HTTP/1.0 200 OK
Content-Type: text/html
Oxycon Job - The Media Made Oxycontin Drug Scare
Pubdate: Fri, 04 May 2001
Source: Cleveland Free Times
Copyright: 2001 Cleveland Free Times Media
Contact: http://www.freetimes.com
Address: 1846 Coventry Rd., Suite 100, Cleveland, Ohio 44118.
Author: Sandeep Kaushik
Bookmark: http://www.mapinc.org/find?186 (Oxycontin)
OXYCON JOB - THE MEDIA-MADE OXYCONTIN DRUG SCARE
On February 5, NBC affiliate WKYC Channel 3 was first in Cleveland to
trumpet a warning about a new national drug epidemic heading our way.
Broadcast on the 6 o'clock news, they called OxyContin "the next
heroin" and boldly stated -- based primarily on the word of two
recovering addicts -- that it was rapidly becoming "one of the most
abused drugs in the country," even though they hadn't yet figured out
how to spell it, repeatedly calling it "Oxyconfin" on their website.
As this basic error reveals, they may not have known a whole lot about
the prescription painkiller, but that wasn't going to stop them from
stoking public fears about a new wave of drug abuse. And, over the
next few days, the rest of the local press followed suit with similar
alarmist stories built on the thinnest of evidence.
The Plain Dealer published its warning about the alleged skyrocketing
abuse of OxyContin on February 10, proclaiming it responsible for a
wave of overdose deaths and a rash of pharmacy robberies and other
crimes in nearby states. The story opened with a scary recounting of a
holdup in Kentucky in which a masked man wielding a firearm
specifically targeted one drugstore's stock of the medication,
ignoring the host of other morphine-like drugs behind the counter,
many of which are actually far more potent and much easier to use.
With remarkable similarity, six days after the PD story appeared,
another pharmacy was held up, but this time it wasn't in far-flung
Kentucky, but right here in Northeast Ohio. Walgreen's in Mayfield
Heights was the target of a masked man wielding a firearm who also
specifically demanded the store's entire supply of OxyContin. And in
this case, too, the perpetrator was uninterested in the plethora of
other powerful narcotics stocked on the dispensary's shelves; he
escaped with more than 1,100 OxyContin pills.
Did local newsmen, seemingly on the cutting edge of journalism, dig up
an underground trend and fortuitously print an account of events that
would be replicated in Cleveland in less than a week?
Or, given the timing and the similar details, could the PD account --
taken from the Associated Press (AP) wire -- have actually prompted
some local addict (or entrepreneur) to replicate the act? After all,
Cleveland police have dealt with the barest handful of
OxyContin-related cases over the last year, not one involving a
pharmacy robbery.
Viewed as a single, isolated event, the timing of the Mayfield Heights
robbery, coming right after the burst of media interest, can easily be
dismissed as coincidence. Barring a statement from the alleged
perpetrator (Mayfield Heights police recently made an arrest, but the
guy can't be reached), it is impossible to know.
But in the last three months, local reporting on OxyContin mirrors
what has become a national media craze, with often exaggerated,
sensationalized stories appearing in hundreds of publications from The
New York Times to small-town newspapers in rural Midwestern
hinterlands. "The `poor man's heroin,'" U.S. News described the drug.
"Prescription Painkiller Gains Status as Thrill Pill" claimed The
Indianapolis Star, while The Cincinnati Enquirer called it the
"`Heroin of the Midwest'; Traffickers' and Abusers' First Choice." But
none could match the Port St. Lucie News, which called it the "New
Crack" and touted its "Heroin-Like High" in the same headline (one's
an upper and one's a downer, not exactly a minor distinction).
Taken together, all of these stories (and countless others) have
misleadingly and preemptively proclaimed a major epidemic of OxyContin
abuse -- it is said to now be "the street drug of choice" in many
cities -- and trumped up the threat it poses to public safety. Rather
than just covering a danger, in many cases they appear to be causing
it, advertising to abusers the existence of a new drug, and how to get
and use it.
Which is bad enough. What's worse, the media hype is also creating a
panic that makes doctors and legitimate users needlessly afraid of
utilizing an important advance in the treatment of pain.
