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Painkillers are a gateway to heroin

By Mariana van Zeller, Special to CNN
  • Mariana van Zeller: Prescription drug abuse is worse than '80s crack epidemic
  • Overdose deaths from prescription painkillers more than doubled between 2000 and 2007
  • Doctors in Florida prescribe 85 percent of all the oxycodone in America, she says
  • Van Zeller: Painkiller addicts are turning to heroin, which is cheaper and easier to obtain

Editor's note: Mariana van Zeller is a correspondent for "Vanguard," Current TV's original documentary series. Her story "The OxyContin Express," about prescription drug abuse and Florida's pill mills, won a 2009 Peabody Award. "Gateway to Heroin," a follow-up investigation, airs Monday at 7 p.m. EDT on Current TV.

(CNN) -- This past winter, I found myself following a drug dealer and his crew up the dark stairway of a triple-decker apartment building on the outskirts of Boston. Reaching a unit on the top floor, the young man pulled a gun from his waistband and set it on a coffee table next to a digital scale and a pile of drugs.

Entering a drug den, you might expect to find cocaine or heroin. But side by side with this pile of "hard stuff" were prescription pills, lots of them.

The little green tablets the men were dealing -- known as "Perc 30s," "Percs" or simply "30s" on the streets -- were 30-milligram oxycodone. In medicine, oxycodone is known as an opioid analgesic, a powerful painkiller prescribed to patients with acute or chronic pain. On the streets, it's known as heroin in a pill, and to borrow some Boston slang, it will get you "completely jammed."

When Gil Kerlikowske, President Barack Obama's national drug policy director, recently described today's prescription drug abuse in the U.S. as worse than the crack epidemic of the 1980s, he was simply echoing what these drug dealers have long known.

"Pills are what it is now," as one of them put it to us that night.

In the U.S., more people are abusing prescription drugs than cocaine, heroin and Ecstasy combined, but the most destructive have been prescription pain drugs such as oxycodone, best known by the brand name OxyContin.

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The Centers for Disease Control data show overdose deaths from prescription painkillers more than doubled from 2000 to 2007, and in 17 states, painkiller overdoses are now the number one cause of accidental death.

Other alarming trends include babies in Florida being born addicted to painkillers and prisons in Kentucky filling up with inmates charged with the petty crimes associated with trying to procure it. Across the nation, pharmacies are being robbed at gunpoint for it -- the most horrifying example occurring this past weekend when four people were killed in a pharmacy robbery on Long Island in what looks like a pill heist gone wrong.

When I began reporting on prescription drug abuse and the booming black market trade in painkillers in 2009, the investigation led me to Florida, where a growing number of cash-only pain clinics have turned the Sunshine State into the "Colombia of prescription drugs."

According to its own state officials, doctors in Florida prescribe 85% of all the oxycodone in America. One doctor in Orlando was recently arrested for allegedly prescribing as much oxycodone in one year as the entire state of California -- 300,000 pills if you're counting.

Florida's "pill mills" have had a devastating effect. On average, seven people a day now die of overdoses in Florida from prescription drugs. But the trail of devastation doesn't end there. Word of Florida's pain clinics has spread well beyond the state's borders as far north as New England.

The dealers I met in Massachusetts told me the oxycodone pills on their coffee table all came from doctor's offices in Florida. They explained how they made regular trips to Miami or Fort Lauderdale, passing through airport security with up to $100,000 in cash taped to their bodies. Young women would then be paid to mule thousands of pills back up North.

This month, Florida Gov. Rick Scott finally signed legislation that aims to monitor the state's pain clinics and put an end to the illicit trade. In April, the White House announced its own plans to cut abuse of oxycodone and other opioids by 15% in five years.

While both moves are certainly welcome, state and federal officials may still be a step behind the streets, where another worrying trend has emerged. In many places across the country, including Massachusetts, oxycodone has become a gateway drug, leading users to a more traditional street drug: heroin.

The truth is heroin is little more than a natural form of oxycodone. It has the same effect on the brain and, for addicts, satisfies the same urge. The big difference is that these days heroin is often more available, more potent and, above all, cheaper.

"I don't think I have met anybody under the age of 30 that's a heroin addict that did not start out using oxycodone or OxyContin," Lt. Tom Coffey of the Massachusetts State Police told me.

Indeed, every heroin addict I met while reporting in Massachusetts shared a similar journey: They began abusing Oxy and became addicted, and then the pills either became too expensive or unavailable. Instead of suffering through the pain of withdrawal, they turned to heroin as a substitute and never looked back.

For those who have suffered and lost because of prescription drug addiction, the importance of state and federal authorities taking the issue seriously cannot be understated. But it's also important for us to acknowledge that painkillers have now introduced a whole new generation of addicts to heroin, an addictive, dangerous drug and one of the most difficult to quit. Every action, no matter how well-intentioned, brings a reaction.

While Florida's new law is unquestionably needed, it also begs us to start thinking about what happens when Oxy addicts up and down the Eastern Seaboard have their supply cut off. If treatment isn't there for them, dealers, like the ones I met, will be.

The opinions expressed in this commentary are solely those of Mariana van Zeller.

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