A few months ago, Jake Epperly was at a country club wedding in suburban Illinois when he overheard a female voice scream, "Give me that lollipop!" This was no petulant child demanding candy but a woman in her 50s yelling at her husband. And Epperly, clinical director and president of three rapid detox clinics and Chicago's New Hope Recovery Center, knew what she was craving: Actiq, a fentanyl-based painkiller that comes in the form of a berry-flavored lozenge on a stick.

Though Actiq was designed for cancer patients whose pain can't be managed by the usual drugs, doctors have prescribed the pops to people with migraines and other types of pain. Cephalon, the company that makes the drug, says that it markets Actiq only for its intended use in cancer patients, but government investigators say Cephalon has targeted a variety of doctors, such as internists, neurologists, and sports medicine specialists. That could explain why, in the first half of 2006, oncologists wrote only a reported 1 percent of the 187,076 Actiq prescriptions filled at U.S. retail pharmacies. Last November the Connecticut attorney general announced that Cephalon had set "high sales quotas...that couldn't be reached without promoting the drug beyond its approved use." The attorney general began investigating the company after a Southington, Connecticut, woman overdosed on Actiq she had purchased from a drug dealer. In 2004 police in Philadelphia discovered that the drug had shown up on the black market under the street name perc-o-pop, and narcotics experts worry that illicit use will soon increase because Actiq has just gone generic, cutting its price by half.

So far the pops have been associated with 127 deaths, two of them children who may have mistaken the medicine for candy. In 2004 alone, illegal use of fentanyl (which is also administered by transdermal patch) accounted for 8,000 U.S. emergency room visits, a third more than codeine and two and a half times more than amphetamines.

Most Actiq addicts in Epperly's detox clinics got the drug through a legitimate prescription because they were in real pain. "But several didn't have cancer," he says. And Epperly suspects that in most cases their pain could have been managed with a less powerful medicine—fentanyl is 80 times more potent than morphine. "This stuff acts directly on endorphins, the pleasure system," he says. "If you tried it, in two weeks, you'd be hooked, too."

Only time will show the benefits and drawbacks to outpatient detoxification services such as Buprenex and Suboxone. Can individuals successfully taper off these opiates?

At Midwest Rapid Detox, we work with patients who have been unable to taper off these drugs. By fully detoxifying the body in a very short amount of time, patients are able to enter treatment for their addiction opiate free. With the additional treatment, patients are able to engage in the recovery process. Many patients are able to recover from this often deadly addiction.

We often treat long term methadone patients who simply do not see a light at the end of the tunnel. There might be abuse of the opiate or a rising and falling of the amount needed to maintain health. Rapid detoxification from opiates (Vicodin, Percocent, methadone, heroin, OxyContin and others) in conjunction with residential treatment can be highly effective for opiate addicts.

Bryan Peterson sat on the toilet in the master bathroom of his Palm Springs, California, home and tried to find a vein between his knuckles. It was virgin territory - he had never injected himself in a spot he couldn't cover up. But now that he'd been fired from his job in the estimating department of a construction company, he didn't care about covering up anymore. Plus, he couldn't find a vein in his arms, which were swollen with pools of pus and heroin. The thin, translucent blue veins snaking across the back of his hand filled him with joy. He slid the needle in beside his knucklebone. It hurt.

Two weeks later, he'd blown out all the tiny veins in his hands and feet. Unable to absorb all that fluid, they burst, adding more blood to the already toxic mix festering under his skin. He started plunging the needle deep into his bicep, shooting heroin directly into the muscle. The drug seemed to sizzle as he injected it.

Peterson was 36 and had been addicted for three years. Before that, he was just a normal working guy who liked to play guitar in a local rock band. Over the past two and a half years, he'd tried to kick his habit cold turkey three times and attended a few Narcotics Anonymous meetings. He'd make it through the first step - acknowledging that he was powerless over his addiction - and that was it. Even with the group therapy sessions and encouragement from fellow addicts, he couldn't stay clean for more than 10 days. The withdrawal pains were so unbearable, he fantasized about cutting off his legs to stop the aching. And when the pain subsided for a moment, he was racked with nausea and diarrhea. His body was holding him hostage: Either take the drug, it said, or you'll feel so much pain you'll want to die.

Then one day Peterson was talking to a friend who mentioned a miracle treatment gaining popularity in the Los Angeles area. Doctors were anesthetizing addicts and using an intravenous drug cocktail to induce an almost instantaneous withdrawal from the heroin. Within 24 hours, an addict would be pronounced clean and sober. Peterson borrowed the $15,000 for the procedure from his family, shot up one last time, and headed for Orange County.

"The 12-step program is an outdated 20th-century concept," says Clifford Bernstein, an assistant clinical professor of anesthesiology at UC Irvine and medical director of the Waismann Institute, the nation's leading rapid detox center. "For 70 years, thanks to Alcoholics Anonymous, addicts have been told they're suffering from a spiritual problem. AA assumes that you can talk someone out of their addiction - which is ridiculous. Addiction is a medical problem. If somebody has cancer, you don't try to talk them out of their disease."