The Dukes Of Hazard
OxyContin was an instant hit with doctors when first introduced.
Hailed by pain management specialists as a wonder drug, it was
considered a major advance in the medical profession's expanding
effort to battle the debilitating effects of severe, chronic pain. As
the good news spread, sales of the drug mushroomed, rising from $40
million in 1996 to more than $1 billion last year, outstripping even
medications as popular as Viagra.
"Without OxyContin I wouldn't be able to get out of bed in the
morning, much less hold down a full-time job," says Tracey Jordan of
Houston, Texas, who suffers from three degenerative disks in her back.
Prior to going on OxyContin in August 2000 she took a host of other
medications, but they "were just too harsh, and didn't really take
care of my pain." Her comments are echoed by hundreds of other
legitimate users of the drug, many of whom participate in a growing
number of internet-based pain management support groups.
Media accounts were correspondingly glowing, though relatively few in
number. For instance, in a September 1996 article, Oxy was said to be
enjoying "a groundswell of international support" at the annual
meeting of the International Association for the Study of Pain, as
members touted it as "an excellent opiod for moderate to severe pain."
Then, about 18 months ago, some cases involving illegal use of the
drug surfaced in Maine, but most media outlets ignored the situation.
Soon after, the drug's popularity began to rise in rural Appalachia,
especially parts of western Virginia, eastern Kentucky, West Virginia
and southern Ohio (in and around Cincinnati). If claims of epidemic
levels of abuse are true anywhere, it's here, says Ashland, Kentucky,
pain specialist Dr. Shelley Freimark. "In this area right now, it is a
severe problem," she states.
This can largely be chalked up to the fact that the usual street drugs
are simply not as readily available in these rural outposts, says Dr.
Phil Fisher, head of the Appalachian Pain Foundation (APF), a group
formed last year by pain doctors devoted to educating the medical
community and public about the many benefits of OxyContin: "This is an
isolated area where it's hard for people to get real street drugs. By
and large, OxyContin is not a street drug in most places."
Also, demographic and economic conditions in Appalachia have
contributed to an established, long-term problem with prescription
drug abuse in the region. In general, the population is older, Fisher
says, and many suffer from chronic illnesses and debilitating diseases
born of years working in the mines, increasing both the number of
addicts and the supply of such drugs.
But a bunch of cancer-stricken ex-coal miners don't make for a sexy
story, not to mention the fact that the media lacked a "hook" around
which to build its Oxy coverage. That all changed on February 6 with
"Operation Oxyfest 2001": more than 100 Kentucky cops joined in drug
raids over a five-county area, netting 207 dealers and users. The
media had its hook, and a swarm of reporters descended on the tiny
town of Hazard, Ky. (pop. 5,500), at the center of the affected area.
Within days, the OxyContin "epidemic" was national news, turning
small-town cops into minor celebrities, especially those who could
turn a phrase. Detective Roger Hall of the Harlan County Sheriff's
Department had the distinction of being quoted in two separate AP
articles that were printed in scores of papers across the country,
including the PD. His claim? That druggies will "kick a bag of cocaine
out of the way to get to oxy." But Hall was topped by Sgt. Kerry
Rowland, head of Cincy's pharmaceutical diversion squad, who had the
pleasure of seeing himself in the dual roles of pundit and
crimefighter on the CBS Evening News, though both were topped by then
Hazard Police Chief Rod Maggard, who seemed intent on cornering the
position of head doomsayer of the Oxy "scourge."
Naturally, the politicians weren't shy about chasing the free
publicity, either. With the heightened press interest, they convened a
series of press conferences and public meetings, culminating on March
1 when Virginia Attorney General Mark Earley convened a major summit
on the Oxy epidemic, which included high-ranking officials from five
states -- Ohio, Kentucky, Virginia, West Virginia and Maryland -- as
well as representatives of the Drug Enforcement Agency and Purdue
Pharma, OxyContin's manufacturer. Not to be outdone by his neighbors,
Kentucky Governor Paul Patton, who had already proclaimed a "near
epidemic" in his own state, announced the creation of a statewide task
force, comprised of officials from 15 separate agencies.
