Pubdate: Thu, 10 Dec 2009 Source: Port Clinton News Herald (OH) Copyright: 2009 News Herald Contact: http://www.portclintonnewsherald.com/customerservice/contactus.html Website: http://www.portclintonnewsherald.com/ Details: http://www.mapinc.org/media/3544 Author: Russ Zimmer, Special To The News-Messenger Bookmark: http://www.mapinc.org/find?232 (Chronic Pain) Bookmark: http://www.mapinc.org/heroin.htm (Heroin) Bookmark: http://www.mapinc.org/oxycontin.htm (Oxycontin/Oxycodone) ADDICTION USUALLY STARTS WITH PILLS, NOT NEEDLES Heroin conjures up images of junkies sharing needles in trash-strewn alleys. Powerful painkillers are clean and distributed legally by a network of doctors and pharmacies. That's the public perception. But there's a disconnect between perception and reality. Abusing painkillers can lead people to make the same decisions as heroin addicts, with sometimes fatal consequences. "They don't understand that people can develop addiction and dependence over a relatively short period of time," Dr. Robert Carlson, professor at the Boonshoft School of Medicine at Wright State University, said of the use of legal opiates. Special Agent Tony Marotta, who heads the U.S. Drug Enforcement Administration's Columbus bureau, said the connection between prescribed opiates -- oxycodone, morphine or codeine for example -- and heroin is not being taken seriously enough. For some users, prescription-strength pain pills are how they get by until the next dose of heroin. For others, pills are how they start down a dangerous path. "Kids are abusing prescription drugs and it's leading to harder narcotics," he said. "You don't wake up one day and say, 'Let's shoot some heroin.'" Dr. Ken Hale, assistant dean of the College of Pharmacy at Ohio State University, said pharmaceuticals have become "the drugs of abuse of choice." The leap from strong, legal pain relievers to heroin is not a long one, he added. "You don't have to be a chemist to see that heroin and OxyContin are almost identical structurally," he said. NEEDLE RARELY COMES FIRST In 2006, Carlson, then the principal investigator for the Ohio Substance Abuse Monitoring Network, led a special study of young heroin users in Ohio. The study found 65 percent of the 58 users said they were addicted to pharmaceutical opiates before heroin, Carlson said. Stephanie Peters, a recovering addict at Stanton Villa in New Lexington, said she was using ill-gotten prescription drugs before she ever shot up. When she started using heroin in 2007, Peters, 24, said she only snorted -- needles were "gross." As she became more gripped by the highs, and the lows, she upgraded her delivery method to "skinpopping" -- injections into flesh, but not veins. Intravenous use would come later. Substance-abuse professionals across the state said many addicts share a common story of stepping up from pain relievers to heroin. Going straight to the needle is rare, said Denise Williams, behavioral health specialist at the Genesis Recovery Center in Zanesville. "Sometimes their use of that medication started off for a legitimate reason," she said. The Ohio Department of Health's Injury Prevention Program stated a "strong relationship" exists between the amount of legal opiates in circulation and the number of people dying from all drugs. Between 1999 and 2007, unintentional fatal drug poisonings increased 304 percent while the total grams of prescription opioids in Ohio increased 325 percent, the program reported. - --- MAP posted-by: Jo-D