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  No Relief
Posted by FoM on April 04, 2002 at 19:50:09 PT
By Damien Cave 
Source: Salon Magazine 

justice After three decades of chronic, searing pain, Marie Dabrowski was finally able to sleep. She was able to think. And sometimes, thanks to her new pills, she could almost forget about her fibromyalgia, a mysterious nerve disorder characterized by fatigue, migraine headaches and full-body aches.

But Dabrowski's respite did not last. The medication responsible for her two-year break from daily misery was OxyContin. And about a month ago, Dabrowski's doctor cut her off. The move had nothing to do with callousness or lack of concern, says Dabrowski, who asked that her doctor remain anonymous.

Instead, the doctor was spooked by a proposed Virginia law designed to intensify scrutiny of physicians who prescribe the drug. In the end, says Dabrowski, it was the prospect of police interrogation that pushed her doctor over the edge.

"When I went in to her office, her receptionist explained to me that it was the DEA that was the problem and that my doctor was scared of getting in trouble," she says. "I told them that this was dangerous. People on OxyContin finally have something that keeps the pain away, and if the pain comes back they're going to commit suicide."

Widespread abuse of OxyContin, a painkiller made by Purdue Pharma LP, was first reported in the media about a year ago. Called "hillbilly heroin" because early cases of addiction surfaced in Appalachia, the pills were being crushed and then snorted or injected by users, who found the drug cheap and easy to obtain. Once touted by its manufacturer as a safe and effective alternative to highly addictive morphine, "Oxy" quickly became the scourge of law enforcement, spreading across the country with lightning speed, leaving hundreds of addicts in its wake.

Even as Purdue hastily promised to produce OxyContin in a form less vulnerable to abuse, legislators in at least 17 states pushed to create strict prescription tracking programs, while others took steps to limit the number of OxyContin pills that people on Medicaid can receive. The Department of Justice has proposed a national crackdown on painkiller abuse, and some states are considering laws that would ban OxyContin, as well as its main ingredient, oxycodone, a synthetic opiate prescribed to millions of patients since 1916.

It is difficult to argue with laws intended to make it harder for addicts to get drugs; and the DEA has said it does not want to limit the supply to those with a legitimate need for relief. But there are dangerous side effects to the new restrictive policies on prescription painkillers -- chief among them, widespread, unnecessary suffering. Patients with chronic pain, routinely undertreated in the past, had in recent years begun to get adequate relief, thanks, in part, to OxyContin, one of the few drugs that reduces or eliminates pain without nausea or damage to vital organs. The onslaught of regulations designed to curtail OxyContin abuse now threatens to reverse these advances.

Increasing numbers of the estimated 30 to 50 million people in the country who suffer from some form of chronic pain say the OxyContin crackdown means they can no longer get adequate or sustained relief. For some, the new rules and medical practices create frustrating delays in receiving medication. But for others, there is no help at all.

Cancer patients and sufferers of debilitating diseases report that they are getting ineffective dosages of OxyContin, running out of places to fill legal prescriptions for it, or finding themselves without doctors, many of whom choose to avoid OxyContin headaches by sending patients to overwhelmed pain specialists struggling with the same regulations.

Our simmering fear of painkiller abuse, brought to a boil by the OxyContin scare, has created a world of hurt for legitimate victims of illness: The war on drugs has increasingly become a war on patients.

"I wake up crying every morning because I don't have anything for the pain," Dabrowski says. "The law isn't even in place, but it's already affecting me. I feel like I'm burning from the inside out."

Americans have something of a tortured relationship with opioids -- pain relievers derived from real or synthetic opium that work on the central nervous system. Doctors were the earliest targets of prescription drug panic: As early as 1914, with the passage of the Harrison Narcotic Act, the government identified doctors as agents of addiction who needed to be controlled if narcotic abuse was to be abolished. The law, refined by a Supreme Court decision in 1919, made it illegal for doctors to prescribe opioids to addicted patients and required doctors who prescribed the drugs to register with the IRS.