Bernstein's steeply angled eyebrows make him look surprised and angry. When he speaks, he's quiet and measured, but his expression suggests amazement at the foolish things people believe. His eyebrows arch even higher when he examines Peterson's ravaged arms.

The procedure is scheduled to take place in the Garden Grove Hospital and Medical Center's intensive care unit, which Peterson now shares with a burn victim, a barely breathing obese woman, and a screaming elderly lady with multiple bone fractures. If he weren't about to undergo rapid detox, Peterson would be considered too healthy to be here. It's been 30 hours since he last shot up, and though he's well into the early stages of withdrawal, he's only suffering from a cold sweat, a dull ache in his leg, and a mounting panic.

The reaction is normal. Opiate molecules have a chemical structure similar to endorphins - a natural hormone that regulates pain and pleasure. When a heroin user shoots up, the opiates in the drug plug into the nerve receptors normally occupied by endorphins. If opiates are administered repeatedly, endorphin production drops. The body has essentially been tricked into short-circuiting the natural pain-pleasure regulation system.

The addiction turns ugly when the opiate is withheld. Without the presence of either the opiates or the natural endorphins, an addict's pain receptors cease to regulate brain signals. The unimpeded flow of stimulation causes acute pain while triggering a cascade of reactions throughout the body: sweating, uncontrollable diarrhea, vomiting, and severe depression. It's not fatal - though it may feel like it - and the addict often relapses just to stop the torment. It usually takes two to three weeks of suffering before natural endorphin production resumes and the pleasure-pain equilibrium is restored.

Considering the ordeal, it's not surprising that quitting cold turkey works only about 5 percent of the time. To improve on that success rate, drug treatment experts have traditionally relied on three approaches: methadone, symptomatic treatment, and Narcotics Anonymous. Methadone, and its modern substitute buprenorphine, are opiates that don't produce a high. An addict taking these drugs has essentially moved from a risky, illegal dependency to a safer, legal one. But if they don't take the methadone, withdrawal begins within hours. For users who don't want to be addicted to any substance, treating the symptoms with a combination of anti-nausea, antidiarrheal, and sedation drugs can help ease the pain of withdrawal. Finally, the support of an NA group is usually recommended in conjunction with all other treatments. These methods have a success rate of 30 percent to 40 percent after a year.

Bernstein says he has a better way to kick opiate addiction - one that painlessly strips the drug from the brain's nerve receptors in 20 minutes. The procedure, which relies on a combination of medicines, is carried out while the patient is anesthetized - a conscious patient would be in so much agony there would be risk of a heart attack. According to Bernstein, the roughly 2,500 patients the institute has treated wake up after an hour and are no longer addicted. Even if an addict were to shoot up after the procedure, there would be no effect. The opiate would be blocked from binding with the receptors already occupied by naltrexone, a drug which must be taken orally for a year. Bernstein says 65 percent of Waismann patients are still clean after a year.

Critics dismiss those numbers and denounce the Waismann method as a scam that takes advantage of desperate addicts. But the American Society of Addiction Medicine has come out in support of the treatment, and the society's former president claims that it's one of the most innovative developments in the field since the advent of the 12-step program in the 1930s.

With a recent surge in the abuse of opiate-based painkillers such as OxyContin, the institute's business is booming. He has put up billboards across the country and has explained the procedure on MTV, CBS, and NBC. So far, he's drowning out his critics. And, like Lasik eye surgery in the 1990s, rapid detox is making the transition from experimental technique to standard procedure offered nationwide. Competitors have emerged: A rival rapid detox center opened last year in Los Angeles, and there are centers in Colorado, Florida, Illinois, Michigan, New Jersey, and New York. Hundreds of addicts are going through rapid detox each year, and proponents like Bernstein are positioning the approach as a modern, humane alternative to Narcotics Anonymous.

Which makes Peterson an early adopter. Now anesthetized, he lies almost motionless in the intensive care unit. Blue fluid is being pumped through his veins. Withdrawal has never been so easy. But it's also never been so deadly.

In 1988, Austrian physician Norbert Loimer was studying opiate withdrawal when he discovered that injecting addicts with naloxone - the intravenous form of the opiate blocker naltrexone - achieved what he referred to as "acute detoxification." It was accompanied by intense suffering, which he tried to alleviate by sedating the patients. It worked. His experimental process condensed the typical weeks-long withdrawal into a matter of days. Though he believed that the procedure was too dangerous to be offered to the public, he published his findings in a medical journal, where they were read with interest by addiction medicine specialists.

One of them was Lance Gooberman, an American MD who concluded that the danger of Loimer's rapid detox method was outweighed by the fact that addicts were dying on the streets every day. Gooberman knew the risks of drug dependence first hand - he was an alcoholic and had been hooked on methamphetamines before he began treating other addicts. He understood that many junkies wouldn't even consider kicking - conventional detox scared them too much. A faster, less painful withdrawal could mean the difference between going into treatment and death for many. So in 1994 Gooberman took Loimer's experimental work and turned it into a business.

