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. - --- MAP posted-by: Beth