"There was a lot of zealous law enforcement activity after the decision," says June Dahl, a pain policy researcher and pharmacology professor at the University of Wisconsin. "The police went out to get docs and a lot of them were thrown in prison. That's the origin of this whole concept that physicians are the cause of addiction -- that they're the ones who should be held accountable."

State laws passed over the next few decades added more specific hurdles for doctors: stronger penalties for over-prescribing, and in some cases, mandatory use of triplicate forms that gave state regulators a copy of every prescription written for opioids and other highly addictive but medically useful drugs -- a category defined by the government in 1970 as Schedule II narcotics.

Most doctors reacted to the laws -- and a growing public fear of drug abuse -- by avoiding patients with pain that required strong medication. There were, and are, exceptions: Doctors who treat cancer patients have typically plodded through the extra paperwork and state scrutiny in order to prescribe opioids. But the vast majority of physicians in states with triplicate regulations responded to additional scrutiny by dropping opioids from the list of drugs they would prescribe. A survey that Dahl conducted in the mid-90s found that only 60 percent of California's 96,000 doctors -- oncologists included -- were authorized to write triplicate prescriptions, and that only 40 percent of these doctors actually did. Other surveys in other states found similar results.

The advent of managed care has compounded the problem, says Dr. Daniel Carr, founding medical director of the pain management program at Tufts New England Medical Center. Diagnosing chronic pain often requires extra time -- X-rays and the usual tests may turn up nothing, even when patients are visibly suffering -- and managed care demands extra efficiency. Doctors who participate in that system, with its attendant focus on quickly moving patients in and out of doctors' offices, "are extremely pressured for time," Carr says. "Anything that looks like it will take more time is a tremendous disincentive."

Greater obstacles to aggressive pain management resulted in more undertreated sufferers of chronic pain. A handful of doctors, aware of the problem, sought to focus on treatment of pain by forming specialized study groups in the early '70s. But it wasn't until 1985, when an article in the New England Journal of Medicine identified a widespread lack of adequate care, that victims of undertreated chronic pain became more visible to doctors and the public.

The journal article, by Dr. Kathy Foley, offered new medication and treatment guidelines that became the model for doctors treating pain. Medical schools and regulatory boards also responded, gradually, with dedicated training programs and ethical guidelines for the treatment of pain. Tufts University was the first, in 1991, to establish a master's program for doctors in pain studies. By 2000, 24 state medical boards had adopted pain guidelines that specifically advised doctors on the dangers of undertreatment. Meanwhile, large healthcare providers created pain clinics, increasing the number of locations where strong drugs could -- and would -- be prescribed.

And then, out of the blue, came the OxyContin scare. Abuse of the drug began to reverse advances in pain management by early 2001, in concert with a broad crackdown on painkillers. The problem with OxyContin was not its main ingredient (oxycodone hydrochloride), which is found in Percocet and other painkillers, and has been around long enough to be widely prescribed and relatively uncontroversial. The problem was with OxyContin's potency, promotion and chemical formula. OxyContin carried an extremely high dose of oxycodone -- up to 160 milligrams or 16 times the highest dosage available in Vicodin. It was extremely popular (sales exceeded $1 billion in 2000), which made it very accessible. And its time-release qualities were easily defeated by simply crushing the pill.

Towns that didn't have easy access to heroin or other hard drugs became the first "Oxy" hotspots. Rural Maine, western Pennsylvania and the Appalachian areas of Kentucky, Virginia and West Virginia in early 2001 were the areas first hit. But word -- and addiction -- spread fast, and deaths attributed to the drug began to be reported. Calls for legislation and increased law enforcement came quickly, and painkillers of every variety came under new scrutiny.

The first controls of the drug sought to cut off abuse by Medicaid patients. There was no body of data indicating that the poor abused the drug more than wealthier Americans, but by the summer of 2001, six states had introduced legislation making it harder for Medicaid patients to get their pills. Other states followed, with regulations aimed at aid recipients with OxyContin prescriptions or at Medicaid patients in need of pain medication. Vermont, at the behest of its Gov. Howard Dean, who is a physician, ended coverage of OxyContin for all its Medicaid patients. If poor patients needed the pills, said the state's lawmakers, they had to move.

