Powerful painkillers like OxyContinn, widely known as “hillbilly heroin,” have emerged as a major crime problem in the United States, with many dealers and abusers obtaining them over the Internet.

Abuse of OxyContin, which is legally prescribed for cancer patients and others with chronic, debilitating pain, first emerged as a problem in the eastern United States, particularly in the Appalachian mountains and in New England, but is now spreading.

The drug releases slowly into the body over a 24-hour period. But if it is crushed or dissolved in water and swallowed, inhaled or injected, it produces an effect similar to a heroin high.

The drug is associated with increased crime and death rates in areas of the country where it has become prevalent. In Tazewell County in southwestern Virginia, authorities estimate that OxyContin addiction is behind 80 percent to 95 percent of all the crime committed there.

Sixty-nine percent of police chiefs and sheriffs have witnessed an increase in the abuse of painkillers such as OxyContin, a survey of police commanders by the National Association of Chiefs of Police said in its 2005 report issued January. The abuse, which began mainly in rural communities, was now spreading to cities, the report said.

“The areas most currently affected by OxyContin abuse are eastern Kentucky; New Orleans; Louisiana; southern Maine; Philadelphia and southwestern Pennsylvania; southwestern Virginia; Cincinnati, Ohio; and Phoenix, Arizona,” the report said.

The drug is extremely addictive. “We’ve interviewed heroin addicts who say they get a bigger hit from this than from heroin,” said Gary Oetjen, a senior U.S. Drug Enforcement Administration official in Kentucky.

OxyContin achieved notoriety in 2003 when conservative talk radio host Rush Limbaugh admitted he had become hooked on the drug, which he used to gain relief from back pain.

The DEA says the drug has been showing up in many other states including California.

“We’ve had a series of arrests here, including one of three doctors who were basically running an OxyContin factory, giving out prescriptions to whoever wanted them in exchange for cash payments,” said Matthew Mangino, district attorney for Lawrence County in northwestern Pennsylvania.

“We’ve had a number of burglaries of pharmacies by people who ignore the cash and just take the OxyContin. We’ve also had a handful of armed robberies where all that the thieves wanted was the OxyContin,” he said.

Mangino is particularly concerned at the way Internet pharmacies are increasingly involved in marketing the drug.

“We prosecuted someone who was dealing over the Internet. It’s a serious problem that is not appropriately regulated and maybe it can’t be regulated,” he said.

A report on Wednesday by the Vienna-based International Narcotics Control Board said billions of dollars of potent drugs including painkillers like OxyContin were being sold over the Internet each year.

“WILD WEST BAZAAR”

Thomas Raffanello, special agent in charge of the DEA’s Miami division said the Internet had become “a virtual Wild West bazaar for spam e-mails and Web site advertisements that sell controlled substances with little or no oversight that the drugs are sold for legitimate medical reasons.”

A bill before the Kentucky state assembly would make it a felony to distribute drugs shipped into the state by unlicensed Internet pharmacies. Authorities also could seize prescriptions ordered from unlicensed, online pharmacies.

According to the Charleston Gazette Mail newspaper, Federal Express has stopped delivering packages from online pharmacies to parts of eastern Kentucky where abuse is particularly widespread.

“It has reached epidemic proportions in the past four years in the southeastern section of Kentucky,” Oetjen said. “Since January 2004, we have opened over 1,800 criminal cases and seized more than 12,000 pills.”

Oetjen also identified Internet pharmacies as the biggest problem facing his agency. “Internet pharmacies now outweigh local doctors and pharmacies as a problem,” he said.