Family deals with
drug-related havoc
by Kelly Feser Eells

"Jane Doe" moved from Santa Barbara to Ojai with husband "John" and their infant son two decades ago. They were young, upwardly mobile professionals, and John soon made his name in charitable causes - while Jane opted to become a "stay-at-home mom."
Their second son, now in his late teens, was born in this "beautiful, spiritual place that represents peace, home and comfort to thousands of people," and the family, by Jane's account, was content.
"I did a pretty good job of mothering," she says with a modest smile. "I home-schooled my kids for several years, was a regular classroom volunteer (when the boys attended public school) and, though we were neither rich nor poor, we always knew love, abundance and happiness."
The Does also know more than a few years' worth of pain. Specifically, the pain of drug addiction; the havoc it can wreak on even the "best of families;" and how difficult it is finding support - local support, especially - in this, "our culture of denial."
A series of sports- and work-related accidents left Jane's oldest child, whom she describes as "a good young man, a lover of life, children, baseball and even good old American apple pie," addicted to Vicodin, a narcotic pain medication widely prescribed from the late 1980s to the present.
Vicodin, or, in its generic form, hydrocodone, is chemically similar to opium (five milligrams hydrocodone is equivalent to 30 milligrams codeine; 15 milligrams is equivalent to 10 milligrams morphine) and is, like oxycodone, e.g., Percocet and OxyContin, classified as a Schedule II controlled substance pursuant to the Controlled Substances Act. (The five controlled substance schedules are separated according to their approved medical use, in diminishing order of their abuse potential. For example, Schedule II substances have legitimate indications for the treatment of severe, acute pain; Schedule I substances, per the U.S. Department of Justice, Drug Enforcement Administration, have "...no legitimate medical uses." Both Schedule I and Schedule II substances, however, are classified as having "... a very high potential for abuse.")
Still, the family's 'real troubles' began one night about four years ago, "when our son ran out of his prescription, and, after complaining of his pain to a 'friend,'" discovered OxyContin.
The drug, Jane notes, "is no different than the heroin that we, as kids, were taught to never use. Except it's actually easier to use, and far easier to get. With OxyContin, there aren't any needles involved; you just crush the pills and sniff them" - thereby removing much of the social and/or psychological stigma associated with heroin use, though other sources say that intravenous use of OyxContin has become common.
Shaking her head, she adds, "OxyContins, or, 'O.C.'s', as the kids call them, are so incredibly easy to obtain. Here in Ojai, by the time our children are 13 years old, some even younger, they'll have been exposed to them God knows how many times: at school, in the shopping centers, right under your nose at the laundromat, and in their best friends' houses. This beautiful, spiritual community has become a dangerous place for our youth, and it's an epidemic that's slowly gaining momentum."
Oxycodone, synthesized from thebaine (a minor constituent of opium) has been around since the early 1960s, most commonly used in painkillers like Percodan and Percocet, prescribed for the treatment of acute, short-term pain. OxyContin, on the other hand, is relatively new. It was developed in late 1995, and by early 1996, was already being hailed as a "miracle drug," able to take away the pain of the dying, terminally ill cancer patients, and just about anyone suffering from a chronically debilitating condition. Indeed, its distributors, Purdue Pharma, L.P., as well as the DEA and the Food and Drug Administration, acknowledge that it "...contains a much higher concentration of thebaine" than any other licit opioid. And a spokesperson for an East Coast pharmacy chain (which has, in response to both a spike in armed robberies and select state mandates to "prevent diversion of the drug to illegitimate dealers," quit stocking OxyContin), called it "the closest thing to heroin you can get."
"This drug," Jane sighs, "doesn't discriminate against class, sex or religion. Our kids, you, me, anyone, can become addicted in one use; it's that powerful. Yes, it takes away the pain. And a whole lot more. It's just doing what it's supposed to do."
OxyContin is, as Jane states, "just doing what it's supposed to do." And that is why patients rights groups, hospice workers, oncologists, and a variety of health care professionals across the country are reluctant to support any of the growing grassroots efforts aimed at imposing stricter government control of the drug.
The Drug Abuse Warning Network, billed as a "national surveillance system" sponsored by the Substance Abuse and Mental Health Services Administration branch of the U.S. Dept. of Health and Human Services, reports that OxyContin prescriptions have increased from some 300,000 in 1996 to close to seven million in 2001. Still, Dr. Russell Portenoy, board member of the American Pain Foundation and consultant to an "oxycodone discussion panel" convened last year by the FDA and the DEA, spoke for a majority of nationally prominent medics when he said that, "imposing (further governmental) restrictions would have the unintended effect of reducing access to patients who genuinely need it."
No one argues that OxyContin abuse is disproportionately higher than abuse of other oxycodone-based medications; another DAWN report, released last December, claims that oxycodone-related deaths "have increased by 400 percent" since Purdue Pharma's product first appeared on the market.
But that doesn't address the fact that all drug overdoses are the result of intentional misuse, from taking medications that weren't prescribed to mixing the ones that were with alcohol and/or other substances, to suicide. It just happens that OxyContin is much "easier" to overdose on than any other oxycodone, described by patients rights activists as "a lifesaver for the millions of pain-afflicted people who legitimately need it."