Over the next five years, Gooberman performed more than 2,300 rapid detoxifications in his offices in Philadelphia and southern New Jersey. According to county coroners, seven of those addicts died of complications relating to the procedure. That was enough for David Samson, New Jersey's attorney general, to file civil charges against Gooberman in October 1999, accusing him of "repeated gross malpractice, professional negligence, professional incompetence, and professional misconduct." Samson contended that rapid detox was an unproven treatment that put too much strain on patients' bodies. It just wasn't reasonable, the complaint explained, to assume that a two-week ordeal could be safely condensed into an hour. He argued that Gooberman was promising more than he could deliver and creating "a clear and imminent danger to the public's health, safety, and welfare."

While Gooberman was building his practice on the East Coast, Bernstein was recruited to head up the Waismann Institute in Beverly Hills, California. The institute was founded by Clare Waismann, a Brazilian businesswoman who realized that rapid detox addressed an unmet need. The market was crowded with 12-step programs and methadone clinics, but all of them required addicts to stick with a program. Rapid detox largely removed willpower from the experience - it was a concept Waismann thought would make her institute the dominant detox facility on the West Coast and, eventually, in the nation.

Bernstein was an ideal partner. He had attended a respected medical school (Rutgers), understood opiate addiction, and was a med school faculty member. He was energetic, believed in the treatment, and was ready to devote his credentials and time to winning mainstream acceptance for it.

But the headlines generated by the case against Gooberman weren't making it easy. Gooberman was on trial, but the defendant in the three-year case was really the procedure itself. Most of the testimony concerned the alleged dangers and benefits of rapid detox. And since the FDA does not regulate medical procedures, the case became a battle over the legitimacy of the treatment.

Samson laid out his argument clearly, beginning with the obvious: Opiate withdrawal is a nonlethal condition, but seven of Gooberman's patients had died. Anesthesia alone carries a small risk of death. When coupled with an infusion of novel drugs, there's no telling how dangerous it can be, particularly since there have been no large-scale scientific studies on the procedure's effectiveness. In essence, he was saying that the cure was worse than the disease.

David Smith, a leading addiction doctor and former president of the American Society of Addiction Medicine, disagreed. Smith testified that rapid detox was the procedure of last resort for addicts who had tried everything else and failed. Many of them just couldn't withstand the pain of withdrawal. Gooberman offered them another option. His patients came from a population whose health was already compromised - just treating them was a risk. But the fact that he tried to help them didn't mean he was responsible for their deaths. "How many would have died if they'd stayed on drugs?" Smith asks. "Treatment is not a threat to public health, and the attorney general did a disservice by trying to criminalize it."

The judge in the case agreed that Samson was overreaching. In a 353-page opinion handed down at the end of 2002, he concluded there was no evidence that rapid detox "caused or contributed" to the seven deaths. He called the treatment "potentially promising" - but rebuked Gooberman for a variety of medical oversights, fined him $11,500, and revoked his license for six months. The attorney general appealed, and Gooberman soon settled the case out of court. He agreed to pay $375,500 to the state and $30,000 to the families of the deceased. He also agreed to have his medical license revoked for two years. His reputation was damaged beyond repair. No hospital would hire him, and he disappeared from public view.

That left one man in the media spotlight - just in time for a surge in demand. Bernstein made it through rapid detox's early years without a fatality, and now OxyContin abuse was skyrocketing. The treatment had been legally vindicated, and Bernstein's main competitor on the national stage couldn't practice medicine anymore.

Bernstein smiles as the cameraman holds the shot. It's early in 2001, and the Gooberman case rages on. 48 Hours, the CBS newsmagazine show, is documenting the plight of Troy Swett, a 22-year-old OxyContin addict. Swett has just arrived at the hospital in Orange County to be detoxed, and Bernstein is ready for his close-up. "Congratulations for coming," Bernstein says, shaking Swett's hand. "It's the first step."

In a traditional 12-step program, the first step is to admit powerlessness over the addiction. Now, according to Bernstein, the first step is arriving at the Waismann Institute. This kind of national exposure is important for Bernstein. It's an opportunity to continue redefining how the public thinks about addiction.

During the segment, Bernstein notes that 90 to 95 percent of his patients are clean after a month. The on-air reporter asks about long-term effectiveness, to which Bernstein replies, "People walk out of here, their withdrawal is finished, and they're not craving." And the segment moves on.

But the numbers deserve more scrutiny. They are compiled by the Waismann staff without independent confirmation. They are also based solely on follow-up phone calls, and there's no guarantee that everyone is called. (At least one Waismann client, OxyContin addict Tim Lincoln, says he was never contacted after he returned home to Texas. He relapsed after two months.) Bernstein doesn't defend the absolute accuracy of the success rate stats. "Maybe it's a little off," he says, "but it's still much, much higher than methadone or Narcotics Anonymous programs."

Even substantiated statistics wouldn't necessarily prove that rapid detox is better than conventional treatments. The type of patients who come to the Waismann Institute tend to have more family and social support and can afford the $15,000 fee. They are more likely to get clean in any kind of treatment program. And there's another twist: Bernstein says that about 70 percent of his patients are addicted to prescription painkillers. He admits that the success rate for heroin addicts is probably lower, but he doesn't know the exact figure. Still, Waismann advertises a single success rate - 65 percent - and is therefore luring heroin abusers with a potentially exaggerated promise.

