The united states is facing a new drug problem - only this time not from South America, but from its own back yard. Oxycontin - a powerful prescription painkiller - is fast becoming a deadly presence. Heroin and cocaine are still the drugs of choice for US junkies, but crushing up Oxycontin pills and snorting or shooting them is fast becoming an alternative high for users. Many have died using it, and now Britain has suffered its first "Oxy" death - Samantha Jenkinson, an 18 year-old model from Hull.

Some commentators say that the American experience doesn't reflect an "explosion" in abuse of the drug, more an explosion of articles about abuse. And the column inches have certainly been stacking up.

Oxycodone, the active ingredient in Oxycontin, is not new. It's similar to morphine, and its properties were first described in the 1920s. The reason for its sudden popularity is due to advances made by Purdue Pharma. The company developed a time-release polymer coating for the drug. This made it more convenient to administer to patients in severe pain and it increased compliance with treatment programmes. Slow release meant a single tablet could now contain up to 20 times the normal dose of oxycodone, making an Oxycontin tablet, pound for pound, more powerful than heroin - making it an ideal drug for cancer patients who often need a large and sustained amount of pain killers.

But controlled release is of no interest to addicts seeking an instant hit who soon discovered that when the tablets are crushed, the slow release coating disintegrates, leaving just the immensely powerful active ingredient.

Abuse first mushroomed in dirt-poor, thinly-populated areas in the US - places where demand was high but dealers didn't traditionally operate. Out there it was much easier to get hold of prescription medication than the usual "street" drugs, causing the media to dub Oxycotin "hillbilly heroin". Some remote communities claim 40 per cent of the population abuse it. Soon it had spread to the cities. The mother of Philadelphia student Eddie Bisch set up the website oxyabusekills.com when her son died after mixing Oxycontin with alcohol.

"As I was downstairs and my son lay dead in his bed, the police sergeant came in and said 'Oxy" kids are dropping dead left and right from this stuff'."Time magazine quoted DEA officials saying it "was only a matter of time before every community in this country is confronted with the problem of Oxycontin abuse". They went on: "No prescription drug in the last 20 years has been so widely abused after its release."

So why, when the authorities are so concerned, is the drug still available? The reason is that Oxycontin is spectacularly successful at what it was made for: improving the quality of life of cancer and chronic pain (CP) patients. It would not only be heartless to withdraw a product that helps so many desperate people, it would set a disturbing precedent. Why should the sick lose out because some people choose to abuse a drug clearly labelled as potentially dangerous? Why should cancer patients and the manufacturers of the drug suffer for others' irresponsibility?

Purdue, aware of the concern, were quick to launch a set of high-profile initiatives to try and get a grip on the problem. They hired Rudy Giuliani - known for his zero-tolerance approach when he was mayor of New York - as a consultant "to advise on initiatives to combat prescription drug abuse". They launched the Painfully Obvious pilot campaign to warn kids of the dangers of prescription drug abuse. They also embarked on clinical studies to investigate the viability of abuse-resistant pain medication.

The media, says the company, also has to take its share of responsibility. Clive Jones, of the global Napp Pharmaceutical Group (which includes Purdue) has accused the press of sensationalism and hyping the problem out of all proportion. He points to the Daily Mail running headlines like "Epidemic", and accuses papers of fuelling the boom in illegal use by publicising the drug's potential.

In Britain, prescription laws are tighter than in the USA, and it's difficult to see the drug getting the same foothold here. But there is a precedent, as the popularity of the prescription drug Temazepam (or "jellies") as a heroin substitute amongst Glasgow's drug addicts shows. However, drug deaths in Glasgow have fallen from 150 in 1999 to 89 last year. This can be attributed at least partly to a concerted effort to remove illegally-sourced prescription tranquillisers from supply, as well as educating drug abusers about the dangers of injecting the drug in tandem with heroin.

As the Home Secretary David Blunkett focuses the government's efforts on an illegal drugs crackdown, they may find they have to broaden their scope.