With the DEA trumpeting the dangers of Oxycontin, a powerful time-release opioid effective in pain relief, and local media across the country jumping on the bandwagon, patients, doctors and the drug's maker are reporting increasing problems for pain patients seeking access to the drug.
"I hear it every day," Skip Baker of the American Society for Action on Pain (http://www.actiononpain.org), a pain patient advocacy group, told DRCNet. "Because of this scare, people are having to drive hundreds of miles to find a physician to prescribe Oxycontin."
The scare is reaching epic proportions, with cops and newspapers across the country eagerly scanning the horizon for any sign of the new narcotic nemesis. "Hillbilly heroin... could become a problem in Texas," the Ft. Worth Star Telegram warned last week, citing "pharmaceutical drug diversion investigators." But, the paper added, "few to no reports" of Oxycontin abuse have been logged. In Evansville, Indiana, meanwhile, police "are watching out for" Oxy and "fear it's on the way," the Evansville Courier & Press reports. Police have seized "at least a couple of tablets in recent months," the paper notes. Milwaukee is also at risk, the Milwaukee Journal reports, even though a major metropolitan emergency room had not seen any Oxycontin overdoses. "We're the last to know, I guess," said one hospital worker.
These reports are merely the latest manifestation of a drug panic underway since the spring, when pockets of Oxycontin diversion and abuse began popping up in the Appalachians (http://www.drcnet.org/wol/187.html#oxycontinhype). According to a Boston University study, 120 people have died from Oxycontin-related causes -- out of six million prescriptions last year.
But Purdue Pharma, the drug's manufacturer, disputes even that even that many have died from Oxycontin overdoses. "Oxycodone [the active ingredient in Oxycontin] is used in over 40 different pain meds, including such popular meds as Percocet," Purdue spokesman Jim Heins told DRCNet. "Toxicology tests can determine the amount and presence of oxycodone, but they can't tell whether it's Oxycontin or Percocet or something else. Coroners usually list oxycodone because without physical evidence, such as a prescription bottle, they can't determine which drug was ingested."
Oxycontin only accounts for 25% of all
oxycodone-based prescriptions, Heins added. Also, he said, many of the
deaths attributed to Oxycontin "are the results of multiple drug abuse
But the publicity generated by the DEA and local officials "is already having an adverse impact on good pain care and good medical practice," Hein said. "We get calls, letters and reports frequently from patients who say doctors won't prescribe Oxycontin for them anymore because of the publicity and because they are scared of being investigated and losing their licenses. And that's just wrong," he added.
Gary Kennedy of Norton, in southwest Virginia -- one of the Oxy panic's epicenters -- is one patient who has suffered because of the hype. "Without Oxycontin, I would be in a nursing home," he told the Roanoke Times. "If I take no medication, it is a constant, killer pain," he said. "It hurts you so bad you want to roll in the floor." But he said that although he needs the drug to live a normal life in his home, he must drive 100 miles round-trip to Kingsport, Tennessee, just to find a doctor willing to dispense the powerful painkiller.
Associations of pain patients and pain care professionals are asking for some balance. In a statement on the Oxycontin controversy, American Pain Society President Dr. Michael Ashburn said, "Concerns over diversion and abuse may be decreasing access to the drug for appropriate medical purposes. There have been reports of pharmacies refusing to stock the drug because of fear of theft, and patients have reported that their physicians have become reluctant to continue to prescribe the drug to them. In addition, publicity over the abuse of Oxycontin has led to increased concern over the use of opioids for the treatment of chronic pain."
Saying he feared pain treatment had "lost ground" because of the Oxy panic, Ashburn pleaded with public officials not to let drug hysterias drive public policy. "When developing public policy, policy makers must be reminded to develop policy that strikes a balance. We should be able to address concerns over diversion without creating barriers to their appropriate use," Ashburn said.
Loretta Johnson, a 66-year-old southwest Virginia resident, told the Roanoke Times she thought news coverage was actually contributing to Oxycontin abuse. She said she used the drug in 1999 with good results after she broke her back in a car accident. "I realize it's a dreadful problem and that people have died and are dying because of it," she said. "But the drug is not the problem. It's just like guns. The gun is not to blame, it's the use of it."