is highly addictive if it is not taken as prescribed. The user develops a physical dependency to the drug, causing withdrawal symptoms very similar to those of heroin abuse, which include violent flulike symptoms. Maslack adds that he has not seen a large amount of OxyContin abuse in this area so far, compared to where he used to work in rural Maine.

“The big drug around here seems to be heroin,” said Maslack. “When I practiced in Maine it was OxyContin because heroin was less available. It’s a matter of availability. This drug is widely distributed as a pain medication, so you can get it everywhere. You can’t get heroin everywhere.”

According to the U.S. Drug Enforcement Agency’s Web site, as of Nov. 1, 2001, medical examiners in 31 states reported 1,096 overdose deaths involving oxycodone. The reports verify that 117 of those deaths were the result of OxyContin. Statistics were not available for the drug’s use specifically in the Albany area, or for New York state. But the Drug Abuse Warning Network reports that oxycodone-related deaths and emergency-room visits more than tripled since 1996, when the drug was first put on the market. In 2000, the organization reported approximately 10,825 oxycodone-related ER visits, resulting in 268 deaths, compared to 51 deaths in 1996.

‘If there was one drug I could do that would not be dangerous, I’d be doing OxyContin all the time,” says Michael, a 17-year-old Albany resident. “You are just so relaxed, it’s not even right. I can’t imagine anyone having pain that bad that they would need a drug so strong.”

The first time Michael tried the drug, he was living in Pennsylvania. His friend stole the pills from his uncle, who had a prescription because of chronic back pain. But usually, he adds, it’s easy to buy it if you know where to look. Michael explains that the pill comes in different doses ranging from 10 to 80 milligrams. The color of the pill also varies depending on the prescribed amount. On one side is the number of milligrams, and on the other are the letters OC.

“It cost around $20 to $30 dollars a pill, depending on the dosage,” says Michael. “I am not sure exactly how long the high lasts because I pass out every time I take it. All the warning out there about this drug is for real. It is dangerous, and I can see how it could become very addictive, because anybody who would try it would like it and would want to do it again.”

Angel, a 32-year-old OxyContin addict, knows all too well how easy it is to become hooked on the drug. She moved to Troy two years ago from Tampa, Fla., to get off OxyContin. But just this past summer, she relapsed on the drug and has had a hard time staying clean ever since. “When I first moved here, nobody ever even heard of the drug,” says Angel. “But now I wouldn’t say that it is everywhere, but you sure can find it.”

Angel says that she first tried the drug at a nightclub in Tampa, but it wasn’t until she started looking after her grandmother, who is dying from cancer, that she started to form an addiction.

“I had heard about the drug, and noticed that was what my grandmother was taking,” says Angel. “This drug has made me do things that I never dreamed of doing.”

Angel says that at first she would steal one or two pills from her grandmother’s prescription bottle. But she quickly started to develop a tolerance and needed more to feed her habit.

“Soon, I was stealing five or 10 at a time from her and replacing them with other medicine like aspirin or whatever I could find that looked like her prescription,” says Angel. “After a while, I was giving her aspirin, watching her screaming in pain and telling her I had no idea why her pain medicine wasn’t working. Meanwhile, I was high as a kite, nodding off, wishing that she would just settle down.”

Patty Wilcok, clinical director at Conifer Park, a drug treatment facility in Glenville, says that she has seen a rise in clients who abuse OxyContin, especially teenagers.

“We have seen a large increase in the past year,” she explains, “mostly in our adolescent unit. But it is hard to say how many come in addicted to just this drug, because with younger people, there is usually more than one addiction”

She explains that many people, especially adolescents, don’t realize the danger in abusing pharmaceutical drugs because it doesn’t hold the same connotation as “hard drugs” like heroin or crack cocaine.

“It’s really tricky,” says Wilcok. “The fact that it doesn’t hold the same stigma as heroin leads to part of the problem. Heroin addicts that sniff the drug think that they are not so bad because they are not shooting it up. OxyContin addicts think they are not so bad because they are not doing heroin or crack. The problem is that they are playing a dangerous game, and they either develop a serious addiction or die from an overdose.”

Joseph LaCoppola, program director at Whitney Young Methadone Maintenance Program, says that he hasn’t seen many people seeking treatment for OxyContin addiction. But, he explains, this may be because it takes time for an addiction to develop in a community before people start seeking services.

“I am concerned that it can become the next big drug,” says LaCoppola. “When I was at a program down in Alabama, OxyContin was the primary drug of choice for most patients. There is a concern that it may spread to New York.”

Wilcok adds that the possibility of OxyContin infiltrating this area is very likely, especially since her facility sees many patients from Vermont, where OxyContin seems to be taking the state by storm. An article written in The New York Times on July 21 says that Vermont actually has cut off state welfare funding for OxyContin because of its high levels of abuse.

