Pubdate: Sat, 21 May 2005
Source: Metrowest Daily News (MA)
Copyright: 2005 MetroWest Daily News
Contact:  http://www.metrowestdailynews.com/
Details: http://www.mapinc.org/media/619
Author: Rep. Peter J. Koutoujian, Guest Columnist
Bookmark: http://www.mapinc.org/find?232 (Chronic Pain)
Bookmark: http://www.mapinc.org/oxycontin.htm (Oxycontin/Oxycodone)

WEIGHING RISKS, BENEFITS OF OXYCONTIN

Few prescription medications have generated as much controversy as 
OxyContin. The mere mention of the powerful pain-relieving medication 
evokes a spectrum of emotions and opinions.

Television and print news reports have documented much of the OxyContin 
fallout. A rash of pharmacy robberies that have threatened public safety, 
deaths related to abuse of the drug and the devastating accounts of 
addiction have made OxyContin a public enemy in the minds of many.

Despite its headline-grabbing gravitas, OxyContin is just one type of 
pain-relieving class of medications known as "opioids." Its potency makes 
it unique. Twice as powerful as morphine, it can replace crippling pain 
with crippling addiction when abused. The U.S. Food and Drug Administration 
classifies OxyContin as a Schedule II drug. Only Schedule I drugs, such as 
heroin, are considered more dangerous. Those drugs have no recognized 
medicinal value.

OxyContin addictions do not discriminate by race, gender or social class. 
Our commission heard testimony from Salem Public Schools superintendent Dr. 
Herbert Levine, whose 15-year-old son developed an OxyContin addiction that 
nearly cost him his life. The Levine example demonstrates how addictions 
can slip into homes and lives we might not suspect.

It was heartbreaking to hear a father recount how his son's suffering went 
untreated until it was nearly too late. We have heard the stories of 
parents who are mourning the loss of their children to addiction. We have 
heard from the addicted, themselves. I have a friend who is trying to put 
his life back together from the destruction wrought from drug addiction. 
These stories are too many and the answers too few.

A recent study from the Partnership for a Drug-Free America found that t 
wice as many teens (one in five) have tried Vicodin as have tried 
OxyContin. It is often referred to as a "gateway drug" because it can lead 
to abuse of harder, illegal drugs. We have heard from individuals who moved 
on to heroin because it is cheaper and more readily available. Whereas a 
single 80-miligram OxyContin tablet can cost $80 on the street, heroin 
sells for $3 to $4 per bag, we are told by substance abuse experts.

A recent University of Michigan study conducted for the National Institute 
on Drug Abuse found that despite a 17 percent overall decrease in illicit 
drug use among teens over the last four years, there has been a 49 percent 
increase in OxyContin abuse. In the Boston area, the emerging age of 
OxyContin users is the 13-17 year-old age group.

We are left with the challenging task of determining what can be done to 
reverse the trend of addiction and abuse.

Banning OxyContin outright may not be the most feasible option. We have 
heard plenty of stories on how the drug has been abused, but we are less 
exposed to cases where it serves individuals suffering from extreme, 
chronic pain. Cancer sufferers, many of whom are terminally ill, comprise a 
significant portion of the OxyContin market. The American Cancer Society 
estimates that over 33,000 people in Massachusetts, at least half of whom 
will experience uncontrollable pain during their illness.

The proper response should entail crafting tighter restrictions on how it 
is manufactured, prescribed, distributed and sold. We must also invest in 
drug treatment programs that can break the addicted from their downward 
spiral of abuse.

We should examine whether it's feasible to encourage limiting the 
prescribing of OxyContin to the treatment of severe pain, such as that 
experienced by the terminally ill. We should also consider limiting the 
amount of medication that can be prescribed in certain cases. Physicians 
prescribing OxyContin and other pain-relieving medications should gauge 
whether an individual is prone to becoming addicted.

We must do more to reduce the OxyContin-related public health threats that 
have primarily come in the form of pharmacy robberies. An incident earlier 
this month in Arlington led to a reported gun battle between a would-be 
OxyContin thief and the pharmacy's owner. Limiting the drug's distribution 
points would reduce the potential for robberies.

At the state level, we can increase our support of drug treatment programs, 
especially community-based support services. Between 2001 and 2004, state 
funding for the Department of Public Health's Bureau of Substance Abuse 
Services budget fell from $45 to $33 million. The House plans to increase 
funding for the upcoming fiscal year to $46 million, but not even that 
amount will allow that state to fulfill the need for services.

There are roughly 40,000 people in Massachusetts waiting for substance 
abuse services. Detox bed totals have dropped from roughly 1,000 to 550. 
When the Framingham detox center closed, the MetroWest region was left 
without a single location.

We must better educate ourselves about how addictions begin. Forty-four 
percent of medications to which children get access are medications used in 
their homes by other family members. Where children once raided their 
parents' liquor cabinet, they now raid the medicine cabinet.

We cannot seek easy answers. Lawmakers, public health officials, law 
enforcement agencies, and the medical community must all work together in 
the coming months and years to develop solutions that are feasible and 
effective. As the House chairman of the Joint Committee on Public Health, I 
am committed to reaching our goals. I hope my colleagues and fellow 
citizens will join me.
- ---
MAP posted-by: Elizabeth Wehrman