Pubdate: Wed, 11 Jul 2001
Source: Chattanooga Times & Free Press (TN)
Copyright: 2001 Chattanooga Publishing Co.
Contact:  http://www.timesfreepress.com/index.html
Details: http://www.mapinc.org/media/992
Author: Kimberly Greuter, Staff Writer
Bookmark: http://www.mapinc.org/find?186 (Oxycontin)

ABUSE OF PAIN MEDICATION ON RISE

It has been hailed as a miracle drug for those suffering from severe, 
long-term pain, but OxyContin also has been criticized as being too easy to 
obtain and abuse.

Officials say there has not been a case prosecuted in Chattanooga for 
OxyContin distribution or possession, but they acknowledge the drug is 
being distributed illicitly in the area.

Ben Scott, resident agent in charge of the federal Drug Enforcement 
Administration office here, calls OxyContin "a drug that's ripe for abuse.

"It's here and we know it's here," Mr. Scott said. "We don't have the level 
of abuse as in other areas."

In Boston, armed robbers looking for the painkiller have hit a dozen drug 
stores in the past three months. Lawsuits filed recently in Kentucky, Ohio, 
West Virginia and Virginia accuse the drug's manufacturer, Purdue Pharma of 
Stamford, Conn., of deceptively marketing it. Police in one Virginia town 
have asked pharmacists to fingerprint customers filling OxyContin 
prescriptions.

More than 120 deaths nationwide have been linked to OxyContin, although 
Purdue Pharma officials say their evidence indicates the victims abused 
other drugs, as well.

Terry Shapiro, executive director of the Council on Alcohol and Drug Abuse 
Services in Chattanooga, said the drug, when abused, produces a high 
similar to that of heroin.

"They get started due to physical pain they're having. Where they cross the 
line into abuse and why, I'm not sure," he said.

A problem develops when someone taking the drug doubles or triples a dosage 
because the user enjoys the effects of the medication, he said.

Paul Laymon Jr., an assistant U.S. attorney, said he has seen evidence the 
drug is being abused here.

"I have had at least three investigations in which the primary drug wasn't 
OxyContin, but there was OxyContin involved," he said.

But experts point out that OxyContin has helped people who live with 
chronic pain.

"For some people pain is a daily, sometimes hourly management problem. 
OxyContin has given them a new lease on life," said Kate Malliarakis of the 
White House's Office of National Drug Control Policy. "It provides freedom. 
It relieves pain so they can function in society."

OxyContin, which has been on the market since 1996, is a timed-release form 
of oxycodone, an opium derivative. It is intended for cancer patients and 
others who suffer from chronic, severe pain. The drug's manufacturer 
reported 6 million prescriptions written for it in 2000.

"The people who need it take it on a daily basis because they have pain on 
a daily basis," said Dr. Sandra Hinds, a pharmacist at Moore & King 
Prescriptions. Dr. Hinds said she has not seen any instances in which 
someone has tried to obtain the drug illegally.

"It's probably going on here, but it hasn't hit that hard," she said.

But Dr. Brad Standefer, pharmacist and owner of Access Family Pharmacy, 
said one patient tried to change the quantity of a OxyContin prescription 
and was arrested.

"That right there will get you a quick trip to jail," he said.

Pat Fitzpatrick, addictive disorders program director for Valley Behavioral 
Health System, said abusers can crush the drug and snort it, mix it with 
water and inject it or remove its timed-release coating and take it orally.

"It is on the streets here. I've seen it in almost all age groups, 
different socioeconomic groups," he said.

Mr. Fitzpatrick said he has seen both cases of people who buy OxyContin 
simply to get high and those who take the drug for legitimate reasons but 
get addicted because their usage was not properly monitored. Withdrawal 
symptoms are not life-threatening but include chills, muscle cramps and 
fever, he said.

Purdue Pharma spokesman Jim Heins said the company has been working on a 
10-point plan to help reduce abuse of OxyContin and other prescribed drugs.

"Everyone is talking about drug abuse, but no one is talking about 
prescription drugs," he said.

The plan includes cracking down on prescription drugs being smuggled into 
the United States from Canada and Mexico, providing physicians with 
tamper-resistant prescription pads and developing abuse-resistant drugs. 
Distribution of the highest available OxyContin dose, 160 milligrams, has 
been temporarily suspended.

The company also is working to educate health care providers to recognize 
signs that someone who does not need the drug is trying to obtain it, Mr. 
Heins said.

"When used appropriately under a doctor's care, it's safe and effective," 
he said. OxyContin is a Schedule II drug under federal guidelines, meaning 
a patient must visit a doctor every time a prescription is needed and 
refills are not allowed.

Dr. Standefer said he believes OxyContin is helpful to those who need it 
and that the key to cutting down on abuse is strengthening penalties for 
those caught with it illegally. He said Access Family Pharmacy gives extra 
scrutiny when an unfamiliar customer tries to fill a prescription or when 
someone asks for an unusual quantity. All controlled substances are kept in 
a safe, he said.

"You couldn't get in it with a cutting torch and a wrecker," he said.

Ms. Malliarakis said steps need to be taken to ensure that patients are not 
seeing multiple doctors to get several prescriptions and that health care 
professionals pay attention to how users are reacting to the drug.

"Health care professionals need to be better educated about addictions. I 
think that's one of the gaps in medical education," she said.
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MAP posted-by: Terry Liittschwager