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On the surface it may seem like Oxy's grip on local teens is just another wave in more than four decades of a failed national war on drugs.

"Alaska has been down this road with meth, crack cocaine and alcohol, so from a media point of view we've been here before," said psychiatrist Paul Topol, who runs a private practice in Juneau.

But a closer look reveals the prescription pain medication, called "OC" among youths for the letters printed on the small pills, is more addictive and harder to get off of than other drugs.

The long withdrawal makes treatment more expensive and, what's more, Juneau may not have the services to treat teen opiate addiction.

"How do you get treatment in this town if you're 16 years old?" asked Topol. "The answer is, you don't."

Juneau does not have an in-patient treatment center where teens can detox.

Executives at Bartlett Regional Hospital considered building an adolescent treatment center 18 months ago but decided the project was too big, said CFO Garth Hamblin.

Hamblin acknowledged a gap in service, but said the financial numbers were being crunched again, this time looking at a smaller project.

The state also acknowledged the gap.

Alaska provides funding to organizations like Juneau Youth Services for out-patient therapy through a program called Bring The Kids Home, said Bradley Grigg, children's behavioral health specialist with the Department of Health and Social Services.

Grigg said he met with Bartlett executives recently about an in-patient adolescent treatment center. He couldn't say whether funding for a capital project was available.

Getting treatment

OxyContin is the name brand of an extended-release form of oxycodone, a medication prescribed for pain. Its maker, Stamford, Conn.-based Purdue Pharma, initially said that because of its time-release formulation, it is less addictive than other pain relievers.

The company and its executives in 2007 paid more than $600 million in fines for that misbranding.

The way kids abuse it - by burning one on tinfoil and inhaling it, or crushing and snorting or injecting it - all of the drug is absorbed at once and produces a euphoric high as powerful as heroine.

OxyContin is a narcotic, and recovery from addiction can be a lifelong process.

"Opiates are a bit different because they have very strong physical withdrawal symptoms associated with them," Topol said. "When you stop using them, you get physically sick."

Withdrawal means nausea, sweating, muscle cramps and joint pain in the back and knees, plus a horrible mood that's clinically known as dysphoria, defined as a state of unease or generalized dissatisfaction with life.

One recovering addict said she couldn't stand it and would do anything - sell all her personal possessions, steal from her family, risk jail and become a dealer herself - to get more of the drug.

Even with treatment, the physical and psychological pain of withdrawal can last weeks.

"If there ever were a poster child of getting hooked on something, opiates would be it," Topol said.

Medical providers in Juneau have different opinions about what addiction treatment works, but all agree a challenge is that Juneau does not have a detox center for teens. Some use out-patient therapies and others suggest those severely addicted check into a treatment center in another city.

The cost of addiction

It's unclear how many Juneau teens are addicted to OxyContin.

It showed up in town as a problem for youth about four years ago, and its use escalated until parents and coaches this summer demanded the school district begin drug testing student-athletes.

One high school student recovering from the drug's addiction said he started seeing it last January at parties and outside school after classes ended.

"It was like the new thing, like if you were a 5-year-old and they came out with a new brand of candy to try," he said. "They would try it and like it and just keep doing it and doing it."

Topol said social acceptance in Juneau also makes this drug different. Addiction is nearly guaranteed among some who try it, so experimentation is like Russian roulette, he said.

"People are playing with it and a certain percentage get hooked."

A local organization that acts as an intervention and referral agency, the Juneau office of the National Council on Alcohol and Drug Addiction, said its cases of OxyContin use among teens went from eight in 2005 to 45 last year.

The standard regime for narcotics addiction is long-term, residential treatment, said Executive Director Matt Felix. The first 30 days can cost $6,000 to $20,000 at a treatment center in the Lower 48, or $30,000 in Anchorage, he said.

After that, Felix tells parents to put kids in a halfway house for at least five months.

The costs can quickly add up, and insurance does not always pay.

Some teens are being treated in Juneau with Vivitrol, which is FDA-approved to treat alcohol cravings. It can be administered in daily pills or a monthly shot.

The shot is painful, costs about $800 and is given for about six months. A Vivitrol patch that's inserted under the skin is not available in Juneau.

Some doctors prescribe a low dose of an opiate, a treatment referred to as maintenance. It keeps cravings at bay and allows patients to function, but it's not a recovery plan.

Out-patient counseling goes along with these treatments.

"There's no right way to deal with this," said Matt Jones, a family nurse practitioner in Juneau. "Some people choose to send their kids off to (a treatment center), others choose to deal with it here. I know some kids have been successful. Others come back and within a day they're back on drugs."

Becoming aware

Felix said the cases at his organization show that children of middle-upper class families are predominantly being affected by OxyContin abuse in Juneau.

One reason is its cost. One 80-milligram pill sells on the street for about $180, according to Juneau police.

Users can quickly burn through thousands of dollars, wiping out bank accounts and running up credit cards, then turning to theft to support their habit.

A significant percentage of theft cases coming before the court are directly tied to OxyContin addiction, District Attorney Doug Gardner told the Empire in August. He said it's one of the community's biggest public safety issues.

Jones, the nurse practitioner, suggested families watch their own and their children's bank accounts.

It's tough to tell if a kid's high on Oxy, but Jones suggested parents buy a home urine test for opiates, available over the counter at local pharmacies. The drug does not stay in the system for very long, so tests should be done soon after suspicious behavior.

Awareness among teens about the dangers of prescription drug abuse also would help, said Katherine Paulick, clinical director at Juneau Youth Services.

Because prescription drugs can be administered by doctors, teens who abuse them can think it's safer than other illicit drugs, she said.

"That perception contributes to them starting this drug - not being aware of the danger," Paulick said.

Teens interviewed for this story said kids are beginning to realize that Oxy abuse can be dangerous. They've seen their friends become addicts and some go to jail.

The school district plans to begin drug testing some students next month.

Many who support drug testing don't expect it to catch a lot of users, but they wanted to have the discussion to open the eyes of others who didn't know about Oxy abuse.

• Contact reporter Kim Marquis at kim.marquis@juneauempire.com.