Coverage peaked on April 9, the day Newsweek screamed "Painkillers."
Inside, the popular newsmagazine's writers had penned two articles,
one on the rising tide of prescription drug abuse, and the other,
titled "How One Town Got Hooked," on events in Hazard. The now retired
Chief Maggard receives credit for tipping off the feds about the Oxy
problem in Hazard.
A bevy of other news heavyweights had already gotten into the act,
including the national TV networks, Time, The New York Times and U.S.
News. The existence of an Oxy epidemic was now an integral part of the
cultural zeitgeist. After the wave of Kentucky stories by the big
boys, the major urban newspapers in the East and Midwest, including
The Plain Dealer, assigned reporters to look for indications of a
rising tide of abuse in their own localities. Not surprisingly, they
found what they were looking for.
Dying For A Fix
Many of the media's "thrill pill" stories have been centered on widely
disseminated and divergent claims that OxyContin, first introduced in
1996, has been responsible for a shocking number of overdose deaths.
Just how many is an open question. The numbers vary from paper to
paper, and are at best unverifiable, at worst wildly inflated. Some of
the published figures appear only once, in a single article, and leave
no clue as to their origins -- for instance, The Plain Dealer's
assertion that OxyContin last year caused 59 deaths nationwide, 35 in
eastern Kentucky. Others are widely spread; most papers across the
country claim that the drug has been responsible for more than 120
deaths, 59 since February 2000 in eastern Kentucky alone.
Repeated across the country, that latter figure, a shockingly high
number for a relatively short time span, originated in early February
with public statements from Joseph Famularo, the U.S. attorney for the
Eastern District of Kentucky, who used it to justify "Operation
Oxyfest 2001," the largest drug sweep in Kentucky state history. In
Virginia, the second-hardest-hit state, Attorney General Mark Earley
claimed 32 deaths in southwestern Virginia since 1997, later revised
upward to 39 by Assistant Medical Examiner William Massello.
The press responded to these announcements with a flurry of stories
that simultaneously, if illogically, promoted the perception of an
out-of-control epidemic and a small group of public officials
masterfully grabbing the bull by the horns. But none of the accounts,
which repeated contentions of a fast-rising death toll in bold, large
headlines, bothered to ask how solid the numbers were, where they were
coming from or what they meant. If they had, they might have been a
little more circumspect in their reporting.
"That figure was given to us by local law enforcement," says Wanda
Roberts, U.S. Attorney Famularo's spokeswoman, about the 59 alleged
eastern Kentucky deaths. That it was generated by the same police
officials who used it to justify Operation Oxyfest does not appear to
trouble Ms. Roberts, who declined to confirm the figure as accurate.
For confirmation, the Free Times turned to David W. Jones, executive
director of the Kentucky State Medical Examiner's office. He asserts
that "as far as deaths go, I've heard different numbers in different
places at different times; I have no idea where these people are
getting their facts and figures." While he stresses that not every
drug-related death is necessarily reported to his office, according to
his data there were 27 oxycodone-related deaths in the entire state in
2000 (oxycodone is the active ingredient in OxyContin).
Of course, at first glance, 27 deaths over 12 months in a single state
- -- even one at ground zero in the spread of OxyContin abuse --
certainly seems noteworthy, and appears to support the implication
that the number of Oxy abusers in Kentucky has exploded. But Jones
parses the numbers further.
Two of the 27 victims, he explains, were found to have both oxycodone
and alcohol in their bodies, with death caused by the interaction of
two nervous system depressants. What's more, 23 others also had a
head-spinning multiplicity of other drugs in their systems, including
highly potent prescription painkillers such as Dilaudid and Fentanyl,
as well as powerful illegal drugs like cocaine and heroin. In the
final analysis, Jones reveals, only two of the 27 fatalities can be
shown to have been due to the effects of oxycodone alone -- not just
two in eastern Kentucky, two in the entire state.
As for Virginia, medical examiner Massello, so loquacious in publicly
proclaiming an "epidemic" in his state, becomes notably tightlipped
when asked by the Free Times for further details about his cases,
though he does admit that a "significant number" of victims had
multiple drugs in their systems.
