Hydrocodone Abuse on Rise in Appalachia

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By TOM BREEN
The Associated Press
Tuesday, August 21, 2007; 3:56 PM

GILBERT, W.Va. -- When his craving for painkillers got to be too much, Steve Dotson lay down and let his wife drive a car over his leg. It hurt, but he could dismiss the pain with thoughts of the medicated bliss that would follow. Soon, he lost his house, the state took his children away and he was spending nights under a bridge, where he hoped to die.

"You get to where you don't even want them (pills) anymore, you just do them so you can get through the day," said the 43-year-old southern West Virginia resident.

Dotson is one of millions of Americans who have experienced the harm that can come from addiction to the prescription narcotic hydrocodone. Less regulated than similar prescription painkillers, drugs containing hydrocodone have quietly become the most widely prescribed _ and, perhaps, widely abused _ opiate painkillers on the market.

With 124 million prescriptions in 2005, drugs containing hydrocodone are the most popular of their type in the country, according to the U.S. Drug Enforcement Administration's Office of Diversion Control. They are sold under hundreds of brand names and generic titles, and hydrocodone can be found in medication ranging from cough syrup to painkillers.

The most commonly prescribed product combines hydrocodone and acetaminophen, which is marketed under brand names like Vicodin and Lortab.

The DEA reported in 2006 that legal retail distribution of drugs with hydrocodone had grown by roughly 66 percent nationwide since 2001.

Its illicit use had grown as well, and by 2005, hydrocodone was the most frequently encountered pharmaceutical of its kind in drug evidence submitted to the National Forensic Laboratory Information System. The Drug Abuse Warning Network has said hydrocodone products are linked to more emergency room visits than any other prescription painkiller.

As abuse has grown, treatment for addiction and dependence has become more common _ and more controversial.

While abstinence-based programs that encourage addicts to quit painkillers like hydrocodone are common, there is also a widespread drug-based way of treating the addiction with methadone, another opioid.

In many parts of the country, methadone clinics have drawn fire from residents and politicians who contend they attract crime. West Virginia's legislature earlier this year passed a moratorium on any new clinics that use methadone until a study can be completed.

"A lot of these people are soccer moms buying Vicodin off the Internet," said Timothy Lepak, a Connecticut-based advocate for alternative addiction treatments. "They wouldn't even think of going to a methadone clinic."

Some physicians now prescribe Buprenorphine, another drug, to help patients cope with addictions. But only about 11,000 physicians nationally are certified to prescribe it, experts said.


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© 2007 The Associated Press

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