Bernstein cites independent studies to buttress his claims. A study from the University of Miami School of Medicine in 2000 reports a 55 percent abstinence rate six months after rapid detoxification. A German clinical investigation in 2000 found a 68 percent success rate at 12 months. But neither study compared the procedure with a control group, so it's impossible to state whether patients would have been more or less successful with another treatment.

Herbert Kleber, director of the division on substance abuse at Columbia University, takes issue with Bernstein's claims. "I challenge him to take 100 addicts off the street and show a 65 percent success rate," Kleber says. "He won't be able to."

Kleber has just completed the largest scientific study of rapid detox to date, and his numbers don't come close to matching Bernstein's. Using a $1 million grant from the National Institute on Drug Abuse, Kleber followed 105 abusers through rapid detox and two other treatments. He found that after three months, rapid detox fared no better than other methods.

But even if it doesn't work as advertised, it's still a useful treatment that can seem like a miracle cure. Even Tim Lincoln, the relapsed OxyContin addict from Texas, grudgingly admits it served a purpose. Before he went to see Bernstein, he tried to quit twice, only to suffer a week of diarrhea, nausea, and severe depression each time. Though he didn't feel good after rapid detox, he didn't have any diarrhea or nausea. Essentially, Bernstein's treatment allowed him to skip that first and most painful week of the process.

It was an illusory victory - Lincoln relapsed within two months. He eventually found the willpower to suffer through the withdrawal on his own and, with the help of Narcotics Anonymous, is clean now. But for addicts who cannot make it through that first week of withdrawal any other way, the $15,000 procedure may be their only hope. And for white collar addicts - business executives, doctors, celebrities, sports stars - the quick fix promised by rapid detox is a powerful draw.

Amanda, a busy Northern California medical-supply sales rep who asked that her real name not be used, was popping 20 Vicodins a day but didn't want to take a lot of time to deal with her addiction. Before she found out about Waismann, she was preparing for a 30-day detox in Malibu. Bernstein, she says, cured her in a weekend: "They put me under Friday. I was a little groggy Saturday. By Sunday, I was ready to get back to work. And I had no desire for the pills."

While criticism from within the medical community hasn't influenced Bernstein, competition may. In November, Chicago-based Midwest Rapid Opiate Detoxification Specialists opened a center in LA. Jake Epperly, the clinical director, distinguishes his method from the Waismann practice by emphasizing "the absolute necessity of a continuing care recovery program" based on Narcotics Anonymous. Epperly runs his own halfway house in Chicago and markets his group as the only rapid detox service in the US with a 28-day inpatient aftercare program.

Of course, closely monitoring a former user's sobriety is a pillar of NA. Addicts are expected to attend 90 meetings in 90 days and speak regularly with a sponsor who has been off drugs for an extended period.

Bernstein has never offered a robust aftercare program. He trusts in the science, not the therapy. At the Waismann Institute, the $15,000 fee includes 6 to 12 follow-up phone calls from a psychologist. Bernstein is particularly adamant that the Narcotics Anonymous approach is counterproductive. "The last thing I want is for my patients to sit in a room with a bunch of other addicts and spend all their time talking about drugs," he says. "It's like a cult. Plus, that's where all the drug dealers hang out."

But Bernstein is adapting. He says that he is in the process of creating his own Waismann-branded luxury recovery center near a beach in Orange County, where addicts can stay after detox. According to Bernstein, it'll be nicer and more effective than Epperly's program. Rather than attend group meetings, patients will be encouraged to play golf and take walks on the beach.

Epperly scoffs at the approach. "Golfing won't keep them off drugs," he says. "Just because their bodies don't crave it doesn't mean they psychologically don't want it."

Bryan Peterson is sitting in the backyard of his parents' suburban home in the hills outside Las Vegas. It has been two weeks since he underwent rapid detox. The swelling in his extremities has gone down, and the scabs on his arms have fallen off. There are dark bags under his eyes, and his skin looks like yellowed parchment. But he manages a meager smile. For the first time in two years, he's been sober for more than a few days. "Everything just looks a little greener," he says, staring out at the mostly gray desert.

Then he taps his fingers on the glass table in front of him. He lights a cigarette. He's got nothing to do. His next scheduled phone conversation with the Waismann psychologist isn't for three days. Peterson admits that he opened the yellow pages a couple of days ago and found the address of a local methadone clinic. "It's the easiest place to score," he says. But he didn't go, and he says that he feels better every day. By mid-November, he was still clean and he moved with his fiance to Glasgow, Kentucky. It's a dry town - no alcohol is sold within city limits - and it's supposed to be very green.

CHICAGO (CBS 2) More than 47 million people have abused prescription drugs at least once. The CBS 2 Investigators look at how the Internet is fueling what experts call this growing health crisis. An addict can connect with pushers on the Net from the privacy of their homes.

A computer and a credit card are all it takes to score addictive drugs on the Internet. No prescriptions are needed.

To ensure the package arrives before their pills run out, cyber addicts are tied to their computers day and night.

