On a beautiful spring day in 2002, I found myself seated next to a teenager named Lindsay Myers as she steered her Jeep® Cherokee through the small town of Pennington Gap, a community in far western Virginia just a few miles shy of the Kentucky border.

We had never met before. But I felt I already knew a lot about Lindsay, or one part of her life. During frequent, long telephone calls over previous months, Lindsay had described her dance into addiction with the high-powered painkiller OxyContin®. The scenes she described were stunning; for instance, during the half-time break of one football game she had raced off the field in her cheerleader’s uniform so she could snort an “Oxy” under the stands.

The lives of people like Lindsay Myers would provide the dramatic drive for the book that I was then researching, one that would eventually be called PAIN KILLER: A “Wonder” Drug’s Trail of Addiction and Death. But researching that book would take me on my own journey into the worlds of prescription drug abuse, pain treatment, and addiction treatment.

It had started in 2001, when an editor at The New York Times had asked me to look into reports that OxyContin, a painkiller aggressively marketed by its manufacturer as less prone to abuse because it was a time-released medication, had turned into one of hottest drugs on the street. The eventual result of that inquiry was not only my book but growing and distressing evidence that illicit narcotics like heroin were no longer necessarily the leading drug-related threat to the public. Instead, legal prescription painkillers such as OxyContin were now vying to claim that unenviable position.

Even setting aside such high-profile cases such as that involving radio personality Rush Limbaugh, one need only look for confirmation at every statistical indicator of drug abuse such as emergency room admission data, medical examiner reports, and surveys of young people such as Lindsay Myers.

“We think the nature of drug abuse in this country is evolving and is moving toward prescription narcotics,’’ John Taylor, the chief enforcement official at the Food and Drug Administration recently told The New York Times.

For me, the most distressing aspect of this situation was a thread that would eventually run as a theme throughout my book. It turned out that all those with a stake in prescription drug abuse, be they drug companies, doctors, lawmakers, regulators, or substance abuse professionals, weren’t united in a simple goal — keeping these valuable drugs in the right hands and out of the wrong ones. Rather, their competing goals, agendas, and perspectives had created a dysfunctional situation that in many ways had caused the OxyContin calamity to occur.

Pain management experts, eager to erase the unfounded view that many patients who used narcotics became addicted to them, had mischaracterized research and given general practitioners the impression that these drugs posed little, if any, risks. Some drug company sales representatives hawked these powerful compounds to doctors whose offices looked more like crack dens than medical offices. And substance abuse specialists had allowed themselves to become relegated to repairing the damage wrought by the inappropriate prescription of these drugs rather than working with doctors so they could help decide which patients should get these drugs and how they could be best monitored.

These days, there appears to be a belated awakening that all those involved in the promotion and prescription of prescription narcotics need to reassess when and how these drugs are used. That’s not to say that pain patients should be denied access to such medications. However, it does mean that the type of marketing and medical juggernaut launched on behalf of OxyContin ought not to be repeated. The Food and Drug Administration can also never again allow a drug manufacturer to make a claim about the reduced abuse potential of a drug, as it did with OxyContin, without first requiring that company to do extensive studies to support that claim.

Last year, not long before going to western Virginia to meet Lindsay Myers, I had the opportunity to attend a meeting of the American Society of Addiction Medicine, a prestigious professional association whose ranks include both pain management experts and addiction specialists. With the OxyContin crisis on the front pages of newspapers and magazines, it was a meeting that quickly evolved in depressing debate between experts and their egos as imaged through competing PowerPoint® presentations.

Pain management specialists continued to argue that the scope of the OxyContin crisis had been hyped by the media; it was nothing more they insisted than the “drug du jour.” Treatment experts argued back that their practices were being flooded by people who were addicted to OxyContin and were abusing.

A year later, however, the results appear in. OxyContin is not simply the “drug du jour”; it and other prescription narcotics are the drugs of choice of a whole generation of teenagers and young people like Lindsay Myers. Now, the question is: What are drug companies, the medical profession, and treatment professionals going to do about it?

Barry Meier is an award-winning reporter for The New York Times, where he has specialized in investigating issues related to public health, business, and the law. He can be reached at This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Read an Excerpt from PAIN KILLER

For more information about PAIN KILLER: A “Wonder” Drug’s Trail of Addiction and Death, visit www.painkilleronline.com.

This article is published in Counselor,The Magazine for Addiction Professionals, February 2004, v.5, n.1, pp. 22-23.

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