MYRTLE BEACH, S.C. (AP) — People in the United States are living in a world of pain, and they are popping pills at an alarming rate to cope with it.
The amount of five major painkillers sold at retail establishments rose 90 percent between 1997 and 2005, according to an Associated Press analysis of statistics from the Drug Enforcement Administration (DEA).
More than 200,000 pounds of codeine, morphine, oxycodone, hydrocodone and meperidine were purchased at retail stores during the most recent year represented in the data.
Oxycodone, the chemical used in OxyContin, is responsible for most of the increase. Oxycodone use jumped nearly sixfold between 1997 and 2005. The drug gained notoriety as “hillbilly heroin,” often bought and sold illegally in Appalachia. But its sales rates now are highest in places such as suburban St. Louis; Columbus, Ohio; and Fort Lauderdale, Fla.
The world of pain extends beyond big cities and involves more than oxycodone.
In Appalachia, retail sales of hydrocodone — sold mostly as Vicodin — are the highest in the nation. Nine of the 10 areas with the highest per-capita sales are in mostly rural parts of West Virginia, Kentucky or Tennessee.
The DEA figures analyzed by the Associated Press include nationwide sales and distribution of drugs by hospitals, retail pharmacies, doctors and teaching institutions.
An AP investigation found these reasons for the increase:
c The population is aging. As age increases, so does the need for pain medications. In 2000, there were 35 million people older than 65. By 2020, the Census Bureau estimates, the number of seniors in the U.S. will reach 54 million.
c Drug makers have embarked on unprecedented marketing campaigns. Spending on drug marketing has increased from $11 billion in 1997 to nearly $30 billion in 2005. Profit margins among the leading companies routinely have been three times higher than in other Fortune 500 industries.
c A change in pain-management philosophy is now in its third decade. Doctors who once advised patients that pain is part of the healing process began reversing course in the early 1980s; most now see pain management as an important ingredient in overcoming illness.
Perhaps no place illustrates the trends and consequences for the world of pain better than Myrtle Beach, a sprawling community of strip malls, hotels and bars. The metro area is home to 350,000 people but sees more than 14 million tourists annually.
During the eight-year period reflected in government figures, oxycodone distribution increased 800 percent in the area of Myrtle Beach, partly because of a campaign by Purdue Pharmaceuticals of Stamford, Conn. The privately held company has pleaded guilty to lying to patients, physicians and federal regulators about the addictive nature of the drug.
Use of other drugs soared in the area, too: Hydrocodone use increased 217 percent; morphine distribution went up 180 percent; even meperidine, most commonly sold as Demerol, jumped 20 percent.
The U.S. attorney for South Carolina secured a 58-count indictment in June 2002 against seven physicians and one employee of the Comprehensive Care and Pain Management Center, a nondescript storefront on Myrtle Beach’s main drag.
The DEA cites 108 prosecutions of physicians during the past four years; 83 pleaded guilty or no contest, while 16 others were convicted by juries. Eight cases are pending, and one physician is being sought as a fugitive.
In congressional testimony, the agency’s deputy assistant administrator, Joseph T. Rannazzisi, estimated that less than 1 percent of the nation’s physicians — fewer than 9,000 — illegally provide prescription drugs to patients. He said it is more common for people to obtain prescription drugs illegally from friends and family members.
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