Pubdate: Sat, 18 Oct 2003
Source: Star-Banner, The (FL)
Copyright: 2003 The Star-Banner
Author: Dr. C. Brooks Henderson
Bookmark:  Rush Limbaugh
Bookmark: (Oxycontin/Oxycodone)


Rush Limbaugh, ordinarily not one of my favorite people, is to be 
congratulated on his frank admission of a drug problem and announcing his 
intention to seek treatment.

Unfortunately, media commentary on the situation has used the rather 
nonspecific term "addiction" without clarification.

When the cause of chronic pain is not amendable to cure and pain remains 
chronic in spite of alternative methods of treatment, various narcotics are 
the appropriate treatment. Most chronic pain patients use the medications 
as directed and do not require constantly increasing doses to obtain relief.

They respect the hazards of overdose and rarely misuse the medication for 
recreational purposes. They may become dependent on of the narcotic, but 
their dependency is not technically different from that of some diabetics 
on insulin. It is a dependency that enables normal life rather than 
preventing it.

Drug abuse is different, in that the drug is used for recreational or the 
relief of psychological miseries that would be more appropriately treated 
by "non-abusable" medications, such as anti-depressants. These individuals 
use steadily increasing doses far beyond any reasonable need in a doomed 
effort to find oblivion or bliss rather than address the psychological 
problems causing their distress.

It is the latter group who take advantage of unwary physicians to obtain 
prescriptions for which there is no legitimate indication and whose 
perceived need for ever larger doses leads them to deal in the black 
market. It is these people who are appropriately described as addicts.

Media's failure to discriminate these groups has caused confusion for 
patients. Too many refuse needed pain relief because of the mistaken belief 
that drug abuse will inevitably follow. Limbaugh's announcement and the 
subsequent media discussion have missed the opportunity to educate the 
public about the difference.

Dr. C. Brooks Henderson, Dunnellon
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