...no need for 'education industry': http://www.abc.net.au/news/stories/2009/08/20/2661146.htm?section=justin Special report: 'Hillbilly heroin' black market booming By Steve Cannane for Lateline Posted Thu Aug 20, 2009 12:45am AEST Updated Thu Aug 20, 2009 12:09pm AEST A strong black market for oxycodone has developed in Australia, and some experts are concerned that Australia could be trending towards US consumption levels, where deaths from oxycodone now outweigh deaths from both heroin and cocaine. Oxycodone, known also by the brand name OxyContin or the American term 'hillbilly heroin', is prescribed for chronic pain. It is meant to be taken orally, but since 2001 there has been a heroin shortage in Australia, and many of those who would previously use heroin now shoot up pharmaceutical opioids. Justin, an OxyContin user, says he uses the drug as a replacement for heroin. Heroin is often quite expensive and oxies are generally cheaper, and you also know exactly how much you're getting, he said. In 2008, pre_script_ion opiates outstripped heroin as the drug of choice for those using the Medically Supervised Injecting Centre in Sydney. But the illicit use of oxycodone is not confined to the big cities. Painkillers are more likely to be injected in rural and remote areas where heroin is even more scarce. Martin Alster from the Wagga Wagga Community Drug Action Team, says the people who run the opioid treatment program in Wagga have not treated a principal heroin user for four to five years. Everybody they've been seeing over the last few years have been using pharmaceutical opioids and that's usually OxyContin, he said. Police are also noticing these trends in rural and remote areas. Earlier this year, a 47-year-old woman from Young, in southern NSW, was sent to jail for selling oxycodone on the black market. Police say she was prescribed over 10,000 tablets of various drugs in just 12 months, and over 2,500 of those were oxycodone. The investigation was significant in that it was the first time in NSW that someone had been charged with the ongoing supply of a pre_script_ion drug, a police spokesman said. 'Easy to source' The woman in question was 'doctor shopping' - getting pre_script_ions from a variety of doctors in and around Young. She would pay around $1 a tablet at her local chemist and then onsell them for around $30 dollars each. Graham, a former oxycodone dealer, used to make a living through doctor shopping in regional areas. On a good week I could make up to $5,000, $6,000 a week from OxyContin, he said. It was quite easy for me to walk into six doctors' surgeries in any given day and walk out of six doctors' surgeries, he said. I did it fraudulently. I'd write my own letters stating that I had an injury and needed OxyContin. I'd give that letter to the doctor and the doctor would give me a _script_. It was very easy. Graham found that users preferred oxycodone to heroin. I tried to go back to selling heroin and people just did not want to buy it ... they preferred to buy oxy over heroin, he said. I couldn't sell the heroin because people knew what they were buying with OxyContin. But doctor shopping is not the only source for the black market in oxycodone. Some pensioners who have been prescribed oxycodone for chronic pain are selling it on the side - a practice known in some circles as 'fossil farming'. OxyContin user Justin says he has noticed pensioners supplying the drug. For the pensioners, it was an opportunity for them to make some beer money, or pay the electricity bill, and for the users, on the other hand, it was a guaranteed supply of the drug at a certain time, he said. Pre_script_ion opiates have also leaked onto the black market through the hospital system. Last year there was 167 reported cases of drugs being lost or stolen from NSW Hospitals. At least 120 of these involved opiates like oxycodone. Dangers and solutions While illicit users of oxycodone claim it is safer than heroin, and stops them committing crime to feed their habits, it is not without its dangers. Those who inject oxycodone without using filters risk damaging their arteries and losing limbs. Steve, as he wants to be known, had his arm amputated after he had been injecting pre_script_ion drugs. I got my radial artery one day and injected it in there, and because there was chalk and gunk in it from the tablets, it blocked all the capillary veins in my hand and my hand eventually died and had to be amputated, Steve said. Steve is a qualified boilermaker/welder. But without the use of both his arms, he cannot work in his old trade. It's affected me to the extent that I have nightmares and dreams every night about working again as a boilermaker/welder ... that's every night I have a dream I'm back at work, he said. And now I've got my life back together I could be quite suitable to go back to work, its just I can't because of my stupid behaviour in the past - it's going to stay with me forever. In Tasmania, where Steve lives, oxycodone use is 10 per cent above the national average. The use or misuse of opioids has been identified as a factor in 61 deaths there in the last two years. Mr Alster says there are solutions, such as data_base_s that can track the daily prescribing rates of these drugs as well as providing better treatment options. Doctors need more support, both with dealing and addiction, he said. So drug and alcohol services, I believe, need to be more along the lines of the UK model, where they've been moved into general practice to support doctors. But also, doctors need good training and guidelines around dealing with non-malignant pain. But there is a fear that any crackdown on the black market use of oxycodone could lead to a backlash against those who need it for chronic pain