'Hillbilly heroin'

[rahli]

A strong black market for oxycodone has developed in Australia, and some experts are concerned that Australia could be trending towards US consumption levels, where deaths from oxycodone now outweigh deaths from both heroin and cocaine.

Oxycodone, known also by the brand name OxyContin or the American term 'hillbilly heroin', is prescribed for chronic pain.

It is meant to be taken orally, but since 2001 there has been a heroin shortage in Australia, and many of those who would previously use heroin now shoot up pharmaceutical opioids.

Justin, an OxyContin user, says he uses the drug as a replacement for heroin.

"Heroin is often quite expensive and oxies are generally cheaper, and you also know exactly how much you're getting," he said.

In 2008, prescription opiates outstripped heroin as the drug of choice for those using the Medically Supervised Injecting Centre in Sydney.

But the illicit use of oxycodone is not confined to the big cities.

Painkillers are more likely to be injected in rural and remote areas where heroin is even more scarce.

Martin Alster from the Wagga Wagga Community Drug Action Team, says the people who run the opioid treatment program in Wagga have not treated a principal heroin user for four to five years.

"Everybody they've been seeing over the last few years have been using pharmaceutical opioids and that's usually OxyContin," he said.

Police are also noticing these trends in rural and remote areas.

Earlier this year, a 47-year-old woman from Young, in southern NSW, was sent to jail for selling oxycodone on the black market.

Police say she was prescribed over 10,000 tablets of various drugs in just 12 months, and over 2,500 of those were oxycodone.

"The investigation was significant in that it was the first time in NSW that someone had been charged with the ongoing supply of a prescription drug," a police spokesman said.

'Easy to source'

The woman in question was 'doctor shopping' - getting prescriptions from a variety of doctors in and around Young.

She would pay around $1 a tablet at her local chemist and then onsell them for around $30 dollars each.

Graham, a former oxycodone dealer, used to make a living through doctor shopping in regional areas.

"On a good week I could make up to $5,000, $6,000 a week from OxyContin," he said.

"It was quite easy for me to walk into six doctors' surgeries in any given day and walk out of six doctors' surgeries," he said.

"I did it fraudulently. I'd write my own letters stating that I had an injury and needed OxyContin.

"I'd give that letter to the doctor and the doctor would give me a script. It was very easy."

Graham found that users preferred oxycodone to heroin.

"I tried to go back to selling heroin and people just did not want to buy it ... they preferred to buy oxy over heroin," he said.

"I couldn't sell the heroin because people knew what they were buying with OxyContin."

But doctor shopping is not the only source for the black market in oxycodone.

Some pensioners who have been prescribed oxycodone for chronic pain are selling it on the side - a practice known in some circles as 'fossil farming'.

OxyContin user Justin says he has noticed pensioners supplying the drug.

"For the pensioners, it was an opportunity for them to make some beer money, or pay the electricity bill, and for the users, on the other hand, it was a guaranteed supply of the drug at a certain time," he said.

Prescription opiates have also leaked onto the black market through the hospital system.

Last year there was 167 reported cases of drugs being lost or stolen from NSW Hospitals. At least 120 of these involved opiates like oxycodone.

Dangers and solutions

While illicit users of oxycodone claim it is safer than heroin, and stops them committing crime to feed their habits, it is not without its dangers.

Those who inject oxycodone without using filters risk damaging their arteries and losing limbs.

Steve, as he wants to be known, had his arm amputated after he had been injecting prescription drugs.

"I got my radial artery one day and injected it in there, and because there was chalk and gunk in it from the tablets, it blocked all the capillary veins in my hand and my hand eventually died and had to be amputated," Steve said.

Steve is a qualified boilermaker/welder. But without the use of both his arms, he cannot work in his old trade.

"It's affected me to the extent that I have nightmares and dreams every night about working again as a boilermaker/welder ... that's every night I have a dream I'm back at work," he said.

"And now I've got my life back together I could be quite suitable to go back to work, its just I can't because of my stupid behaviour in the past - it's going to stay with me forever."

In Tasmania, where Steve lives, oxycodone use is 10 per cent above the national average.

The use or misuse of opioids has been identified as a factor in 61 deaths there in the last two years.

Mr Alster says there are solutions, such as databases that can track the daily prescribing rates of these drugs as well as providing better treatment options.

"Doctors need more support, both with dealing and addiction," he said.

"So drug and alcohol services, I believe, need to be more along the lines of the UK model, where they've been moved into general practice to support doctors.

"But also, doctors need good training and guidelines around dealing with non-malignant pain."

But there is a fear that any crackdown on the black market use of oxycodone could lead to a backlash against those who need it for chronic pain.

