Throughout many parts of the country, a particular pattern of use, abuse and transference has occurred when it comes to the prescription painkiller OxyContin.

It starts with OxyContin hitting a particular “market” and becoming popular among users, who range from teenage kids to older adults.

The OxyContin, when sold at the street level, can go for anywhere between $40 to $80 to $100 a pill, depending on the size of the pill.

After abusers can no longer afford OxyContin, those who have become addicted often turn to heroin, which sells for anywhere between $25 to $80 per gram.

In many cases, a large portion of this population of users is made up of teens and young adults. King County is no different. A 2009 report compiled by King County noted that heroin users ages 18-29 had jumped from 17 percent in 1999 to 29 percent in 2009. Users of prescription painkillers in the same age group had sharply increased over the same timespan, from 16 percent in 1999, to 61 percent in 2009.

Mike Heinisch, director of Kent Youth and Family Services, explained in a recent phone interview how that pattern has progressed in King County in the past several years.

“Youth who are using prescription meds often start out mixing and matching over-the-counter medications. And then they move onto prescription meds that are narcotic in nature,” he said. “Those are expensive. If you’re using them, acquiring them through a prescription yourself, or (in the case of youth) more likely through a parent’s prescription, ultimately, that’s a pretty expensive habit. And heroin on the street is a lot cheaper, and essentially gives the same kind of high. They’re moving from prescription drugs of that class to heroin.”

Heinisch said his staff sees an equal breakdown in youth who find themselves stuck in the OxyContin-heroin cycle, with users split equally between male and female. He notes that for youth who make the transition from the prescription drugs to heroin, youth typically smoke heroin instead of injecting it.

Socioeconomic status seems to be of little difference, according to Heinisch and his staff. Washington state has a history of a higher than average prescription rate for narcotic painkillers, which has increased supply at the street level.

For the youth who make the transition from prescription painkillers to heroin, Heinisch said one of the biggest risk factors is that they’re using an uncontrolled and unregulated street drug.

“In the long run, one of the dangers for any person is the nature of the street drug that they’re acquiring and using,” he said. “What it’s cut with to extend its amount for sale on the street — what are those other additives chemicals that users are putting into their bodies? If you’re using needles, of course, you’re exposing yourself to the blood-borne diseases of hepatitis and HIV.”

Heinisch’s point is underscored by a spike in heroin-related deaths in King County last March. At that time, a number of people had died from apparent overdoses of a new heroin that had hit the streets. This strain of heroin appeared to be supercharged, according to the county at the time.

Parents and treatment

Another cause for the eventual shift to heroin is the formulation changes that have been made to OxyContin in recent years, said Federal Way Police Department (FWPD) spokeswoman Cathy Schrock.

Previously, OxyContin pills were easily crushed or melted for snorting or injection, but after sustained pressure on the maker of OxyContin, Purdue Pharma, the company changed some parts of the chemical make-up of the drug to stop that from occurring.

“It was easily addictive, it was leading to robberies and prescription forgeries and that sort of thing. As a result of the surge of addicted people to prescription drugs, the pharmaceutical companies changed Oxy,” she said. “And what the trend has been is that Oxy is not doing what it used to for the addicted, and the drug that’s closest to it is heroin.”

Heinisch said that local law enforcement agencies, such as FWPD, King County Sheriff’s Office and others, have been a force for good in combatting the problem of youth using the drugs.

“Local law enforcement are working closely with local treatment providers and that they aren’t always just looking for punishment,” he said. “They’re looking for enforcement, obviously, but they’re also looking at how to reclaim these kids in conjunction with providers.”

Another challenge that providers like Heinisch face with youth addiction is that their clients are indeed young, and have the rest of their lives in front of them.

“The nature of working with youth who are abusing, using, or are potentially addicted…we’re trying to teach them self-control, to re-establish self-control, and change their life patterns so they aren’t finding themselves in situations where they want to use,” he said. “That’s very different than adult treatment, which tends to be more of a life or death situation.”

Parents who see their teens or young adults trapped by either OxyContin or heroin should tackle the problem head on, Heinisch said, but should try to remain positive as possible when dealing with such a serious issue.

“Don’t go into denial. Don’t put your head in the sand. Recognize that you may be looking at a problem. Don’t fear it. Pursue it,” he said.

“Accompany that with whatever message you need to give of being supportive of your son or daughter, and them getting back to a healthy lifestyle. Not a message of ‘You let me down,’ or ‘I’m disappointed with you.’ Any kind of negative message isn’t going to help. What you need is support, encouragement and confidence that love, trust and respect are part of this process. But ultimately, don’t wait. Don’t think it can’t happen to me and my child.”