Like all social problems, the origins of OxyContin abuse are located in social events and require social explanations. Kentucky’s problem with OxyContin has particular social circumstances. They include: Purdue Pharmaceutical’s sales and marketing strategies, Congress’ declaration of the “decade of pain,” the medical community treating pain differently, the DEA granting increases in manufacturing, and a history of pharmaceutical use and abuse in rural Kentucky. However, OxyContin is not affecting drug arrest rates, given that arrests increased significantly in 2001 but decreased in 2002. The OxyContin-crime panic, like others, is a socially constructed occurrence. Scares usually result in an extreme reaction to a perceived drug problem that may not necessarily correspond to its actual social or individual harm. Drug scares, as moral panics, are symbolic crusades that involve particular interest groups or agencies that lead the way in labeling the drug as dangerous. In some cases those groups and agencies benefit from such labeling. The OxyContin-crime propagated relationship is the latest. OxyContin, an oxycodone drug, is among the most powerful analgesic currently manufactured. OxyContin provides significant and sustained pain relief and is listed as a Schedule II narcotic under the Controlled Substances Act. For decades, pharmaceutical drug abuse has been a significant social problem in Central Appalachia, Kentucky. News headlines and stories have documented the OxyContin problem. This report presents the trends in OxyContin’s use and abuse. It presents evidence of an epidemic created in part by organizations in both the public and private sectors. It describes the marked changes in OxyContin arrests but concludes that the arrest trends likely reveal more about law enforcement than drug use. Tables, figures and references