OxyContin: Pain Relief vs. Abuse

Are Worries Over Abuse Having An Impact On The Drug's Legitimate Use As A Painkiller?

(WebMD)  Pinsky, author of When Painkillers Become Dangerous: What Everyone Needs to Know About OxyContin and Other Prescription Drugs, says the risk of addiction is so great, not only for addicts but for anyone genetically prone to addiction, that any patient who comes forward with pain should first be asked if there is a family history of alcoholism or addiction.

"How does the health care provider know who is genetically predisposed to addiction? It may be hidden back three generations. The risk is triggering opioid and opiate addiction, the addiction with the poorest prognosis." Opioids and opiates act similarly on the brain and the terms are often used interchangeably, but unlike opiates, opioids, such as methadone, are not morphine based.

Pinsky admits to holding a minority view when he says no one should be treated with opiates more than two weeks, particularly if there's a family history of addiction. "If you have a history of addiction and have an extraordinary need to go beyond two weeks, it needs to be monitored very carefully by someone in the addiction field." He says there are many non-narcotic pain medications, such as Toradol, and alternative therapies, such as acupuncture, massage, and chiropractic treatment.

Pinsky, who is medical director for the department of chemical dependency services at Las Encinas Hospital in Pasadena, Calif., tells WebMD he admits at least two patients a day for overusing painkillers. "They've been addicts all along. They didn't suddenly develop an addiction. They come to me with overwhelming pain — back pain, neck pain, headaches. They can't sleep."

He says chronic physical pain in addicts is often an expression of past trauma. Drugs relieve the pain but feed the addiction. His approach is to take them off the pain medicine. "I say it will be the worst pain of your entire life for two weeks, but that will be the end of it. Meanwhile, we do 12-step and group therapy programs with them and intensive treatment of their withdrawal."

The Backlash of OxyContin Abuse
In certain parts of the country, the crackdown on illegal use of OxyContin has made it hard for pain patients to get legitimate prescriptions.

"OxyContin was the first prescription medication listed as a drug of concern by the federal Drug Enforcement Agency, which made it a target," says Ronald T. Libby, PhD.

The drug, Libby says, is "monitored by pharmacies and [Perdue] Pharma, the maker of OxyContin. Some physicians, knowing the DEA or sheriff is looking at these scripts, refuse to write prescriptions for fear of prosecution. Doctors can be scammed, and if a patient takes some pills and sells some, the doctor can be guilty of diversion." Libby is the author of a Cato Institute policy report titled "Treating Doctors As Drug Dealers: The DEA's War on Prescription Painkillers" andprofessor of political science and public administration at the University of North Florida in Jacksonville.

"The war on drugs has become a war on legal drugs, on patients who take them, and on doctors who prescribe them," Serkes tells WebMD.

The Association of American Physicians & Surgeons has issued a warning to doctors: "If you're thinking about getting into pain management using opioids as appropriate, don't. Forget what you learned in medical school —
drug agents now set medical standards. Or if you do, first discuss the risks with your family."

Libby, who is writing a book entitled The Criminalization of Medicine: America's War on Doctors, says OxyContin can be safer to take than nonsteroidal anti-inflammtory drugs (NSAIDs) such as ibuprofen and aspirin. "OxyContin does no damage to internal organs, but NSAIDs irritate the stomach lining, liver, and other organs."

Pinsky says, "If you had cancer you would thank God OxyContin exists. Unfortunately there's a huge social movement vilifying it as an evil product of drug companies. It's total nonsense. The drug itself is not bad. It's a great medication, but it has to be used by skillful clinicians."

Finding Balance
It's a challenge to balance the needs of chronic pain patients, health care providers, the chemical dependency treatment community, and law enforcement. But efforts are under way. The Pain & Policies Study Group at the University of Wisconsin Paul P. Carbone Comprehensive Cancer Center issues annual progress report cards evaluating states' policies regarding the use of opioid analgesics in pain management. The concern is that cancer pain is often undertreated, and opioids like OxyContin are essential.

Evaluation scores reflect a balaned approach in which law enforcement practices to prevent diversion and abuse do not interfere with the medical use of opioid analgesics in treating pain. In the group's 2006 report, it was noted that policies adopted in the last decade by 39 state legislatures and medical boards addressed doctors' concerns about being investigated for prescribing opioid pain medications.