J. David Haddox, senior medical director at Purdue Pharma of Norwalk,
Conn., which is required by law to report any information about
adverse reactions to the Food and Drug Administration (FDA), says his
people haven't had any better luck in getting answers: "I don't quite
understand how they can report the information to the newspapers but
can't explain it to us."
And there's more. Oxycodone is the opiod agent in at least 40 separate
brand-name prescription medications besides OxyContin. While it is the
strongest oxycodone formulation in terms of milligrams per pill, there
is absolutely no way of telling, Jones explains, whether an
oxycodone-related fatality was due to OxyContin or another drug.
Other jurisdictions report similar findings. The Free Times has
obtained a confidential table of drug-related deaths from 1996 to the
present in Blair County, Pa., which encompasses the city of Altoona,
prepared by the county coroner. Her data shows that of the seven
oxycodone-related deaths in her jurisdiction in the last five-plus
years, six involved the presence of multiple drugs, often including
heroin, and one was a suicide.
In fact, not everyone who dies from an oxycodone overdose does so
accidentally. For the long-suffering, often terminal patients who
comprise the vanguard of legitimate OxyContin users, suicide by opiate
overdose often seems like a painless way to escape a life of terrific
suffering. Such suicide cases are often lumped in with accidental
overdoses in compilations of Oxy-related deaths, making the
already-inflated numbers appear even greater.
Even when the deaths can be reliably confirmed, for the most part they
do not point to a vast increase in the overall number of prescription
drug abusers. Rather, for the most part, the evidence of multiple-drug
usage implies that a substantial majority of OxyContin abusers are
longstanding drug addicts who have either switched to Oxy from other
prescription or illegal drugs, or took it occasionally as a substitute
for other, more preferable, drugs in short supply in their particular
geographic area, such as rural Kentucky.
"Most of these people have been abusing prescription drugs for a
while, and have just switched over to OxyContin," says Kentucky state
Rep. Jack Coleman, a legislative expert on prescription drug fraud and
abuse and a member of the recently formed state OxyContin task force.
"The problem is not particularly the abuse of OxyContin," he adds.
"It's with prescription drug abuse in general."
His view is echoed by Dr. Karla Birkholz, board member of the American
Academy of Family Physicians, who says that "6 to 7 percent of the
American population uses illicit substances, and that number has held
pretty steady over time."
Epidemic In A Teapot
If you read the stories, or watched some of the local TV coverage, you
probably think that Oxy is the "street drug of choice" in Cleveland
(not to mention the rest of the country), and is sweeping across NE
Ohio with the "vengeance" of crack cocaine -- so proclaimed The Plain
Dealer in a front-page story on April 3. But if so, this represents a
complete reversal from January 2000, when the Ohio Substance Abuse
Monitoring Network (OSAM) prepared a scientific study for the Ohio
Department of Alcohol and Drug Addiction Services (ODAD) about
"patterns and trends of drug use" in Cuyahoga County.
At the epicenter of the "epidemic," only two of the 27 deaths can be
attributed to Oxy alone.
The report claims that (aside from alcohol) crack is the "predominant
drug of choice" with users in Cleveland, with heroin a strong second.
As for prescription drugs, it states that Percodan, Vicodin and
Demerol are "popular" and "easily available," but makes no mention
whatsoever of OxyContin, though it does claim that prescription drug
abuse is generally on the rise. Unfortunately, the OSAM data is too
out of date to conclusively refute the PD's claim of a current local
Oxy sensation, which relies heavily on anecdotal evidence and sweeping
pronouncements from narcotics cops, all from far outlying semi-rural
suburbs.
Then there was the 11 pm report on WEWS 5 on April 16, riddled with
grandly fearsome claims: Since the drug began "booming on the black
market," the number of "holdups at pharmacies have grown to such a
large extent" -- at the time, there had been two, the one in Mayfield
Heights and another, aborted attempt in Summit County near Akron --
that area pharmacists were "living in fear." To support this
contention, the reporter interviewed one Mayfield Heights police
detective and one pharmacist, the latter appearing with his face in
shadow.
