Pubdate: Fri, 27 Jul 2001
Source: Sun News (SC)
Copyright: 2001 Sun Publishing Co.
Contact:  http://web.thesunnews.com/
Details: http://www.mapinc.org/media/987
Author: Elaine Gaston

PAIN TREATMENT SUFFERING AS A RESULT OF DRUG ABUSE

OxyContin abuse and the recent closing of a Myrtle Beach pain management 
clinic have made local doctors more cautious about prescribing the potent 
painkiller. Stories about OxyContin abuse also have led to concern among 
legitimate patients taking the drug. Local doctors who treat pain say 
they've had patients express fear that the drug will harm them and have 
asked to be taken off the drug.

"It's extremely hard because a majority of pain doctors use a lot of the 
medications that are becoming tagged the bad drugs," said Dr. Jeff 
Benjamin, a neurologist at Strand Regional Specialty Associates' Spine & 
Neurologic Institute. "This is about abuse by the doctors and the patients 
... a few bad apples."

Much of the fear among patients is linked to reports of people abusing the 
drug and overdosing on the medication, doctors say.

The fear among local physicians is connected to the closing of 
Comprehensive Care and Pain Management Center at 7714 N. Kings Highway. The 
clinic closed in mid-June because of sanctions by the Drug Enforcement 
Administration, which has declined to discuss the case because of an 
ongoing investigation.

At least one doctor has had his DEA license suspended, temporarily 
prohibiting him from prescribing narcotics such as OxyContin.

"No physician wants to be called on the carpet," said Dr. Anthony 
Alexander, a physiatrist at Strand Regional Specialty Associates in Myrtle 
Beach. "Therefore, they're very cautious about writing those prescriptions 
and about documenting what the diagnosis is."

Michael Ashburn, president of the American Pain Society, said, in a 
statement earlier this year, that "Concerns over diversion and abuse [of 
OxyContin] may be decreasing access to the drug for appropriate medical 
purposes."

Benjamin agreed.

The DEA scrutiny of the local clinic and reports of OxyContin abuse "has 
created this fear for the moment," Benjamin said. "I can say we're not 
treating the patient as fairly as we should out of fear you'll be labeled 
as the next questionable pain clinic."

The Food and Drug Administration has said the drug is safe when used 
properly and under a physician's supervision.

OxyContin, created for cancer patients and for the treatment of moderate to 
severe chronic pain, has been beneficial to a number of patients, doctors say.

Cancer patient Bob Agresta, 63, of Surfside Beach, takes OxyContin for 
tumors on his spine. Other pain medications have failed to bring relief 
from the pain that made sitting, standing or lying in one position for too 
long uncomfortable.

"I'm one of the people that need it," Agresta said. "It's been wonderful 
for me. All these people that are abusing it just makes the people who 
really need it look bad."

Dr. Scott Sauer with the Center for Pain Relief in Myrtle Beach said 
reports about OxyContin abuse have created a social stigma.

"[Patients] think they're doing something wrong by taking OxyContin," Sauer 
said. "They come in and want to come off of it. We then have to educate 
them about it and try to inform them they're taking it properly."

Treating pain has moved to the forefront of medicine in recent years.

The Joint Commission on Accreditation of Healthcare Organizations the group 
responsible for certifying the quality and safety of hospitals, nursing 
homes and clinics nationwide has adopted standards for treating pain. On 
Jan. 1, the group began requiring medical facilities to show they meet 
certain standards for the assessment and treatment of pain. Clinics must 
also inform patients of their right to effective pain care. If the 
facilities don't comply, they can lose their accreditation.

Despite the advances in pain management, pain often goes untreated, mainly 
because people are afraid of the medications and because some physicians 
are uncomfortable with dispensing them, Benjamin said.

Drug therapy is one treatment option for pain sufferers.

Other treatments might include injection therapy, use of anti-depressants, 
use of anti-seizure medicines, physical rehabilitation or a combination of 
all treatment methods.

"Patients should expect to meet a caring physician who is genuinely 
interested in their care and their complaints and who's willing to do a 
thorough physical and use diagnostics to determine the generator of their 
pain," Alexander said. "That physician should devise an individualized 
program or a medications program to lessen or alleviate that patient's pain."

INFO : Facts about pain More than 75 million Americans live with serious 
pain, 50 million have from chronic pain, and each year another 25 million 
experience acute pain as a result of injuries or surgeries. 45 percent of 
all Americans seek care for persistent pain at some point in their lives. 
Source: American Academy of Pain Medicine
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