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