The evidence seemed suspect -- a Mayfield Heights lieutenant had
already told the Free Times that the February robbery was the only
Oxy-related case of any sort he'd ever seen in his jurisdiction. So a
check of 15 randomly selected local pharmacies was conducted to test
just how frightened employees were, and how many Oxy-related incidents
they'd experienced. Not one pharmacist contacted reported even a
single case of people attempting to pass bogus or suspicious
prescriptions, much less a robbery. Nor did any admit to "living in
fear."
Next, the Free Times turned to the Cleveland police, who keep records
of drug-related crimes and arrests, thus providing an indirect
barometer of usage levels. "OxyContin hasn't been much of a problem
here in the city of Cleveland," admits Lt. Sharon McKay, public
affairs officer for the Cleveland police. "Some other prescription
drugs are a much bigger problem around here, like Vicodin," she adds.
Since the beginning of 1999, Cleveland cops have filled out only eight
OxyContin-related incident reports, a infinitesimal fraction of the
more than 11,000 drug busts in the city each year -- and several of
those involved the petty theft of handfuls of pills from medicine
cabinets and the like.
There is another scenario, however unlikely, that still needs to be
examined. It may be that Oxy abuse has risen so quickly that it has
gone from virtual nonexistence to the currently claimed exalted levels
in only the last few months, and the Cleveland cops just haven't
caught on yet. Since there was no hard data available for this period,
the Free Times arranged an anonymous interview with a local drug
dealer; if anyone knew how popular Oxy was locally, it would be him.
"I'd never heard of the stuff until about a month ago, when one of my
customers asked me about it," he told the Free Times in mid-April. "He
showed me an article in the paper that talked about how everyone
wanted this shit, so I did a little checking and found some
available." A 20mg pill sells for $20, he reports. Prices may rise,
however, should demand pick up -- Dr. Fisher of APF says that street
prices in Appalachia have jumped 50 percent as a result of the recent
media hype.
But if Oxy abuse isn't much of a problem in Cleveland, despite the
media assertions to the contrary, how bad is it really across the
country? The most relevant data come from the Drug Abuse Warning
Network (DAWN), compiled by the federal government's National
Institute on Drug Abuse (NIDA), which tracks drug-related emergency
room visits across the country, broken down by each specific drug.
The most recent DAWN figures do show a 72 percent increase in the
number of oxycodone-derived ER incidents, from 3,060 in the first half
of 1999 to 5,261 in the equivalent period in 2000, but nevertheless,
the total number remains very low compared to many other drugs; during
the same period, there were more than 18 cocaine and 15 heroin-related
visits for each one involving oxycodone. Indeed, the data show that
there were almost twice as many hydrocodone-based incidents (the
narcotic ingredient in a number of opiates, including Vicodin) as Oxy
ones.
Such figures cannot help but raise serious doubts about just how large
the much-ballyhooed OxyContin epidemic actually is. Dr. June Dahl,
professor of pharmacology at the University of Wisconsin Medical
School and president of the American Alliance of Cancer Pain
Initiatives (AACP), points out that "cocaine accounts for half of all
drug-related emergency room visits, at a cost of more than $30 billion
annually." When placed in that context, claims of a national OxyContin
epidemic "seem incredibly exaggerated."
And there is another reason why the increase is not as significant as
it might first appear. The increase in ER visits was largely
predictable since legitimate use of OxyContin rose by a similar
amount, argues Dr. Fisher of the APF. He points to Vicodin as a much
more serious prescription drug problem, since illegal usage of it as a
percentage of its total sales is rising much faster than that of
oxycodone. "That's the real problem," he claims. "Compared to it, Oxy
only accounts for 10 percent of the cases but gets 90 percent of the
attention."
Old Wine, New Bottles
Not everything that happens is news, and all news is not created
equal. It's not just that the media has produced a lot of Oxy stories
in the last three months, it has produced a lot of Big, Important Oxy
stories, often splashed on the front page of newspapers or as the lead
on local TV news programs. Why so much attention?
