Pubdate: Sun, 03 Jun 2001
Source: Atlanta Journal-Constitution (GA)
Copyright: 2001 Cox Interactive Media.
Contact:  http://www.accessatlanta.com/ajc/
Details: http://www.mapinc.org/media/28
Author: Wes Allison

FDA PANEL WILL STUDY UPROAR OVER OXYCONTIN

In one short year, OxyContin has become the dastardly villain in the
war on drugs, engendering the ire of prosecutors and federal
regulators while being blamed for dozens of deaths from New England to
Florida.

Nervous physicians are on the lookout for addicts faking injuries to
con prescriptions. The government is considering restricting
distribution.

As law enforcement tries to battle the illegal use of OxyContin, a
powerful prescription pain reliever that has become a hot new street
drug, some patients and pain management groups worry they'll be the
ones to suffer.

Already some doctors are blanching at prescribing it, they say, and
advocacy groups fear new government restrictions that will make it
more difficult for people who need it to get it.

"I had to literally go beg doctors to give me a prescription because
everybody is so paranoid," said Liz Constable, who suffers from
fibromyalgia and read about the benefits of OxyContin in a
fibromyalgia newsletter, then visited three doctors before one agreed
to let her try it.

"I'm a 51-year-old retired schoolteacher," she said, exasperated. "The
last thing I'm going to do is sell a drug on the street."

Dr. Russell Portenoy, a member of the board of the American Pain
Foundation and chairman of pain management and palliative care at Beth
Israel Medical Center in New York, blames media hype and government
overreaction for having a "chilling effect" on some doctors.

Portenoy, a national leader in the field of pain management, has been
asked to serve as a consultant to a U.S. Food and Drug Administration
panel that will meet in the fall to consider whether oxycodone, the
generic name for OxyContin, and other opioids need more
restrictions.

He says patients have reason to worry.

"Because of the pervasive fear of these drugs in this country, what I
would call the stigmatism of these drugs, stories about (misuse) may
drive regulators and those in law enforcement to take actions that are
not warranted and would have the unintended effect of reducing access
to patients who need them," Portenoy said.

Maggie Tucker, 39, who has lesions on her spine from multiple
sclerosis, had been on several drugs that left her groggy and in pain
before she mentioned OxyContin to her physician.

He agreed it could help but didn't want to be the one to prescribe it,
she said. She got it from a pain specialist four months ago.

"He was afraid just because the DEA would come down on him because
he's a family practitioner," said Tucker, an insurance agent who has
been unable to work. "He said I need somebody to back me on this. Your
best bet is to go see" a specialist.

Since being approved in 1995, OxyContin has become one of America's
most prescribed medicines for chronic pain, reportedly with sales of
$1 billion last year. Its popularity rose as family doctors, who long
resisted giving opioids to people with nonfatal diseases, have become
more comfortable with stronger drugs.

Some people suffering from chronic pain say they tried other
medications but those drugs made them feel sleepy or didn't work as
well.

"For the first time in 15 years, I've had days where I've been able to
function. And that's been a blessing," said Ed Madonia, 74, who
suffers from a diseased spinal column and took Percodan for a decade
before switching to OxyContin early this year.

OxyContin is a synthetic morphine, an opioid like Percocet or Vicodin.
The key to OxyContin is its timed-release formula, in which small
amounts of painkiller are released into the bloodstream gradually,
usually over 12 hours.

But when used illegally, the pill is often crushed and snorted, or
mixed with water and injected, or chewed. This delivers all the drug
at once, producing an intense high that also can kill.

Addicts and dealers typically steal it from pharmacies or patients or
buy prescriptions from unscrupulous doctors. Or they concoct elaborate
ruses in hopes of persuading a physician to prescribe it.
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