Americans desperate for a heroin-like high are turning to a version of the popular pain killer OxyContin smuggled in from Canada, which is easier to abuse than an updated formula available in the U.S.
James Burns, assistant special agent in charge of the Drug Enforcement Administration's operations in the state of New York, said his agency has seen a sharp increase in cross-border smuggling of the prescription narcotic pills in the past year. "I'm talking about trafficking organizations that are bringing in a thousand pills or so at a time," he said.
The medication's active ingredient is oxycodone, a powerful opioid drug similar to heroin and morphine that is designed to be released over 12 hours. But people can get the full and sometimes lethal dosage by crushing the pills and then snorting, injecting or chewing the medication.
In April of 2010, the manufacturer Purdue Pharma got approval from the American Food and Drug Administration to replace its pills in the United States with a more tamper-proof version, but a safer format will not be on the market in Canada until 2012.
The disparity between the American and Canadian product has meant premium prices – and hefty profits – in the United States for the illegal pills.
The DEA says Canadian OxyContin pills on the American black market can go for as much as $1 a milligram, or between $80 and $100 for a single pill.
By contrast, a box of 60 tablets can be bought legally with a prescription in Canada for about $300 – around $5 a pill.
"That s a pretty substantial profit margin right there," Mr. Burns said. "We expect to see an increase in traffic until the pills are reformulated in Canada."
But that may take a while. Five months after the FDA okayed the new version in the United States, Purdue Pharma submitted what it called OxyNEO to Health Canada in September, 2010. It took until August of 2011 for Ottawa to grant what it calls "market authorization."
"The tablets have been hardened by a unique process to reduce the risk of being broken, crushed or chewed," said Randy Steffan, director of communications for Purdue in Canada.
When exposed to moisture or dissolved in water, the new pills gum up into a thick, unusable gel making snorting or injecting difficult.
But Mr. Steffan said ongoing discussions with the provinces whose public insurance programs pay for prescribed drugs will mean the new pills will be available "in the coming months."
"It's important to obtain Canada-wide approval for coverage of OxyNEO by provincial drug plans," he said.
The delay has Canadian drug-abuse experts worried.
"It's unfortunate – having it sooner rather than later is obviously what we would like," said Beth Sproule, a clinician scientist specializing in prescription drug abuse at the Centre for Addiction and Mental Health in Toronto. She said the high dosage of opioids in OxyContin and its vulnerability to tampering means the upsurge in abuse in recent years has been "dramatic."
The most recent CAMH survey of Ontario students in Grades 7 to 12 in 2009 shows that almost one in five have taken opioid pain relievers for non-medical reasons – the third highest substance abuse after alcohol and marijuana.
In the meantime, the older Canadian pills have become a hot commodity in the illegal American drug trade.
Three weeks ago, Joseph Julien of Stevensville, Ont., was arrested near Buffalo in a joint American-Canadian investigation in what prosecutors allege was "a large conspiracy" of OxyContin trafficking, involving more than 10,000 prescription pills. Mr. Julien, currently in custody in Buffalo, faces several charges of conspiracy, distribution and trafficking.
Last November, the DEA and other agencies arrested another man and woman from Ontario on charges of smuggling OxyContin across the St. Regis Mohawk Reserve and Agent Burns said there are several "ongoing cases" still under investigation.
He said the newer American version of the pills is so unpopular among criminals that recently thieves interrupted their hold up of a pharmacy when they discovered that was all that was available.
"They just turned around and left," the DEA agent said. "They didn't want to be bothered."