The report concludes: "Despite a growing effort by policymakers and regulators, the fear of regulatory scrutiny remains a significant impediment to pain relief and will take years of further policy development, communication, and education to overcome."

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[trillion1]

My doctor never had a problem prescribing codiene for an inoperable back problem. I was never prescribed enough to get addicted just to relieve the pain when needed. Then the goverment had to started meddling. Since they don't feel my pain they say I don't have any pain. Goverment "thinking". Now I have had to find outside sources to live a normal life.

[seer999]

The entire issue of pain management is very complicated. It is made more difficult by the governments ongoing attempts to practice "back seat" medicine. The prime example here, is that JCOAH (joint commission on accredidation of hospitals) now lists pain as a "fifth" vital sign. A hospital can actually be penalised for not adequately treating a patients pain. There is also a legal risk to a physican who does not adequately treat a patients pain. BUT, if that same hospital or physician treats pain in good faith and in accordance with the rules, they may be prosecuted as "pill pushers" or "pill mills". Simple isn't it!?

[skater314159]

To BeBe28, I am sorry for your losses, but I disagree with you.

I have a condition that causes me to have chronic pain - I have had it since I was 15, and I will have it until it kills me. My life basically ended when I first began to suffer from my disease. I was not even able to do anything but lie in bed, in pain, unable to even get up to go to the bathroom by myself. I couldn't go to school or do anything that normal teenagers get to do. My disease is a death sentence.

Thanks to drugs like Oxycontin and Morphine (which are used in my case to treat the severe, chronic pain) in addition to other drugs which make my disease managable, I now have my life back. I still have severe health problems, and can't do a lot of things... but I instead focus on what I can do. I am married, finishing up college, and looking at going into a career where I can help others who are facing health issues like my own. If it was not for Opiates, Immuno-suppressives, and RA drugs, I would still be lying in bed, or dead.

As I said, I am very, very sorry for you loss BeBe... but I am very, very thankful for my life. Please don't take my life away by banning a drug that makes it possible for me to be free of pain. Please let me and all the other people who suffer have relief.

Thanks.
skater314159

[glb1969]

Just goes to show why we should prohibit the government from interfering with an individual's right to medical treatment and privacy.

[jjp735i]

It's a shame how people scream to remove a drug that does help so many people who need it.

Yes there is abuse of drugs and alcohol, but that does not mean people who need treatment should have trouble finding it, nor should a Doctor be afraid to prescribe a medication they feel is needed.

Alcohol abuse causes the same hardships listed in some complaints posted here, but people screamed to be allowed to drink even though there is no real reason for it. Why are people in large number not calling for alcohol to be banned?

Let people receive the treatment they need. if you find abuse, report it. Don't make all people suffer because you don't like something.

[bebe28-2009]

I could write a book on what Oxycontin can do to a person's life. My son became addicted through a doctor's care. The entire staff at this facility was later arrested and are in jail. It became a nighmare for all those whose family members were being treated by these so called professionals. My son lost everything, I lost my marriage, all of us are in financial ruin and that is just the beginning. I despise the drug and I can tell you that it is one of the hardest addictions to get over. They can take it off the market for all I care. I think that the pharmaceutical company should be made to compensate every family torn apart and destroyed, because of this drug!!!!!!

[mikekleber]

Several years ago I became addicted to Vicoden after an auto accident left me with multiple injuries. Addiction is a horrible condition. No one can truly understand the problem unless they have gone through the ordeal. People change completely when addicted. I only sought help after losing a job, lost respect from co-workers, and realizing what my problem had done to my family. That was twelve years ago. Two years ago, while walking through my shop, I slipped and fell. I broke two bones in my pelvis. Pelvic fractures are painful. Walking is painful, but sitting is worse. I did not want to become addicted again. My wife would give me one pill at a time. The pills really didn't help, so I just took Tylenol. I learned that a person can endure quite a bit of pain. For nine months, I had pain every day and night. I realized how powerful the mind can be. My prayers to all in chronic pain, and to all of those addicted.

[sparks224]

Rush is high.