For one thing, OxyContin is new, and the media are constantly in
search of something different, unusual or unknown with which to
titillate its audience. "The media are thrill-seekers looking for the
next big ratings turn-on," contends nationally recognized media critic
Norman Solomon, the author of nine books on the mainstream media and
writer of the "MediaBeat" column in Extra!, the magazine put out by
Washington-based media watchdog group Fairness and Accuracy in
Reporting (FAIR). "You know they're embarked on an intellectually
dishonest course when 18 people on a new drug becomes much more
important than tobacco, which results in 700,000 deaths a year."
Also, ironically, media crazes touting the arrival of some apparently
new, dangerous drug whose unchecked spread surely spells the doom of
Western civilization is as old as the hills. Dr. Dahl of AACP likens
the current spate of "fear mongering" Oxy stories to the 1930s-era
film Reefer Madness, with its laughably over-the-top rendering of the
evils of marijuana use.
In the more recent past, a number of other "new" drugs have received
similar treatment from the press, bursting onto the media radar screen
with supernova brightness for several months before boredom set in and
they were rarely heard about again. At the beginning of the last
decade it was "ice," a smokable form of methamphetamine, which a slew
of print articles and television reports touted as "the crack of the
'90s." Apparently too expensive and difficult to manufacture, ice
never attained the exalted heights the media predicted.
Much of the problem with the way drug abuse is reported stems from the
advent of the openly declared War on Drugs in the early 1980s, when
the media signed on as a full partner in the government's effort to
demonize drug use and stigmatize users. "The media presented the drug
problem as a war of the holy people against the depraved people, and
we haven't gone far past that moralizing tone, unfortunately," says
Solomon.
And there's a racial dimension to this coverage as well. Contrary to
statistics compiled by NIDA and the Office of National Drug Control
Policy (ONDC), the prevailing perception that crack is a ghetto drug
abused by poor people of color affects almost every aspect of the drug
war, from public policy choices (punishment vs. treatment) to
legislative decisions (crack is worse than powder coke) to law
enforcement tactics (racial profiling), and media choices.
Prescription drug abuse in general, however, is known to be primarily
a white, middle-class phenomenon.
Oxycodone, it turns out, is probably the whitest drug of all. DAWN
compiles drug mentions in reports from medical examiners, and breaks
the resulting figures down by race. In general, white people accounted
for 65 percent of such mentions for all drugs combined, but a whopping
87.4 percent of those for oxycodone, the highest proportion of
mentions among the 14-odd drugs reported at least 100 times. By way of
comparison, whites accounted for only about 60 percent of the heroin
mentions. Apparently, when a black guy in the inner city gets hooked
on crack, it's business as usual, but when a middle-class white girl
in the South gets a jones for Oxy, it's front-page news.
"The whole drug issue is fraught with almost totally unacknowledged
class and racial aspects," argues Solomon. "It's a big reason we have
such racially driven disparities in the prosecutions and penalties
associated with different drugs."
Working Hard For The High
OxyContin is an odd choice of drug to be responsible for a tidal wave
of illegal abuse. There is no question OxyContin is a strong drug --
oxycodone is a powerful narcotic derived from opium, like morphine or
heroin. Milligram to milligram, it is twice as potent as the former,
according to data compiled by the U.S. Department of Health and Human
Services. And OxyContin contains a lot of oxycodone; it is produced in
five pill sizes, ranging from 10 to 160mg. Percodan and Percocet, both
frequently abused oxycodone-based analgesics, only contain 2.5 to 10mg
of the narcotic element per pill.
But OxyContin is formulated in a manner that happens to make it
somewhat difficult to use to attain a high. Newspaper stories have
consistently reported that the pills are manufactured with a special
coating that releases the drug into a legitimate user's bloodstream
evenly over time, thus providing a constant level of pain relief. But
even this basic fact is wrong in its technical details, reveals Dr.
Haddox of Purdue Pharma.
The pills do boast a time-release mechanism, he explains, but this is
the result of internal ingredients known as "retardants" rather than
any outer coating. Therefore, in order to get a high from the stuff,
illicit users have to finely crush the pills so as to disable the
time-release feature, whereupon the resultant powder is either snorted
or dissolved in water and injected. "You have to work to abuse this
drug," he says. APF's Dr. Fisher makes a similar point: "It's a lot of
work to go through to get high off this stuff -- a lot of other drugs
are a lot easier to misuse."
