January 13, 2011

When drug abuse is a prescription

A Civic Project story


The Indiana Walk-In Clinic, 7 S. Fifth St., Indiana, Pa. Photo by David Loomis




































By Lindsey Rodrian


INDIANA -- A student at Indiana University of Pennsylvania resisted eye contact as she recalled her fight with addiction. Her long blond hair fell over her shoulder, draping down her arm. As she pulled at her American Eagle sweater, she revealed a bruised, yellow-ish inner arm, a mark of intravenous drug use.


"The last thing I remember saying is, 'I've never felt this good,'" said IUP senior Mary Williams -- not her real name -- in a Nov. 16 interview as she described the moments leading to her heroin overdose seven months earlier.

Williams said she had been introduced to drugs during her freshman year at IUP.


"It started with prescription pills, Adderall actually," said Williams. "The Adderall would keep me up. So then I started to need something to help me sleep."


Adderall is a classified as a Schedule II drug -- it has a high risk of abuse but has accepted medical uses, according to the National Institute on Drug Abuse.


It is prescribed to help control symptoms of attention deficit hyperactivity disorder (ADHD), according to The National Center for Biotechnology Information. But it can cause severe psychological or physical dependence.


Williams said she never had been diagnosed with ADHD. But she received a prescription for Adderall in September 2008.


The prescription was provided by the Indiana Walk-In Clinic, 7 S. Fifth St., just south of Philadelphia Street, Williams said. Her September 2008 appointment was her first visit to the clinic. The clinic does not accept insurance and requires an $85 fee up front before treatment.


"After I paid the receptionist, the nurse took me back into a little dingy room sectioned off by a curtain," said Williams. "When the doctor came in, he asked me three basic questions and wrote me the prescription."


The prescription Williams received was for 60 Adderall pills, 10 milligrams each, she said. The doctor who wrote it was Dr. Tahir Usman Mir.


Mir, a graduate of King Edward Medical University in Lahore, Pakistan, is a licensed Pennsylvania physician and surgeon. He received his medical license July 1, 1977, according to the Pennsylvania Department of State.


SOME primary-care physicians will prescribe medications to patients when that domain of medicine should be left to a psychiatrist, said Dr. David M. Myers, a psychologist at IUP's Counseling Center, during a Nov. 9 interview in his office.


"There are two walk-in clinics in town," said Myers. "And the one off Philadelphia Street does not have a good reputation."


Nevertheless, the Indiana Walk-In Clinic is growing in popularity, according to Williams.

"A lot of people go to the clinic for things like Xanax or Oxycontin," said Williams.


Xanax, a drug used to treat anxiety and panic disorders is in a class of medications called benzodiazepines. It works by decreasing abnormal excitement in the brain, according to National Center for Biotechnology Information. 


Oxycontin is used to relieve moderate to severe pain. It is in a class of medications called opiate (narcotic) analgesics. It works by changing the way the brain and nervous system respond to pain, according to NCBI.


Abuse of both Xanax and Oxycontin is on the rise in the United States, according to the National Institute on Drug Abuse


Williams said people prescribed the drugs in Indiana receive ample supplies from the Walk-In Clinic on South Fifth Street.


"They take them or sell them," said Williams. "And each time they go back to the clinic, the doctor ups the dosage and amount."


Dr. Mir, the only practitioner listed at the clinic, was contacted by phone Oct. 23 at 3 p.m., and Oct. 29 at 12:30 p.m. Both times he refused an interview.



ABUSE of prescription drugs is prevalent in Indiana, said Steve Olish, a case manager for the Armstrong-Indiana Drug and Alcohol Commission.



Steve Olish.jpg

Steve Olish, case manager, Armstrong-Indiana Drug and Alcohol Commission. Photo by Ida Arici

 "If you go looking around in Indiana, Amrstrong County, Blairsville, you can find a dirty doctor," said Olish.


The local trend mirrors trends nationwide. In 2006 and 2007, 80.7 percent of nonmedical users of prescription pain relievers obtained the drugs from a friend or relative for free, according to a 2009 report by the Office of Applied Studies within the federal Department of Health and Human Services. Study participants indicated that a friend or relative had obtained the drugs from just one doctor.


The study also reported that only 1.6 percent of study participants said a friend or relative had bought the drug from a drug dealer or other stranger.


Prescription drug dependence is on the rise in the United States, according to OAS. In 2002, an estimated 963,000 Americans were dependent on pain relievers in the previous year. In 2009, the number rose to 1.4 million, an increase of 49 percent.


A 2006 report showed that a rise in drug-overdose mortality was due to deaths from prescription drugs rather than from illicit drugs such as heroin and cocaine, according to the federal Centers for Disease Control.


In 2009 the problem came home to IUP when two students died of drug overdoses. On Feb. 10, 2009, Douglas James Haney, 18, of Bellefonte, was found dead in his dorm room. Haney died of an overdose of Fetanyl, a powerful synthetic opiate used for pain treatment, according to the coroner's report. Haney did not have a prescription for Fetanyl.


On March 18, 2009, Brenton F. Croll, 18, a freshman nursing student from Roaring Spring, Pa., was pronounced dead. Croll died of a mixture of Xanax and alcohol. Croll did not have a prescription for Xanax.