So easy, apparently, that the DEA has taken the unprecedented step of scrutinizing a specific brand, as opposed to entire class - like methaqualone, marketed as a "safe barbiturate substitute" from 1965 until 1984, when it was reclassified as a Schedule I controlled substance - of drug. In response to such scrutiny, Purdue Pharma has removed its highest strength OxyContin, the 160-milligram tablet, from the market and is currently working with the FDA on the development of an "abuse-resistant" form of the pain relieving tablets.
In addition, the company is distributing educational kits designed to "help physicians distinguish between real pain sufferers and fakers," kits that include, among other things, "tamper-proof prescription pads."
Unfortunately, none of these measures seem to have helped make OxyContin any less available to Ojai Valley youth.
"When my son realized he couldn't get off this drug without help," said Jane, "he and his friends got together for 'meetings' to try and help one another. But, sadly, these meetings fell apart after only a few weeks."
Since that time, "my son detoxed himself twice. My husband and I helped him detox several times at home, and, in between, he detoxed several times in a hospital."
Detoxification is the process by which chemically dependent people return to normal physical and mental functioning by either abruptly or gradually discontinuing use of the chemical they're dependent on. With chronic alcoholism and opiate addiction, the body goes through extremely severe withdrawals - profuse sweating; shaking; nausea; headaches; sometimes accompanied by uncontrollable itching and always accompanied by overwhelming bouts of fatigue, i.e., "the nods" and/or "the chills" - lasting anywhere from five to 21 days. Some people withdraw "cold turkey," others under a physician's care, with or without the assistance of such medications as Antabuse (for alcoholism) and Naltrexone, an opiate blocker that tells the brain it's received the drug it had been dependent upon to release naturally-occurring, "pain-killing" endorphins.
Despite her son's many attempts at detoxification, Jane concedes that, "he couldn't stop."
Between the euphoria delivered by OxyContin itself, not to mention the prevalence of oxycodone-based drugs in affluent, "bedroom communities" like Ojai, her son could manage only a few days' sobriety between detoxification episodes. "In desperation for his life and, frankly, suicidal, he began methadone maintenance last spring. Not a choice he or we thought he'd ever have to make for his life. But, without methadone, there really were only a few 'alternatives' remaining: detox in prison, die on the streets, or, as has sadly twice been the case here recently, die in your own home."
Methadone, a synthetic narcotic developed during World War II as a cheaper alternative to morphine, does not produce a "high." What it does do, per its proponents, as well as the U.S. Dept. of Health and Human Services, Substance Abuse and Mental Health Services Administration, is provide a humane way of weaning opiate-dependent people from street drugs; more importantly, it helps them "shift their focus." Instead of spending their days thinking about drugs or how to score them, they're free, like Jane's son, for instance, to return to "normal life."
Though her son is back at work and is, for the most part, showing signs of successful recovery, methadone maintenance is an intensive, i.e., daily, form of treatment, requiring a minimal six months-to-two-years' commitment.
"My son counts five friends who have entered methadone treatment (programs) in the last few months and, of those five, two have dropped out and are back on OC's. When I asked him what made the difference between those who stayed and those who left the treatment program, he replied that 'one of them didn't want to tell his mother'" he was on methadone. And, without a drivers license, "he simply didn't have a way to get to the clinic for his daily dose.
"Our value system," Jane concludes, "is really skewed."
She indicates that mainstream society's reluctance - "and our own community's refusal, in particular" - to equate 'white collar,' prescription opiates like OxyContin with illicit/Schedule I substances like heroin, mescaline or LSD makes "us all part of the problem. We've all participated in this disease, this growing epidemic.
You hear people say, 'that sort of thing' would never happen here. Not at Nordhoff or Thacher or, God forbid, Villanova.' We were taught that, only those 'bad boys and girls from Watts or Harlem' did heroin. But it's here, and we must all set aside any selfish desire to shield ourselves" from being 'exposed' as parents of drug users. "Ojai has a very dark side, believe me. It is up to each one of us as adults to come out of denial and help our children into recovery. Even now," said Jane, alluding to both recent OxyContin-related tragedies and reports of the drug's potency, "my son has 'friends' who are just starting to use OCs. We have to be willing to be willing to see and hear what we never wanted to. We have to put some time, money and energy into the community so that our young people feel they have a steady, honest, dependable" source of help they can turn to, "without worrying about being ridiculed or disowned."
As parents, "we can attend AA, NA, Al-Anon - which has been a Godsend to me; my son's addiction literally brought me to my knees - and other support groups, and if you're suffering from your own drug or alcohol problem, your kids will need even more support. Encourage them to attend Al-Ateen meetings. They deserve to be able to talk about their feelings and gain relief from this terrible disease just as much as you do. These aren't bad boys and girls' these are our beloved children, and they deserve a chance to become healthy, happy adults."

© 2002 The Ojai Valley News

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