"I'm on Medicaid and I'm scared that the state's going to stop paying for OxyContin," says Sarah Murray, a 51-year-old Louisiana woman on Medicaid who suffers from multiple cysts in her kidneys and liver. "I know in some states they've stopped paying. And if they stop paying here, I'm dead."

In the past 18 months, 17 states set up electronic prescription databases to track doctors who prescribe, and patients who receive, Schedule II drugs. Six more states are considering similar systems. Meanwhile, legislators in West Virginia are considering a ban of all the drugs that contain oxycodone. One Pennsylvania legislator has introduced a bill that would move OxyContin from Schedule II to Schedule I, a category that includes mescaline, heroin and other drugs considered to have no medical purpose.

"The entire idea of [the Virginia tracking law and others like it] is to go after people who are willingly and intentionally breaking the law," says Tim Murtaugh, spokesman for the Virginia attorney general's office. "It's clearly growing as a problem, and we believe that it's the commonwealth's responsibility to address it."

But doctors have blanched at the sweeping changes and proposed bans, and their panic has only increased in the wake of cases like that of Dudley Hall, a Bridgeport, Conn., doctor charged July 17, 2001, with 36 counts of over-prescribing. Sure, they argue, Dr. Hall, who prescribed more OxyContin that any other doctor in his state, (earning the title Dr. Feelgood), deserves to be prosecuted. But Hall was busted by officers posing as patients, and doctors fear that undercover operations will become the norm. The new laws, say doctors, even if they didn't lead directly to Hall's arrest, make police especially brash, far too confident in their ability to decide which prescriptions are valid or invalid.

Just the specter of law enforcement meddling in medicine has been enough to cause physicians to drop needy patients, says Michael Brennan, a pain management doctor who manages a private pain clinic in Fairfield, Conn., a wealthy town only a few miles from where Hall was charged.

"Doctors are like prairie dogs," he says. "One or two will stick their heads up, but as soon as something bad happens to them, they all go underground."

The American Medical Association stresses that there's no data showing a major shift in prescribing practices or referrals. And says Dr. Herman Abromowitz, a member of the AMA's board of trustees, "The AMA is trying to reassure doctors that if they're doing the right thing -- if they're prescribing appropriately -- they shouldn't have anything to fear."

But Brennan argues that the increased presence of law enforcement is hard to dismiss. In fact, he says that he's still reeling from an unexpected visit by the DEA around Thanksgiving. Though he's strict about whom he'll write prescriptions for -- he regularly meets with family members to ensure that abuse isn't occurring -- he says that "every time I see a big blue Suburban come by my office, I'm like 'Oh man, I hope they're not coming for me.'"

Many doctors looking for creative ways to deal with new layers of regulations have found loopholes that can result in further suffering for the patients they are willing to keep. Many physicians, for instance, are continuing to prescribe pain medication, but are cutting dosages. For sufferers of chronic pain, who often require increased dosages over time because of increased tolerance to their medications, this is a move that promises less relief in the face of increasing pain.

Dabrowski, for one, says she's suffering unnecessarily because of this practice. Dale Denton of Franklinton, La., says it has been disastrous for his 79-year-old father, who suffers from an advanced form of melanoma. Four months ago, his father's doctor cut his father's daily medication intake in half -- from two 40-mg tablets of OxyContin to two 20-mg pills. "Then the doctor cut him down to morphine, which is making him sick," says Denton, whose father is on Medicaid. "He told her about it but she wouldn't give him enough. She said there's too many dopeheads. I said, 'They're not going to get it,' and she said, 'Damn right, because I'm not giving it to him.'"

In fact, most users of OxyContin and other strong pain medications are not addicts, says Carr at Tufts University. "For every one case of a robbed pharmacy to get an opioid, there are probably 100 people who are undertreated or appropriately treated."

But, adds David Joranson, director of the pain and policy studies group at the University of Wisconsin Medical School, "America is a country where the treatment of pain is governed by how we perceive the drug-abuse problem." As a result, he adds, "there's a multiplier effect." Laws aimed at the minority are having an enormous effect on the majority, most of whom feel they can barely survive without their pills.

