Next to its tarry opiate cousin, "hillbilly heroin" appears clean and trustworthy — pastel tablets neatly engraved with the dosage digits of modern medicine.
But oxycodone packs a painkilling wallop with a strong addictive force. It hooked Rush Limbaugh, and these days it has gained a firm foothold in the youth party scene — with grim consequences.
A combination of OxyContin — the brand-name oxycodone drug — Xanax and alcohol halted Joey Rovero's breathing in December, killing the graduate of California High School in San Ramon in his room at Arizona State University. He had driven to Southern California a week earlier, paid a doctor $75 for a visit and took home 90 OxyContin tablets, 30 Xanax and 90 muscle relaxants, his father said.
He sold half to his addicted roommates. But Rovero, who played high school football and shunned illegal drug use, kept the rest for himself.
"Joey told his girlfriend, 'Hey, I'm not doing anything illegal. I've got a prescription. It comes from a doctor,' " said his father, Joseph Rovero, of San Ramon. "What we came to find out later was at the fraternities down there, 60 percent of the kids were using these painkillers recreationally. The kids don't realize how dangerous this is. Some of them do, and yet they're so addicted to it, they can't stop."
That false sense of pharmacological safety, experts say, has helped drive a pill-popping trend among teens and young adults that appears to be escalating.
Emergency room visits for abuse of oxycodone products rose 152 percent from 2004 to 2008, with an even steeper increase among people younger than 21, according to a study released last month by the Centers for Disease Control and Prevention and the Substance Abuse and Mental Health Services Administration.
A federal survey of high school students found that more than one in five had taken drugs such as OxyContin, Percocet, Vicodin or Xanax without a doctor's prescription. The highest prevalence, the study found, was among whites.
That's no surprise to law enforcement and treatment providers, who say OxyContin, codeine and other prescription drug abuse among youths tends to circulate most in affluent areas — where access to medical care may be greater, and acceptance of hard street drugs lower.
"It seems to be a big problem more in south (Contra Costa County) — Danville, the San Ramon area, Walnut Creek," said police Cmdr. Norm Wielsch of the Contra Costa Narcotics Enforcement Team, or CNET. Police often find a few pills during a traffic stop, then search a house to find a stash, he said.
"What we see happening is doctor-shopping. The guys that are getting it and selling it out here are basically hiring people to go to the doctor and say they got pack pain."
Youths may at first find a simpler route: their parents' medicine cabinet, Wielsch said.
"The negative stigma of it is very much less than if I go out to the corner and buy black tar heroin."
Yet the rise in abuse of OxyContin, in particular, may be contributing to a resurgence in heroin use among youths statewide, said one California drug enforcement agent. Addiction to OxyContin, a synthetic opiate, can cost as much as a dollar a milligram on the black market — far more than a heroin habit.
"That's a natural segue," said Kent Shaw, assistant chief for the state Bureau of Narcotic Enforcement. Shaw calls youth abuse of OxyContin and other prescription drugs "a silent, growing problem," silent in part because they rarely rate the splash of a cocaine or major marijuana bust.
But the effect is felt in homes and treatment centers across the region and state.
At New Leaf Treatment Center in Lafayette, about 50 patients are under treatment for OxyContin addiction at a given time, said Gantt Galloway, a doctor of pharmacology. Galloway describes a euphoric effect. "There's also relaxation that takes away anxiety, and it's a sleepy, relaxed sort of high," he said.
"What you run into is, kids see other kids who have just started using it. They're not having a problem yet. They're still in high school or college. They haven't dropped out yet," he said. "I think that sort of fuels the ease of using it, because you don't see people around who are having horrendous consequences.
"To see some little, physically small, relatively immature 16-year-old come in here with a full blown habit — it's bracing."
One former addict from Concord said he started in high school at age 16. He and his friends would crush the pills and snort them.
"It was super cheap back then, and it was kind of cool to snort stuff at the time. We didn't really know what they were or how serious they were," said the man, now 25, who declined to give his name, saying he worried about the stigma. "You feel really, really relaxed. You don't have any worries on your mind."
He became hooked at 19, he said, then turned to heroin before quitting New Year's Day.
Deaths of youths across the country — and the parents who have become advocates — have focused federal and state attention on the problem. In the East Bay, Rovero's parents and others in the San Ramon Valley recently formed the National Coalition Against Prescription Drug Abuse, aiming to draw attention and money to the problem.
Efforts to attack it have centered largely on supply — shining a light on "pill-mill" doctors, and on stopping addicts from shopping around for several doctors' prescriptions at once.
"How do we stop the doctor shopping? And on the other side is doctors and pharmacists out there who are oversupplying these drugs for financial gain. Both of these things are going on simultaneously, really affecting people and children," said Bob Pack of the Troy and Alana Pack Foundation, formed after Pack's two children were killed in 2003 by a hit-and-run driver with a string of Vicodin prescriptions.
The parent advocates are pushing for expanded funding of the statewide prescription pill database, which provides real-time access to prescription information for doctors and pharmacists who sign up to access the system. Far wider use of the system would help doctors and pharmacists identify abusers and limit their access, while helping law enforcement track high-volume doctors, Shaw said.
But recent legislation by state Sen. Mark DeSaulnier, D-Concord, to have drugmakers fund about $5 million a year for the program failed to make it out of committee. DeSaulnier said drug companies have balked at the cost, but that he hopes to persuade them.
"It's an epidemic. If they're not part of the solution, I think it's worse for them in the long run," he said.
A spokeswoman for Purdue Pharma LP, the maker of OxyContin, said in an e-mail that the company opposed the bill but supports "appropriately designed" prescription monitoring programs. She did not elaborate.
"Prescription drug abuse is a serious public health concern and Purdue is taking an active role in being a part of the solution to the problem," Libby Holman wrote.
By John Simerman
Contra Costa Times