“I am not sure why this drug is so prevalent in Vermont,” she adds,” but many of the clients that we see from there are addicted to the drug.”

Word on the street is that the drug is already here and is becoming more popular by the day. “It’s not hard to find it,” says Jody, 23, who lives in Albany. “It seems like this summer it became the thing to do. It went from people saying ‘Oxy what?’ to saying ‘So-and-so has some OxyContin, let’s go party.’”

Drugstore cowboy: Watervliet Pharmacy was robbed for OxyContin. Photo by Joe Putrock.

While some local treatment facilities may not be seeing an influx of OxyContin addicts, drugstores across the nation are. The DEA reports an increase in the number of robberies of pharmacies and residences specifically for OxyContin. Just this past April, Watervliet Pharmacy was robbed by a man with a gun seeking OxyContin. Kelly Gilchrist was working the night that the robbery took place. She said that the man entered the store around 8:15 and was shopping for greeting cards. At 8:30, just before closing, he handed the pharmacist a note that stated that he had a gun and wanted OxyContin.

“We saw the handle of his gun sticking out of his pants,” she says. “So we unlocked the draw where we kept the OxyContin and he took all of the bottles that we had. He then apologized and walked out of the store.”

She explained that as a result of the robbery, the pharmacy will carry the drug only if it has a special order to fill for a customer.

James Miller, spokesman for the Albany Police Department, says that this is a difficult drug to control because of the way in which it is distributed.

“It’s not your typical street drug,” he says. “It’s not being sold on the street corner where you can visually see it, like a simple investigation. This takes more time, more investigative work to delve into it.”

He explains that the whole sector of users is difficult to infiltrate, because it is the college crowd that, he says, secludes themselves.

“It is not the easiest atmosphere to get into from a street perspective,” says Miller. “We have our eye on it. We are aware that it is out there, but as far as a priority goes right now, its use has not risen to the point where we can just take all of our resources and focus specifically on that right now.”

But for Purdue Pharma, prevention and education has quickly become its latest public relations campaign. Jim Heins, associate director of public affairs at Purdue, says that his organization has been working with various law enforcement agencies and with the medical community on prevention and education efforts that, he hopes, will curb the abuse while still making sure that the medication is available to the patients who need it.

One method under consideration is to put the narcotic blocker naloxone in OxyContin tablets. If the tablets are crushed and then sniffed or injected, naloxone would enter the bloodstream to block OxyContin’s effects. But Heins said that even clinical trails for this approach are years away.

“There are 50 million Americans that are living in chronic pain,” said Heins. “The vast majority of that pain is undertreated, so undertreated pain is the real national health problem and all of the focus and attention on diversion and abuse of OxyContin, while valid, is actually having a negative impact on the treatment of pain.”

But many lawmakers and other officials have accused the pharmaceutical giant of being too successful at promoting its drug. According to an article written in The Miami Herald on Dec. 13, 2001, Asa Hutchingson, a DEA administrator, told a House Appropriations subcommittee that the drugmaker’s aggressive marketing practices have made the drug readily available. The Herald reported that the number of OxyContin prescriptions nationally has grown to 5.8 million.

Paul Goldenheim, Purdue’s executive vice president, responded by saying that the allegations were untrue. He told the committee that the company has worked with the Food and Drug Administration to strengthen warnings on OxyContin package inserts and helped law-enforcement officials develop placebo tablets used in sting operations.

But many members of Congress are unconvinced and have sought an investigation into how the manufacturer marketed and promoted the powerful painkiller. And some state legislatures have proposed stringent laws to deal with the OxyContin epidemic in their streets. The Wall Street Journal reported in February 2002 that lawmakers in Florida, Ohio and Pennsylvania have pitched proposals to tighten physicians’ standards for prescribing the medicine, set up prescription-tracking systems to catch fraudulent users, and strengthen sentencing laws for offenders. In Maine, tougher penalties have been enacted for illegally selling OxyContin and other prescription drugs.

For Randy and Yvette Gif-ford, all the legislation and research in the world can’t turn back the hands of time and protect their only child from what happened to him on the morning of July 14. Their only consolation, they say, is that others will learn from Jesse’s tragic life cut short.

“The morning that I heard the news of Jesse’s death just keeps flashing in my mind,” says Yvette Gifford, tears streaming down her face. “My stepdad called me over and said Jesse went to sleep last night and he didn’t wake up. He is at Albany Med and he is dead. I felt like running but I didn’t have anywhere to go. This is something that no parent should ever have to go through.”

“It just doesn’t make sense,” says Randy Gifford. “It is not supposed to happen this way. All of the dreams and hopes that we had for our son are gone and nothing can bring him back. We just hope that one person can learn from what happened to Jesse so another family doesn’t have to live with the pain and sadness that we are dealing with as a result of OxyContin.”

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