"It was all consuming looking for Websites. Trying to keep track of it. Where am I going to get it next? How am I going to get it," said one west suburban woman.

She created a spreadsheet to track her orders from 10 different Websites. She was addicted to the painkiller Vicodin, taking up to 40 pills a day.

"I had to keep them coming in at all costs. At all costs," she said.

She even borrowed $25,000 on her home to pay for her addiction and didn't seek treatment until her habit threatened to cost more than money.

"I would be falling asleep constantly,” said the woman, who is now a recovering addict. "I was driving my children around in the car in this type of condition."

Chicago emergency rooms have reported a huge increase in the number of overdoses from painkillers and stimulants. All too often, they're fatal.

"We have seen an increase in overdose deaths related to the non-medical use of prescription drugs, absolutely. This is nationwide and in every city across the country," said Carol Falkowski at the Hazelden Foundation in Center City, Minnesota.

Here in Chicago, Todd Rode, an alcoholic, was taking legally prescribed anti-depressants. Rode died when he added powerful painkillers bought illegally on the Internet to the mix.

"I was floored that he could get this over the Internet without any kind of monitoring. It's just horrendous," said Lisa Christenson, Rode’s sister.

So who are the typical cyber addicts? You'd be surprised. Many are stay-at-home moms high on stimulants.

"What some of them have really talked about is almost feeling like a super mom. Get the kids to where they need to be, and clean the house and cook dinner and get all those things done," said Beth Sack at Linden Oaks Hospital in Naperville.

Others are stressed out professionals.

"We had one person from the Board of Trade, a trader, that was getting 500 Vicodins a week," said Jake Epperly at the New Hope Recovery Center at Lincoln Park Hospital.

"I think the problem of online purchases of drugs is epidemic and its going to get larger," Epperly said.

Recent crackdowns in the United States have prompted illegal cyber dealers to go international. That makes it tougher for the feds to track them down.

"We work with foreign governments, but in the end we have no legal authority in another country so it’s very difficult to regulate internet pharmacies located off shore,” said Food and Drug Administration Commissioner William Hubbard.

And that's why it was easy for us to score drugs like online. We ordered Vicodin, Xanax, a strong anti-anxiety drug, and Ritalin, a potent stimulant from three different Websites.

The Vicodin was ordered from a Website registered in Greece, and was sent from Amsterdam with a prescription from a doctor in the Netherlands.

None of the sites required us to provide a prescription. Instead we just filled out a medical questionnaire.

"We view that as a sham. It leads to a prescription that is also a sham," Hubbard said.

And these Websites demand charge outrageous prices. For example, our generic Xanax cost $153 on the Internet, compared to the average pharmacy price of about $15.

But did we get what we ordered? Tests at the University of Illinois School of Pharmacy revealed the Ritalin and Xannax were real. But instead of Vicodin, we got a less potent, but potentially addictive painkiller Tylenol3 with codeine.

"All of these drugs turned out to be prescription drugs, and they can be deadly if overdosed," said Adam Negrusz, associate professor at the University of Illinois.

As for recovering addicts, the constant barrage of e-mails peddling drugs could always trigger a relapse.

"If you can't handle that you have to pretty much throw your computer away because it’s there always in your face," said the west suburban woman, who was addicted to the painkiller Vicodin.

To find out which Websites are legitimate, be sure the Websites require a prescription from your doctor. It should also give a phone number to contact them. When you do, find out where they're located and licensed.

In the wake of the controversy over the prescription narcotic Oxycontin, health experts and insurers are raising concerns about the increasing use - -- and abuse -- of Actiq, a newer and faster-acting prescription painkiller.

Actiq, derived from opium, comes in the form of a berry-flavored lollipop or lozenge that takes seven to 15 minutes to hit the bloodstream after a patient places it in the mouth.  The drug, sold by Cephalon Inc.  of West Chester, Pa., was approved by the Food and Drug Administration in 1998 for severe spikes in pain.  It is so powerful and potentially addictive that its label says Actiq "is intended to be used only by oncologists and pain specialists" knowledgeable in using opioids to treat cancer patients who are already tolerant to opioid therapy for their underlying chronic pain.

But use of Actiq appears to have grown far beyond cancer treatment.  Among the 321,463 U.S.  prescriptions written for Actiq last year -- up from 77,478 in 2001 -- 26% were written by family-practice doctors or internists, five times the number in 2001, according to data from NDCHealth, a health-care information company.

Workers compensation programs usually handle relatively few cases of cancer.  Yet in 2003, as more doctors prescribed the drug to patients, Actiq shot up to 15th on the list of total medication costs in worker's comp claims at The Hartford Financial Services Group.  It had ranked 66th two years before.

In many cases, patients with back or neck pain or other ailments are taking the drug four or more times a day, racking up annual bills of $12,000 to $18,000 for Actiq alone, says George Furlong, vice president of provider and payment services for CHOICE Medical Management Services, a Tampa, Fla., workers-compensation managed care company.  Those big bills have prompted many health plans to keep Actiq off their formularies for covered drugs or to require special authorization for its use.  As of May 1, Medi-Cal, California's Medicaid program, will cover Actiq only after a doctor shows that it is for cancer-related pain.  But provisions in many states prevent workers-comp administrators from restricting coverage of painkillers like Actiq, even for nonapproved use.

