Pubdate: Wed, 26 Dec 2001
Source: Hartford Courant (CT)
Copyright: 2001 The Hartford Courant
Contact:  http://www.ctnow.com/
Details: http://www.mapinc.org/media/183
Author:  Alen J. Salerian
Note: Alen J. Salerian, M.D., is medical director of the Washington 
Psychiatric Center and teaches at the George Washington University School 
of Medicine.
Cited: American Pain Foundation http://www.painfoundation.org/
Bookmark: http://www.mapinc.org/find?186 (Oxycontin)

DEPRIVING PATIENTS OF OXYCONTIN IS A CRIME

As a psychiatrist, I have treated many desperately ill patients
suffering from depression and other psychiatric problems as they
struggle to cope with serious and often painful illnesses and injuries
such as cancer, AIDS and gunshot wounds.

The drugs used to keep these patients alive and to control their pain
are strong medicine - they have to be to work. But unfortunately, the
very strength that makes these drugs so helpful to people who need
them makes them harmful to people who don't need the medications but
take them anyway to get high.

As every physician knows, all medications can be abused when taken at
high dosages beyond prescribed levels, or when crushed, smoked or
injected to quickly deliver a drug that is designed to enter the body
slowly.

No one would argue in favor of banning all drugs because of their
potential for abuse. And even if society took such an absurd step, it
would do nothing about the problem of drug abuse. If simply banning a
drug kept it out of the hands of abusers, no one in America would be
abusing heroin, cocaine or marijuana.

Knowing all this from my experience in treating patients, I was
disturbed to read about members of Congress criticizing Purdue Pharma
of Stamford - the maker of the pain medication OxyContin - for failing
to do more to stop a relatively small number of abuse cases involving
that drug.

Pain is a serious problem in America. According to the American Pain
Foundation, there are an estimated 50 million to 70 million people in
the United States who are in pain and are either not treated or
undertreated. Surely, the needs of these people deserve the attention
of Congress and the media.

About 2 million people suffering from pain are being treated by
doctors with OxyContin. When taken properly and at the correct dosage
level, OxyContin is safe. The timed-release medication gradually
enters the body over 12 hours, providing pain relief over the whole
period. The slow release is what patients suffering from constant pain
need to provide extended relief.

Drug abusers take excessive doses of OxyContin, crush the tablets and
snort or inject them so that the drug enters their systems
immediately, causing a heroin-like rush. No one does this to treat
pain - people do this to get high. Tragically, some of these drug
abusers have died, just as abusers of many other drugs have died in
far greater numbers.

Ultimately, neither physicians nor drug companies are law enforcement
agencies. Demanding that physicians or drug makers take over the job
of the U.S. Drug Enforcement Administration and other federal, state
and local police agencies is like demanding that car makers police
roads to stop speeders, or that computer makers police cyberspace to
stop computer crime.

Of course, every person suffering from chronic pain wishes the pain
would simply go away without the use of any medications.
Unfortunately, that rarely happens. So the real choice for most severe
pain patients isn't whether to take medication - it is which
medication to take.

OxyContin, which became available in 1995, is a good medication. It
was the first "designer" painkiller to alleviate pain for 12 hours
with minimal side effects. Previously, most pain medications had many
unpleasant side effects and wore off in three to four hours.

Some pain medicines - non-steroidal anti-inflammatory drugs - can
cause bleeding ulcers and other complications that resulted in about
16,000 deaths in the United States last year. But instead of focusing
on these many tragic deaths, the news media and some representatives
in Congress have focused on the reported 282 overdose deaths in which
abuse of OxyContin is suspected of playing a role, even when other
abused substances were found in the same person's body.

News stories and congressional inquiries focusing on the abuse of
OxyContin but ignoring the drug's role in helping millions of pain
sufferers frighten patients and paint a distorted picture of the drug.
Banning this medication makes as much sense as banning cars because
some people are killed in traffic accidents.

For many of my own patients stricken with debilitating pain, OxyContin
has been a godsend. We shouldn't punish these pain victims any
further. Depriving these long-suffering people of the medication they
need would be a crime.
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MAP posted-by: Richard Lake