Intravenous use is the most efficient means of maximizing the high,
and the printed accounts, following the leads of narcotics officers,
report that injection is a common and widespread means of ingestion
among abusers. This assertion appears innocuous and unsurprising at
first glance; after all, oxycodone is reported to be similar in effect
to heroin, far and away the most common intravenously abused drug
(addicts get a rush, an immediate wave of intense pleasure, from
injecting it). And a Summit County Sheriff's Department detective
tells the Free Times of nearly always finding blackened, encrusted
spoons, evidence of intravenous injection, in the homes of Oxy abusers
during busts.
What the detective does not seem to know, and what the media reports
almost never reveal, is that OxyContin is actually very difficult and
dangerous to inject, even after being crushed. The retardants mixed in
with the oxycodone in the pills cause abscesses -- horrible wounds
caused by rotted flesh -- at the point of injection. "It's incredibly
dangerous to abuse OxyContin intravenously," the Purdue doctor explains.
It seems unlikely, therefore, that IV drug users, who form the
hardened core of opiate abusers, would prefer Oxy to other opiates.
Rather, it is far more plausible that such addicts use Oxy as a drug
of last resort when heroin, comparable in effect and often cheaper, is
not available. What, then, to make of the blackened spoons? Indeed,
many of the OxyContin addicts falling into police custody in
ever-increasing numbers appear to be mostly the same old junkies the
cops have always been busting -- they just happen to now be
occasionally dabbling in Oxy in order to supplement their habits and
stave off withdrawal.
The Real Victims
All of the media hype, complete with gripping headlines and
fear-inducing content, is provoking feelings of anger and derision
from growing numbers of doctors who specialize in chronic pain
management. For years, this area of medical treatment was largely
ignored or underemphasized by most physicians, says Dr. Dahl of the
Cancer Pain Initiatives. "Historically, there have been a lot of
inaccurate preconceptions and oversensitivity about opiod analgesics
and other narcotics, which has kept them from being used as much as
they should," she states.
The flurry of accounts surrounding Oxy has not only stalled progress
in this area, but has sent the treatment of chronic pain reeling
backwards into ignorance and fear.
With all of the media sensationalism about the crackdown on illegal
use, particularly the spate of stories about the occasional arrests of
corrupt doctors, more and more physicians are becoming leery of
prescribing OxyContin, or have stopped using it altogether, even for
patients who desperately need the medication. One doctor in St.
Charles, Va., has even gone so far as to begin a petition drive to
pressure Purdue Pharma into withdrawing the drug from the market,
though a company spokesman states that they have no intention of doing
so.
"My job is to take care of the worst of the worst pain cases," Dr.
Fisher says, "but now I'm seeing run-of-the-mill patients whose
doctors are afraid either that they'll be prosecuted for prescribing
OxyContin, or that they're somehow being duped and the drugs they
prescribe will end up on the street."
In addition, the negative media attention is not only making it more
difficult for legitimate patients to get the medication they need, it
is making them afraid of taking it when it is prescribed for them.
"I'm treating two little old preacher's wives," Fisher says. "Both are
afraid of getting addicted, and one is sure someone's going to break
into her house to get her supply of the drug."
All of this is not to say that the problem of Oxy abuse is not growing
in some American cities, including perhaps Cleveland. Media accounts
notwithstanding, however, it is still abused far less than other
prescription drugs like Vicodin. And in many, if not most, of the
instances, a substantial portion of the blame for the rise in illicit
use can be laid directly at the door of the media, whose prominent,
sensationalized, fear-mongering coverage of this one pharmaceutical to
a large extent creates and drives the burgeoning demand for the drug.
Thus, the Mayfield Heights robbery.
And given this sort of hyperbolic coverage, was it not just a matter of
time before another local pharmacy was robbed of its supply of
OxyContin? That is exactly what recently transpired. On Sunday, April
22, the Rite Aid pharmacy in Brook Park was robbed. Ignoring the
treasure trove of other opiates stocked behind the counter, the thief
zeroed in on only the Oxy, making off with a supply of 250 pills with a
list value of $1,100.
- ---
MAP posted-by: Andrew