Off-label drug use, that is, administering a drug for an illness the drug wasn't specifically approved to treat, isn't illegal and is common in medical fields in which doctors tend to experiment with the latest advances in therapy.  Some pain specialists report small doses of Actiq successfully treats sources of severe chronic pain such as migraines.

But some addiction specialists say the drug's growing use has coincided with an increase in its abuse and illegal trade.  In recent months, police in Philadelphia made several arrests of people who allegedly sold Actiq on the street for $20 a dose under the name "perc-a-pop."

Jake Epperly, president and clinical director of Midwest Rapid Opiate Detoxification Specialists and New Hope Recovery Center in Chicago, says his staff treated their first cases of Actiq addiction about three years ago.  In most of those early cases, patients originally had been prescribed the painkiller for a legitimate injury.  In the past 18 months, Mr.  Epperly has started seeing people who got Actiq illegally or by doctor shopping.

So far, no one is calling Actiq the next Oxycontin, which became a widely abused street drug.  Actiq may not have as much street appeal because it isn't as cheap and its effects aren't as long-lasting.

But some addiction specialists and pharmacists say Actiq's powerful, sudden relief makes it particularly enticing for some drug abusers.  Unlike Oxycontin, "Actiq is designed to deliver a quick effect in the first place," says Robert Bonner, vice president of medical claims and medical director at The Hartford.  "It is ripe for misdirection."

In a survey of some 200 law enforcement agencies, diversions of Actiq to street sales were reported seven times in 2002, while diversions of Duragesic, a patch with the same pain-killing ingredient as Actiq, were reported 159 times, says James Inciardi, director of the Center of Drug and Alcohol Studies at the University of Delaware.

Doctors disagree on whether use of Actiq should be strictly limited to prevent abuse.  "People start feeling the withdrawal and that makes them think they actually need more," says Clifford Bernstein, an anesthesiologist and medical director of the Waismann Institute in Beverly Hills, Calif.  Dr.  Bernstein says he uses a fraction of the opioids to treat patients' pain that many other pain specialists do.

Carl Hess, medical director of the Anaheim Memorial Pain Management Center, says the drug can bring long-sought relief to certain patients dealing with excruciating pain.  However, he concedes that for some chronic-pain patients "it can almost work too well."

Actiq still accounts for a very small piece of the multibillion-dollar market for opioid pain medications.  But sales have taken off since Cephalon inherited the drug in October 2000 after taking over Salt Lake City biotech firm Anesta Corp.  Actiq sales have more than quadrupled since 2001 to $237 million last year, and Cephalon is predicting a 37% to 58% increase this year.  Sheryl Williams, a Cephalon spokeswoman, attributes the growth to more recognition among physicians that pain remains an undertreated, widespread problem.

Nevertheless, some of the robust growth is being driven by increased visits by the company's 450 sales representatives to noncancer specialists.  The reps now pitch the product to pain specialists and even some primary-care doctors who treat pain.  Ms.  Williams says the company calls on noncancer specialists because many of them also treat cancer patients suffering from pain.

In the eight years since OxyContin was approved by the Food and Drug Administration, the opium-based painkiller has gone from miracle drug to what some experts fear may be a nationwide epdemic.

Seemingly almost overnight, OxyContin is on the lips and in the mouths of nearly every segment of the population, from college students to little old ladies to MTV's Jack Osbourne, who admitted his OxyContin addiction in April an dhas since been through rehab. Courtney Love and Rush Limbaugh are among a growing list of high-profile people who have given OxyContin abuse national exposure.

And Chicago has its fair share of abusers, especially young adults. "I've worked in addiction treatment for 24 years," said addiction specialist Jake Epperly, president of Midwest Rapid Opiate Detoxification Specialists in Chicago. "I have never seen a phenomenom like this OxyContin thing." Dubbed everything from "hillbilly heroin" to "heroin in a pill," OxyContin has become one of the most abused pain pills in the nation, experts say. Congress' investigative arm, the General Accounting Office, is preparing a report-due next month- on the marketing of OxyContin. Some critics contend that the FDA should require tighter restrictions on prescriptions for the narcotic.

Why would congress be concerned about the marketing of a pill meant for handling chronic and severe pain? Because the abuse of OxyContin "has taken hold across the country," said Dr. Andrea Barthwell, deputy director of drug demand reduction for the Office of National Drug Control Policy. The narcotic has moved into urban and suburban areas from rural areas, where authorities first began tracking its abuse several years ago. The Drug Enforcement Administration says OxyContin is a "highly abused substance" in Illinois, as are Vicodin, Lorcet and Lortab. According to the DEA, prescription drugs are abused almost twice as often as illegal drugs, and 1 million people nationwide have used OxyContin for non-medical reasons.

Epperly said his rehab clinic is seeing large increases in patients younger than 25.

"It's definitely increasing in Chicago, there's no doubt about it," Epperly said. "The opiate population of Chicago generally has younger people." While OxyContin addiction touches a broad range of people, Epperly said he's finding that this is more of a suburban, upper middle-class white thing." Epperly is also concerned that parents and educators are missing signs of the epidemic.

