It wasn’t a back-yard fist fight that put two juveniles on their backs last week. It wasn’t an evening of funneling beer in front of friends that forced Demopolis Police to drop in on the fun.

Last week, law enforcement found two juveniles unconscious after they finished off a vicious bout with the latest drug frenzy.

On a national level, about 220,000 people used OxyContin for non-medical purposes in 1999. In the latest figures available, non-medical use of OxyContin spiked to 1.9 million in 2002.

Has OxyContin now become the latest trend for drug abusers in Demopolis? It depends on who you ask.

“Right now, on a scale of 1-to-10, I’d say the problem is about a three,” said Jeff Manuel, public safety director and acting police chief for Demopolis. “But if we don’t do something about it soon, it will be an eight before we know it.”

Manuel, who could not release specific information about the DPD’s OxyContin arrest last week because it involved juveniles, believes more and more people in the city have gained access to the pain medication.

“The kids, especially, are getting hold of it,” he said.

While Manuel sees the OxyContin epidemic expanding, one local pharmacist believes that particular drug phase has already passed through Demopolis.

“I’m not so sure we might not have already peaked with OxyContin,” said Stan Reeves, owner of F&F Pharmacy. “There’s not as much interest in it as there was probably a year or two ago.”

In Demopolis, other drugs like Loritab still dominate the prescription drug scene, according to Reeves. At the same time, even he understands the power of OxyContin.

“Overall, that drug has skyrocketed,” he said.

From Manuel’s perspective, where illegal use garners the most attention, OxyContin has the ability to become the next drug of choice in Demopolis.

What is it?

By now, most people have heard of OxyContin. In the medical community, the drug has been praised for its effectiveness in treating pain — especially for cancer sufferers.

Dr. Gregory E. Skipper, medical director for the Alabama Physician Health Program, wrote a 2001 article detailing the OxyContin plight as it relates to the medical community. In that article, he explained the rise of OxyContin as one of the safest treatments for pain, in part because it contains no aspirin or acetaminophen.

However, creating a safe drug has led to the abuse of OxyContin just as quickly.

“To the media, a breaking story. To chronic and terminal pain sufferers, relief… To the drug abuser and addicts, an instant rush and euphoria — or death; to their families, grief… To law enforcement, the latest in a long series of drug problems,” Skipper wrote.

The drug, obviously, has become a problem in Alabama and the United States, but its proper use has been hailed by most in the medical community.

In a story published in The Mobile Register, cancer specialist Dr. Michael Meshad said there is no way he’d ever stop prescribing the drug, regardless of illegal abuse.

“I would continue to use it, because if it’s not this one that’s being abused, it’s another drug,” Meshad told the Register. “If a patient has a terminal disease, it’s our job to prevent suffering, and this drug is very good at that.”

Along with the pain caused by cancer, OxyContin also is used for bursitis, neuralgia and arthritis.

How is it abused?

In Demopolis, like most other areas of the nation, OxyContin is altered by abusers in order to enhance the effects of the pain medication.

One of the medical benefits of the drug is the 12-hour treatment cycle it offers when taken orally. But for abusers, an immediate high from OxyContin isn’t hard to achieve.

Along with taking the drug orally, abusers crush the pills and inhale them. Others grind the pills, mix them with water, and inject them intravenously.

“This is a high-powered medication that can cause problems,” Manuel said.

Indeed, the drug is so powerful that users who take large dosages risk severe respiratory depression that can lead to death.

“Inexperienced and new users are at particular risk because they may be unaware of what constitutes a large dose and have not developed a tolerance for the drug,” according to the DEA.

Where does it come from?

Because the medical community has such high regard for OxyContin — when used legally — abusers have little trouble finding the pills.

“This was 20 years ago, but when I moved [to Demopolis] from Tuscaloosa, I found I had a lot of the same patients,” Reeves said of his pharmaceutical business. “For us, it’s hard to track because [abusers] will go to different physicians and different pharmacies.”

Tracking the illegal sale of OxyContin has stumped most of those involved in the drug industry.

Manuel said finding purchase points is incredibly difficult.

“Right now, there’s really no way to monitor it,” the acting police chief said. “Part of that is because there’s no way of knowing who’s supposed to have it and who’s not supposed to have it.”

OxyContin’s medical popularity means many adults have the drug. And with such wide access, Manuel believes parents and healthcare workers must be held responsible for young people who abuse the drug.

For Reeves, limiting the sale of OxyContin is a difficult task because abusers know how to make “legal” purchases.

“Most of them pay in cash, and if they have a prescription, then there’s not much we can do,” he said. “If someone does pay with insurance, then it’s easier for me to track it.”

But even then, Reeves said it’s hard to deny the sale of OxyContin to a person who has a prescription.

“I’ll call the physician, and if there’s a problem, then I’ll report that to the physician,” he said. “But in a lot of ways, you have to give people the benefit of the doubt. Even though I may be suspicious, there may be patients who really need the medication.”

As Reeves puts it, there is no black-and-white answer to the OxyContin dilemma.

“You really hate to give the drug to an abuser of pain medication,” he said. “At the same time, you don’t want to deny a person the drug when they need it.”

Both Manuel and Reeves said there is little way to enforce abuse of the drug right now, except in instances like the recent case where young people passed out from too much OxyContin.

“We were able to make an arrest, but it wasn’t really in connection with that case,” Manuel said. “The kids wouldn’t tell where they got the medication from.”

Another problem police face is the access young people have to their parents’ or grandparents’ medicine cabinets.

“In the event someone passes away, these kids will go and get the medicines,” Manuel said. “Then, they’ll start trying out all the medication.”

Dangerous? Yes. Preventable? Very difficult.

“It takes people helping out,” Manuel said. “The home health workers are supposed to flush the drugs if someone dies, and sometimes, that doesn’t happen.”

Street Value

Access to OxyContin apparently is simple. Making a profit off the drug is even easier.

According to Manuel, one pill can go from anywhere between $10 and $25.

“You can make $100 just by selling four pills,” Manuel said.

Other national groups, including the DEA, say street value of OxyContin is even higher.

A 40 mg tablet can go for $40 per pill and the 80 mg tables can be sold for $80.

“That’s a pretty good profit,” Reeves said. “I wish I could make that kind of money on our prescriptions.”

Where there is a high profit return, police often find it difficult to stop the sale of prescription drugs. And according to Manuel, putting a crime task force back in place may be the only way Demopolis can stop an epidemic that has already sent at least two juveniles to the hospital.

Nationwide, there are 120 known deaths from OxyContin — 12 of those were reported in Alabama, according to the DEA. Now, for local law enforcement, the task is simple: Keep it from happening here.