Hillbilly heroin a growing problem in B.C.’s small communities

Small communities in British Columbia largely untouched by the scourge of hard drugs are discovering a similar danger that some consider even tougher to tackle because it’s handed out with a doctor’s blessing.

VANCOUVER — Small communities in British Columbia largely untouched by the scourge of hard drugs are discovering a similar danger that some consider even tougher to tackle because it’s handed out with a doctor’s blessing.

So-called “hillbilly heroin” is a prescription pain killer that’s been badly abused in parts of Atlantic Canada, Ontario and Quebec, partly because it’s easier for addicts to get than the real stuff and has therefore become popular in rural areas.

Now, B.C. physicians and a new study from the University of British Columbia say the addictive drug, formally called oxycodone, has hit the westernmost province.

“Certainly we’re aware of it,” said Dr. David Smith, who works in mental health and addictions at B.C. Interior Health, adding he’s seen “a very significant upswing” in the rates of prescription medicine abuse, particularly opiates.

The Canadian Rx Atlas had previously shown B.C. residents used less of the medicine than other provinces, but the new study — which examines 2006 data — indicates that has changed. Twenty of 30 communities in the Interior Health Authority were above the provincial average.

Lillooet, about a four hour drive from Vancouver, charted the highest use at 47 per cent.

Oxycodone, usually sold in a form called OxyContin, is legitimately distributed to treat acute and chronic pain, particularly for cancer. It’s nature as an opiate, which works on the reward centres of the brain, means it’s highly addictive because people will develop tolerance and need increasing quantities to get the same effects. Stopping the drug leads to withdrawal symptoms.

Individuals addicted to the drug often shop doctor to doctor, feigning symptoms and double-filling prescriptions where it can be done, Smith said.

When taken as prescribed, Oxycontin has a mechanism that releases the drug over a 12-hour period. But chewing the tablet, crushing it and then snorting or mixing it with water and injecting provides a more immediate high.

“They feel a very rapid and incredibly powerful rush or high … and very quickly following that, they say that they feel kind of a sense of peace and sense of warmth and comfort all over,” Smith said of the description he’s heard from people who abuse the drug.

Overdosing can stop a person’s breathing and kill them, and addicts also face increased risk of HIV transmission and hepatitis if using needles.

B.C. physicians can and should play a leading role in alleviating the issue, said Dr. Shaohua Lu, an addictions psychiatrist who chaired a position paper for the B.C. Medical Association that looks for solutions to prescription abuse.

“In a B.C. office, sometimes it might not be easy to make the balance of assessment between a medically necessary prescription and potential diversion,” he said. “(But) physicians can be a part of the solution when given the tools.”

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