"A lot of people's heads are in the sand," Epperly said. "You go around Geneva, St. Charles, Hinsdale, that area, and they don't realize the kids are on this OxyContin stuff."

Computer users are assailed daily with spam pushing prescription drugs from legal and illegal Web sites. The FDA and the DEA earlier this month formed a task force that will aggressively pursue outfits that market prescription drugs illegally over the Internet.

While some are criticizing the marketing of OxyContin, Purdue Pharma, which manufactures the drug, is spending more than $200 million to education health-care professionals and warn parents about the danger of OxyContin abuse.

It is an effort that didn't reach Indiana residents Steven Mayer and his wife, Amber, until it was too late.

The pair became addicted to OxyContin in 2000 shortly after some friends with legitimate presciptions shared some pills with them. At first, Steven Mayer told the Journal Gazette in Ft. Wayne, Ind., he chewed the pills to get high; later, he injected it.

To feed their addiction, the pair went on a two and a half year robbery spree, stealing from pharmacies in Indiana, Michigan and Ohio until they were arrested and convicted, he said.

Steven Mayer was sentenced to 35 years in prison, while his wife is serving a 6-year sentence. OxyContin "took the place of everything," he told the newspaper.

Authorities aren't only targeting addicts. Dr. WIlliam Hurwitz, a 57-year-old pain-treatment specialist, was recently indicted in Virginia on federal charges of over-prescribing pain killers.

Hurtwitz's critics point to previous runnins with the law to justify the prosecution, but supporters believe he and other doctors in the field of pain management are being unfairly targeted simply because they're helping people in pain.

"There is no question that doctors now fear being held liable if they prescribe painkillers," said Dr. Michael Fleming, president of the 94,000-member American Academy of Family Physiciams.

"I was a victim" - Oxycontin addict says problems began after back surgery

It wasn't neccessary for Bill Stelcher to wander dimly lighted streets to feed his drug addiction.

All he had to do was call in his prescription.

For three years, Stelcher said he never took more of the opium-based painkillers Oxycontin or Dilaudid than was prescribed by his doctors after he had spinal surgery in May 2000.

That didn't stop him from becoming so addicted that his body "screamed" for more of the medication.

There's a whole voice inside of you that's talking, saying 'Get more, get more,' " said Stelcher, 35, who lives in Barrington.

After trying to quit at least several times, in April, Stelcher took his battle with his three-year addiction to Lincoln Park Hospital's New Hope Recovery Center, a drug rehab clinic. His wife, Michelle, borrowed $16,000 from friends to send him there.

"I felt like I didn't know which way it was going to go," his wife said, "I'll either get him there and he'll be my Bill again, or he'll die." The agony of addiction began when Bill Stelcher, who has been drug-free for six months, suffered unbearable pain after his spinal surgery. It was around this time that he first remembers taking OxyContin.

"It made me a little bit nauseous, I think, at first," he said, "But it was so extremely effective. It went straight to the source of the pain." As effective as the drugs were, Stelcher also found that their effects didn't last forever.

After taking OxyContin for a few weeks, he would develop a tolerance and have to switch to Dilaudid. When he built up a tolerance to Dilaudid, he would turn to a morphine pump, which injects it through the back directly into the spine. Then the cycle would repeat. "Every time the medications would not work, we'd take the next stuff," he said.

On Halloween 2001, Stelcher took his regular dosage of OxyContin and then put some chewing tobacco in his mouth. After swallowing some tobacco, he wasn't able to cough it up, and his breathing stopped. Paramedics called to the house were able to revive him and prevent any long-term brain damage.

"That was something that made me very conscious of keeping my eye on him and how the medication was affecting him," Michelle Stelcher said. "For a long time, I was constantly checking his breathing during the night." She later got into arguments with Bill's doctor who precribed him more medication but didn't allow her to have a say in the matter. "(The doctor) would basically say "He's my patient and he's still in pain," she said. The final straw came this spring when Bill became disoriented and fled the hospital. His wife found him at a nearby clinic. He forced her to let him out of the car, and he began wandering on the Kennedy Expressway. After a few minutes, he returned to the car and agreed to go to the clinic. The fear was that I would lose the one thing that was giving me any comfort in this world," Bill Stelcher said.

Neither Bill not Michelle Stelcher blame the doctors who prescribed him the painkillers, arguing they were working with the tools they had available. What the Stelchers would like to see is drug companies using their profits to find safer tools to help patients who need to manage their pain. "I have been, in my opinion, a victim of this whole situation," said Bill Stelcher, who remains in pain. "I was an unwilling participant and a victim, and I believe that."

How Three Chicagoans' everyday lives evolved into extraordinary journeys.

"I was a madman," says Vincent Hunihan who worked for nearly 15 years as a trader in the Treasury bond pit at the Chicago Board of Trade. "I'd get up in the middle of yoga class like I was going to the bathroom, then I'd sneak into the office and call the trading floor to find out what was going on."

