Pubdate: Sun, 28 Apr 2002
Source: American Press (LA)
Copyright: 2002 Shearman Corporation
Contact:  http://www.americanpress.com/
Details: http://www.mapinc.org/media/926
Author: Sunny Brown, Jeremy Harper
Note: Item titled by MAP
Bookmark: http://www.mapinc.org/oxycontin.htm (Oxycontin)

OxyContin Stigma

Some local doctors and patients are concerned that abuse of the pain drug 
OxyContin stigmatizes those who use the medication legitimately for chronic 
pain.

They say that for every thrill-seeking abuser of OxyContin, there are many 
more using the drug successfully under the supervision of a doctor. 
OxyContin - which is referred to on the street as "hillbilly heroin," 
"killer" and "Oxy" - is prescribed for chronic or long-lasting pain. Its 
active ingredient is oxycodone, which is found in the painkillers Percodan 
and Tylox.

The oxycodone in the tablet is time-released over 8-12 hours, which 
eliminates the need to take repeated doses.

But when crushed or dissolved and then ingested, it delivers an instant 
high similar to heroin.

Of late, OxyContin has been a particularly popular drug among illegal users 
in the Sulphur area, law enforcement officials say.

The drug's manufacturer, Purdue Pharma of Norwalk, Conn., is working on a 
tamper-resistant formula, which they say could be available in three years.

In the meantime, doctors and patients have to deal with the abuse and the 
problems it creates.

Dr. Kevin Gorin, a pain management specialist certified by the American 
Board of Pain Medicine, said the stigma has made many doctors overly 
cautious about prescribing OxyContin.

"I think that we have received many more referrals from physicians who were 
prescribing the drug who now have greater concerns about prescribing it," 
Gorin said.

That can cause trouble for patients using OxyContin lawfully to manage 
pain, Gorin said.

One such person is Sulphur resident Theresa Blaylock, who has multiple 
sclerosis.

"I know OxyContin has a bad reputation, but it's a miracle for people like 
me," Blaylock said. "Because some people don't want to follow the rules, 
they're putting those people who need the drug at risk, too. People like me 
... we're going to be the ultimate victim."

Two years ago, Blaylock started experiencing symptoms she couldn't explain, 
and soon had chronic pain throughout her body.

Doctors tried unsuccessfully to control the pain with the popular 
medication Vicodin and anti-inflammatories.

"You can't endure it for long," Blaylock said. "I did that for almost two 
years. It was a nightmare."

After a series of misdiagnoses, doctors determined in January that she had MS.

The muscle constriction and spasticity of MS created constant pain and 
suffering, making everyday life difficult. For Blaylock, simple tasks of 
getting out of the bed and walking across the room became nearly impossible.

"When your dealing with chronic pain, it takes a toll on your body and 
mind," she said. "Your attitude changes, everything about you that you once 
knew in your life is different."

With the MS diagnosis, her doctor determined that she needed some kind of 
medication that would stay within her body throughout the day. The solution 
was OxyContin.

She now takes two 20 mg doses of OxyContin daily, and two Vicodin if needed 
for "breakthrough" pain when each OxyContin dose wears off.

"It's not the cure, but it's one way to battle the pain," Blaylock said. 
"There is nothing on the face of the earth that will take care of all the 
pain."

No longer confined to bed, she can tend to her African violets, and spend 
time on her sewing hobby.

Blaylock's account is common, Gorin said.

"Many patients have indicated that the medication has given them their life 
back or allowed them to live despite their chronic pain condition," Gorin said.

The difference is OxyContin's time-release mechanism, Gorin said. Unlike 
standard pain drugs, OxyContin produces a sustained release of the 
medication instead of the peak-and-valley release typical of other medications.

"When you have that more equal distribution of the medicine you have less 
of a sedation effect," Gorin said.

Lake Charles resident Steven Breaux has lived with the sedation effect of 
traditional pain medications.

Breaux's life was turned upside down when he was hit by a car while riding 
his Harley Davidson through the intersection of Hodges and Kirby on Sept. 
28, 2000.

His left leg was reduced to more than 200 pieces, his right arm was broken 
in five places and even though he was wearing a helmet, his face was crushed.

Two months later, he emerged from Baylor Medical Clinic, barely able to 
function.

In the midst of 19 major surgeries, doctors prescribed a mixture of Vicodin 
and Percocet, which left him heavily sedated and still in pain.

Breaux first took OxyContin in January 2001. It was the first time he slept 
since the accident.

At his peak, he took 300 mg a day. The large dose brought side effects, 
including profuse sweating and periods of nausea.

"None of this comes without a price," Breaux said.

Despite the negative side effects, the pain relief made life more tolerable 
for Breaux and his family, who he says experienced the pain with him.

"I watched my kids suffer with me," Breaux said. "Sometimes they think that 
it's there fault. They don't think they have done enough."

This February, Breaux worked with his doctor to start gradually reducing 
his OxyContin intake. Over a period of 32 days, he quit using the 
medication entirely.

Though users who crush or snort the pill can experience withdraw symptoms 
similar to heroin addicts, those taking the medication correctly can stop 
with relative ease.

"If used correctly, a sustained medication should be less difficult to stop 
using than a traditional pain medication," Gorin said.

Gorin said in light of the well-documented cases of abuse, he is careful 
when prescribing OxyContin, but remains confident in the power of the drug.

"I'm cautions in choosing who receives the prescription, but it is still 
written as soon as we make sure the state board medical guidelines are 
satisfied," he said. "It's a good drug. It helps a lot of people's lives."
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MAP posted-by: Jay Bergstrom