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. - --- MAP posted-by: Terry Liittschwager