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'Oxycotton' the New Street Drug of Choice for Many


Television and newspaper reports about OxyContin-related arrests in Kentucky prompted many of Swerdlow's patients "to call in and say they weren't going to use the drug anymore because it's bad, it's addictive." That reaction has Swerdlow worried because when the drug is "used medically, as it should be used, it does not cause addiction."

Edward Davis, a 40-year-old who runs a medical billing company in Benicia, Calif., disagrees with Murray and Swedlow.

Davis says he has been hooked on OxyContin for the past year. He began taking it to ease the chronic pain he suffers as a result of a car accident three years ago.

Today, he tells WebMD, "I need about nine 40-mg pills a day." The monthly cost runs from "$1,300 to $1,500, which my insurance company pays," he says.

To "break the cycle and get on with my life," Davis says he tried "going cold turkey, but it was awful. For five days I had tremors, nausea, vomiting, leg pain, diarrhea. I couldn't walk. It was disgusting." On Valentine's Day, Davis will check into the Waismann Institute in Los Angeles for a rapid detox treatment.

Davis' story is pretty typical, says James Mulligan, MD, medical director of the Caron Foundation, a chemical dependency rehabilitation center in Wernesville, Pa. Even when taken as directed, any narcotic can become addictive, he says.

Nevertheless, "long-acting opioids [such as OxyContin] are very appropriate for treatment of chronic pain syndromes," he tells WebMD.

"There are really two types of addiction that we are talking about here," Mulligan explains. "The street use when the pills are crushed then snorted or injected gives a tremendous high. The other addiction is the middle-class 'pill' addiction where someone is taking many pills a day because it tends to increase energy. We see this with Percodan as well as with OxyContin."

It's the street use that has both addiction specialists and police worried. Harlan County, Ky., Sheriff Steve Duff tells WebMD his department has been grappling with "oxycotton" for the past year.

In a sweep last September, Duff and his deputies and arrested 67 people for possession of the drug.

"When I look at drug arrest warrants since 1999, 85% to 90% of them are for OxyContin use," Duff says. Moreover, although the Harlan County population is only 36,000, Duff says there have been eight deaths caused by overdoses of OxyContin in the past year alone.

On Feb. 1, his department arrested Ali Sawaf, MD, and charged him with six counts of illegally prescribing drugs, three counts of bribery of a public official, three counts of witness intimidation, and two counts of being a persistent felony offender.

"We thought we shut him down last fall, but he just moved to another location. This office didn't even have an examining table, just a desk and a receptionist," Duff says. Sawaf is being held in Harlan County Jail for arraignment next week.

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