Myers, the psychologist who treats IUP students fighting addiction, cautioned against drug experimentation during his Nov. 9 interview.


"We know that when an opiate dispenser is made available to lab rats they will stop using food and water and literally use the drug until they drop over dead," said Myers. "We are not much different."


Admission to Pennsylvania rehabilitation centers for treatment of prescription-drug addiction has increased from 2008 to 2010, according to Armstrong-Indiana Drug and Alcohol Commission records. In 2008-2009, 6,790 patients were admitted for opiate/ synthetic addiction treatment in Pennsylvania facilities; in 2009-2010, 9,314 people were admitted statewide, an increase of 37 percent.


Olish, the Armstrong-Indiana Drug and Alcohol Commission case manager, has witnessed the increase and severity of prescription drug abuse in Indiana County.


"I tell everyone this: It ends one of three ways -- rehab, jail, death," said Olish staring blankly in his office. "I remember an IUP student that came to me with a prescription drug addiction. I told him those were his options. Eight months later I went to the jail to do an intake, and there he was."


--Lindsey Rodrian, a junior majoring in journalism at Indiana University of Pennsylvania, is from Pittsburgh.




Sidebar: For more info


For more information on this story, contact the following sources:


Steve Olish

Case manager

Armstrong-Indiana Drug and Alcohol Commission

334 Philadelphia St.

Indiana, Pa. 15701

Phone: 724-463-7860

E-mail: solish@AIDAC.ORG




David M. Myers, Ph.D.


The Counseling Center

Center for Health and Well Being

Suites on Maple East G-31

901 Maple Street

Indiana, Pa. 15705

Phone: 724-357-2621

E-mail: dmyers@iup.edu





Sidebar: To get involved/get help


For more information on drug and alcohol treatment facilities in the area, contact the following:


The Open Door

Alcohol and Other Drug Treatment Center

334 Philadelphia Street

Indiana, Pa. 16066

Phone: 724-465-2605

E-mail:  opendoor26@hotmail.com

Web: www.theopendoor.org


The Counseling Center

Counseling Services

Center for Health and Well Being

Suites on Maple East G-31

901 Maple Street

Indiana PA, 15705

Phone: 724-357-2621

Web:  www.iup.edu/counselingcenter


Armstrong-Indiana Drug and Alcohol Commission

10829 U.S. Route 422

Shelocta, PA 15774

Phone:  724-354-2746

Web:  www.aidac.org




Sidebar: To report suspicious activity


To report illegal prescription drug sales, contact the following:


Addiction Technology Transfer Center Network

Substance Abuse and Mental Health Services Administration

Drug Enforcement Agency International Toll-Free Hotline

Phone:  1-877-RxAbuse (792-2873)

Web:  www.attcnetwork.org




Sidebar:  How this story was reported


"Mary Williams," the IUP student treated by Indiana's Walk-In Clinic, was interviewed by the reporter of this story on Oct. 23, Nov. 16, Dec. 5 and Dec. 10. The editor also interviewed her.


The HawkEye granted the student's request for anonymity in response to her desire to find employment in her field following graduation.


-- David Loomis, editor


An addendum by the Editor:

Jury selection slated in trial of local doctor

By The Indiana Gazette | Oct. 21, 2012 | Page 1

A year after being charged with trading drugs and money for sex from his patients, an Indiana doctor faces trial Monday in Indiana County Court.

Prosecutors from the Pennsylvania Attorney General's office and a defense attorney for Tahir Mir will begin jury selection for proceedings in Judge William Martin's courtroom.

Investigators from the attorney general's Medicaid Fraud Control Section and Indiana Borough police arrested Mir on Oct. 11, 2011, in a third-floor apartment at 7 S. Fifth St., above his Indiana Walk-In Clinic medical office.

A physician since 1977, Mir came under investigation in 2009 when regional health insurance companies, Indiana area pharmacists and local residents raised allegations about his practice, prosecutors charged.

The attorney general charged him with two counts each of insurance fraud, controlled substance violations, conspiracy and bribery -- all felonies -- and a misdemeanor count of resisting arrest, charging that he scuffled with police when they arrived to take him into custody.

According to a criminal complaint, Mir prescribed painkillers for drug-addicted patients, charging them $65 or more in cash at their office visits. One of the patients became an informant and told police that she became sexually involved with Mir, claiming that he gave her prescriptions, money and gift cards in exchange for sex, according to prosecutors.

The attorney general's office reported that investigators arrested Mir with the woman's help, after she exchanged text messages with him, arranging to meet him in the upstairs apartment to get a prescription for Endocet tablets. Agents arrived at the time Mir expected the woman and found him with the prescription, according to charging documents.

Mir, who will turn 62 on Friday, was jailed for two days and was released after posting $50,000 cash bail, then waived his right to a preliminary hearing on the charges on Jan. 18.

Online court records show trial dates in May and August were postponed, and that Mir's attorney, Marc David Daffner, of Pittsburgh, on Oct. 12 filed a request to again delay the trial. Martin did not act on Daffner's motion.

Jury selection is scheduled to begin at 8:30 a.m.


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About this Entry

This page contains a single entry by Ms. Lee C. Vest published on January 13, 2011 12:56 PM.

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