Link

[faustus]

Some pensioners who have been prescribed oxycodone for chronic pain are selling it on the side - a practice known in some circles as 'fossil farming'.

fossil farming. LOL classic

there was a hack segment on triple j about this today.

[alkatrope]

A friend of mine OD'd on oxy the other month.. Idiot ate and snorted 300mg.

Lucky his little brother heard him choking from the other room and called the ambulance in time :\

[FancyPants]

^^^ OMG 300mg?

Can't believe people are injecting this shit into their veins without even using any form of filter. Jesus if you want a better bioavailability than just eating (which oxy's is quite high comparatively anyway) stick that shit - hurr - up your tailpipe and Robert's your mother's brother.

When they say opiates/opioids have been a contributing factor, that could mean they've had oxy or whatever in their system but were also fool enough to eat too many benzos as well or another CNS depressant.

Oxys are S8 right? I thought they couldn't be prescribed until a GP has called the pharmaceutical whatsamajiggy and confirmed there's only one script for that patient? Or maybe they need authorisation to prescribe S8 just the first time... I don't know.

[Legba]

There was a discussion on JJJ's hack yesterday afternoon.

Podcast

The second half of the podcast.

[nabraxas]

let's hope we don't go down the American road, where many doctors are too frightened to prescribe adequate pain killers.

[t st tantra]

i've already come across doctors who will not prescribe an opioids even panadine forte.

the other doctors said it was his right.....what about the hypocratic oath?would you just like to do the part of your job you want to do?

locums here have been prosecuted for prescribing pethedine.

the head of drug and alcohol services in this state was charged for prescribing opiates to me and a couple other people.

but the law already stops the prescription of adequate pain relief.

there is no provision for immediate pain relief for most.you have to wait for the pills to metabolize.....no wonder cannabis is used widely.......

t s t .

[faustus]

what about the hypocratic oath?would you just like to do the part of your job you want to do?

locums here have been prosecuted for prescribing pethedine.

at my local medical centre, there's a notice stating that due to their religious beliefs, doctors so and so are unwilling to provide referrals for abortions, or give any advice relating to termination. at my local pharmacy, they refuse to stock condoms. IMHO that's complete bullshit -- what if scientologist doctors refused to prescribe antidepressants or write referrals to psychiatrists?

you're definitely right, you shouldn't be allowed to choose to ignore parts of your job.

re: refusing to write a script for painkillers, i think this is a little more complicated: the doctor could very well have decided that the potential risks involved in you using painkillers e.g. abuse/dependence potential outweighed the benefits, i.e. pain relief. therefore, he'd still be applying the hippocratic oath.

[t st tantra]

re: refusing to write a script for painkillers, i think this is a little more complicated: the doctor could very well have decided that the potential risks involved in you using painkillers e.g. abuse/dependence potential outweighed the benefits, i.e. pain relief. therefore, he'd still be applying the hippocratic oath.

this fellow would not prescribe pain relief for anyone.......citing the above!bullshit!

i had approval from the drug and alcohol board for opiates, he just wouldnt prescribe for anyone. i just had to find a new gp.....which suited me.he was really a financial doctor trying to build a medical empire for himself and too scared of complications to his plan,imho.....so i was pleased when he went bankrupt!

t s t .

[Thelema]

yup, it's the ol economic argument, if u don't like it, go elsewhere. Don't matter how it should be. LOL

[FancyPants]

...

but the law already stops the prescription of adequate pain relief.

there is no provision for immediate pain relief for most.you have to wait for the pills to metabolize.....no wonder cannabis is used widely.......

t s t .

Yep. I had to drive myself to Westmead hospital with horrible kidney stone pains late one friday or saturday night to get a shot of morphine because my oxy and codeine hadn't been enough. I was totally honest with them about the use of both. No point lying and them giving me an inappropriate dose. They let me drive myself home a few hours later because I'm only 15mins away.

[samadhi_sam]

Yep. I had to drive myself to Westmead hospital with horrible kidney stone pains late one friday or saturday night to get a shot of morphine because my oxy and codeine hadn't been enough. I was totally honest with them about the use of both. No point lying and them giving me an inappropriate dose. They let me drive myself home a few hours later because I'm only 15mins away.

For several decades I suffered chronic kidney stones which necessitated numerous trips to GPs or hospitals for a shot of an analgesic, often morphine but commonly pethidine was the drug of doctors choice.

This was the only way effective form of pain relief in my case, pill based opiates just didn't do the job.

I have also been prescribed oxycodone (Endone 5mg) on many occasions and these didn't require external approval, yes they are Schedule 8 poisons (labelled Controlled Drug). Perhaps regulations have changed?

Fortunately these renal colic problems have all but disappeared in recent times (once or twice a year is the norm now, much improved from multiple times a week).

Peace