Pubdate: Tue, 10 Jul 2001
Source: Richmond Times-Dispatch (VA)
Copyright: 2001 Richmond Newspapers Inc.
Contact:  http://www.timesdispatch.com/
Details: http://www.mapinc.org/media/365
Author: Leslie Miller (Associated Press)

STATE CONSIDERING LIMITING USE OF OXYCONTIN

BOSTON (AP) _ The state Division of Medical Assistance is considering 
restricting Medicaid recipients' access to OxyContin after more than a 
dozen Massachusetts drugstores have been held up in the past few months by 
armed robbers seeking the powerful painkiller.

Massachusetts would join five other states seeking to curb abuse of the 
drug by requiring prior approval from Medicaid to obtain prescriptions for 
it. Last month, Florida became the fifth state to put restrictions on the 
drug's distribution to Medicaid recipients, following the examples of 
Maine, West Virginia, Ohio and South Carolina.

"We are considering whether or not we want... some prior authorization or 
some other control over the prescriptions of OxyContin," said Paul Jeffrey, 
pharmacy consultant with the division, which administers the state's 
Medicaid program. "We have not come to any conclusions."

A pharmacist who shot and killed a robber addicted to oxycodone, the active 
ingredient in OxyContin, said the drug ought to be banned completely.

"There's no other way of getting it out of the public's reach," said Dana 
Shore, a licensed pharmacist who owns Shore's Drug in Belmont.

In 1990, a man addicted to Percocet, which also contains oxycodone, walked 
into the pharmacy and reached for his gun, Shore said. Shore shot and 
wounded him. The two grappled on the floor in hand-to-hand combat, the gun 
got loose and Shore shot him dead.

Shore said he sees an increase in the overprescription of OxyContin, which 
releases oxycodone slowly into the body, unlike Percocet.

Abusers crush the pills and inhale or inject the powder to get the same 
kind of euphoric high that heroin brings. OxyContin, which hit the market 
in 1996, has been linked to at least 120 overdose deaths nationwide.

"I know people getting 200 to 300 tablets a month," Shore said. "That's 
more than you should get in a lifetime."

The recent rash of robberies in Massachusetts has law enforcement officials 
concerned that abuse of the drug is moving into the urban Northeast after 
exploding in rural Maine and Appalachia.

The company that introduced OxyContin in 1996, Stamford, Conn.-based Purdue 
Pharma, opposes efforts to limit access to the drug by the terminal cancer 
patients and other pain sufferers for whom it's intended.

"We have concerns about any measures that will raise barriers to pain 
control for patients with a legitimate medical need," said James Heins, 
Purdue spokesman.

Karen Ryle, a pharmacist at Boston Medical Center, blames Purdue Pharma's 
aggressive marketing to doctors for the spread of OxyContin abuse.

"They spend a lot of money on advertising," she said. "Patients are 
intimidating doctors into ordering the drug."

West Virginia last month sued Purdue Pharma, claiming the company 
aggressively tried to get doctors to overprescribe the drug while failing 
to warn of its potential for abuse.

Company officials said the drug has been marketed in compliance with 
federal requirements and is safe when used properly under a physician's 
supervision.

"Purdue is very conservative about how we market," Heins said. "We don't do 
direct-to-consumer (advertisements)."

The company's top research priority is developing a version of OxyContin 
that is resistant to drug abuse, he said. Purdue also makes available a 
tamperproof prescription pad in parts of the country where 
prescription-drug abuse is high.

Purdue has not asked Massachusetts' pharmacy board to approve use of the 
tamperproof pad, Heins said.

The company wants to work with law enforcement officials to curb abuse of 
the drug, Heins said.

The pharmacy board voted on Monday to request the state's police chiefs to 
have patrol officers stop by local pharmacies.

The board also voted to send a letter to all pharmacies requesting them to 
be sure their employees are aware of their surroundings and that video 
surveillance equipment works.
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