In those days, Hunihan was an adrenaline junkie. "I enjoyed chaos in my life. I thrived on it," he reflected. "If my head contained an imaginary body of water, I loved when the waves were rocky." But when yoga came into his life, the churning waters became calm. "I really like it this way," says Hunihan, whose conscious evolution into mindful living began when he enrolled in his first yoga class 18 years ago.

"I was a swimmer who kept getting injured," says the 51-year old Hunihan who swam competitively for many years. "I would go to the health club and work out, but I would get injured just by lifting weights." Then someone told him that yoga might help build his upper body strength. So Hunihan enrolled in a yoga class. Once he began practicing yoga on a regular basis, he not only strengthened his upper body, but he also resolved to examine the way in which he'd been living his life.

"Yoga gives people a shift from their everyday consciousness," says Todd Jones, senior editor at Yoga Journal. "Often," Jones explains, "yoga practice is the only time many of us slow down enough to drop into a deep awareness of our bodies which can be a doorway to even deeper truths about ourselves."

Like Hunihan, there are those who turn to yoga as a way of staying physically fit, yet, often, the more they practice the postures, they find that they're not only shaping up their bodies, but they're also fine tuning their minds and spirits.

Becoming Whole

According to yogic thought, we come into this world with patterns of doing the same things in the ways. "By practicing yoga we begin to recognize patterns that no longer serve us," says Joan Budilovsky, who's an international yoga teacher, author of The Complete Idiot's Guide to Yoga and lives in Oak Brook. "We learn that it's not about changing another person, place, or thing."

Elizabeth Graham's (not her real name) introduction to yoga was a rude awakening. Her life became more unsettled when she first began practicing 12 years ago. Graham now knows that the turmoil she experienced was actually a sign that she was ready to release aspects of her life that no longer worked for her.

As her yoga practice unfolded, the 35-year old Graham recognized that she was in an abusive relationship and had a history of attracting abusive lovers; she also realized she attracted abusive situations in her job as well. "As I reflect upon my life, I realize that I was attracting all of this abuse to myself. It was the way I was thinking about myself," she says. "I needed to recognize this and realize that this was no longer ok for me."

Because of the breakthroughs she had through her yoga practice, Graham managed to finally leave her husband after three years of physical and emotional abuse. "You become less and less comfortable in the situation," Graham says. "Your energy shifts and you're no longer able to be around the same people or in the same situation. You're growing, shifting, and evolving. Your vibration is rising ever so slightly; you're able to become more clear."

Her insight into the causes of her abuse has inspired her to become a yoga teacher, a Reiki Master -- a healer who uses light touch therapy to balance energy centers in the body, and pursue a career in Traditional Chinese Medicine. "It's all about making lifestyle changes to heal yourself. It's all about becoming whole."

Break Down...Break Through

Hunihan, the former bond trader, says that his yoga practice also led him to re-examine his lifestyle. After more than 20 years of working in the trading pit, this ex-navy man slowed down long enough to see how much he relied on alcohol and drugs to make it through his hectic days. He also realized how the booze he drank and pot he smoked affected his ability to love. "My heart was completely shut down," he says. "That's what made me so good at trading. If I lost 50 grand, it was no big deal. I was like 'fuck it. What's next?' You can't just sit there and cry," he says. "I drank and got high so I wouldn't have to feel."

Then Hunihan hit rock bottom, "I lost everything, " he says. For the last four years of his career, he didn't make any money so he lived off his savings until it ran out. "It was hard for me because so much of my identity was wrapped up in money," he says. "I went through a huge ego dismantling -- a humbling. I used to be the master of the universe. I used to have plenty of money, so much that I could afford to take four months off each year to go on a vacation. Now I had less money than the guy bagging groceries at Treasure Island. "I was no different from him, " Hunihan says.

Finally, Hunihan received a phone call from a longtime friend who had heard about his hardships. The friend asked to meet him at a bar they used to frequent in Chicago's financial district -- but on this day Hunihan wouldn't be leaving the bar wasted. The friend told Hunihan he had two choices: he could order a drink, in which case the friend would never see him again -- or he offered to help Hunihan dry out at an alcohol and drug rehabilitation center. Hunihan agreed to go. "It was the best thing that happened to me in my entire life."

Today, Hunihan still works in the financial district -- but not as a trader in the pit. He teaches yoga in an empty conference room at the Chicago Board of Trade and will soon open a yoga studio there called Akal (Awareness) Yoga. He believes he's offering people who work in the financial district something more valuable than money -- peace of mind. "At first I felt funny returning to the Board of Trade. I felt like I couldn't make it as a trader," Hunihan says. "But from time to time, I'd see people I used to work with and they would congratulate me. They'd say 'Man, you've made it! I'm still chasing money and I'm tired. But you've done it. You've gotten out. You're free!"

The most challenging, yet rewarding, class he teaches, however, is one he organized for people receiving treatment at a substance abuse center. "I understand them," he says. "When those students get it, it's like a light bulb goes off. They realize there's a body connected to their mad minds. They get the mind, body, spirit connection."

Hunihan, now sober for more than three years, does not have the material wealth he used to, but he's more than happy with his new life. "I've never had the inner peace that I have now," he says. "I don't have the void."