Denton is angry that his father is suffering from unnecessary pain, but he is even more furious that his father's suffering is making the end of his life intolerable. "When he was on Oxy, he could he enjoy his life a little," Denton says. "He was comfortable; he was able to go in the yard a bit. But since they took him off, he's been down in bed and he ain't been back up."

Doctors in many areas also are shuffling pain patients off their rosters. Rather than deal with the increased scrutiny, they're referring patients to pain specialists, many of whom are already overwhelmed. Michael Brennan is dealing with the issue first-hand. About 90 percent of his practice's 800 patients suffer from non-cancer chronic pain and Brennan says that he's in danger of burning out -- in large part because he's receiving a substantial uptick in referrals.

"We have little old ladies on 10 milligrams of OxyContin referred to us because their doctor doesn't want to prescribe it," Brennan says. "People aren't willing to take the risk for their patients. Some will put their patients on non-narcotic pain relievers -- which puts patients at risk -- and others ultimately just say, 'Hey, let's send them to the pain doctor.'"

John Schoos, 45, is a retired banker who used to fill his prescription for the opioid Levo-Dromoran at the CVS near his home in Hawthorne, N.Y. Now, to calm the constant pain resulting from nerve damage suffered during treatment of testicular cancer and hip surgery, Schoos has to go to Memorial Sloane Kettering Hospital in Manhattan, an hour's drive away. And even there, he says, there's strong prejudice against pain medication.

"One of my family friends is a doctor at Memorial, a surgeon," he says. "He knows that I've been on this drug for a long time so one night, he asks me at a party, 'Hey, are you off the pills yet?'"

"And I was like, Jesus, if he doesn't get it, the fact that I need these pills to get up in the morning, imagine how many others don't understand."

Once patients get their drugs, they are frequently limited to a maximum of one month's supply. That means they run out faster, and then, because pharmacies can no longer carry large supplies, they struggle to find a pharmacy to refill their prescriptions. A further limitation, which is another direct result of the painkiller crackdown, is that many patients are being forced by their doctors to sign contracts in which they promise never to visit another doctor or pharmacy for prescriptions. So, if the pharmacy specified in the agreement doesn't have what the patient needs, the patient has to decide what is worse: to violate a contract by going to another pharmacy? Or to forgo medication that makes life livable?

Sara Patterson was forced to make such a choice just last month. Her daughter Holly, who is 7, suffers from damaged nerves and a degenerative spinal disorder. Essentially, says Patterson, "her body doesn't regulate the pressure of her spinal fluid, and the fluid puts pressure on her damaged nerves, which causes the pain."

Holly's form of excruciating agony comes and goes. She can spend three or four months in unrelenting, paralyzing pain, and then enjoy a month of relative comfort, only to have the pain strike suddenly once again. Last month, when the pain hit, Patterson called her daughter's pain clinic -- a two-hour drive from her Central Florida home -- to get a prescription for Holly. The doctors didn't answer.

In a panic, Patterson went to Holly's local pediatrician, who immediately offered to prescribe medication. "But I said no, you can't do that," Patterson says. "I told her I had signed a contract that prohibited me from buying medication from another doctor. I was afraid of getting in trouble." Instead, Holly endured another day without relief before getting the right medication from the "legal" source.

Meanwhile, Patterson says she fears that Holly will commit suicide.

"Every birthday, she blows out her candles and wishes for the pain to go away," Patterson says, her voice quivering. "She constantly says that she doesn't want to live. She just asked me 15 minutes ago if she could go ahead and kill herself. Right now she doesn't understand what it means to terminate her life. But what happens when she gets older? She might actually succeed. Our time is running out."

The DEA justifies its steps to limit access to opioids with figures that blame the diversion of OxyContin from patients to addicts for an estimated 300 deaths in 31 states over the past two years. As recently as March 22, DEA chief Asa Hutchison called for more prescription-drug tracking to help law enforcement nab addicts and doctors.

To be fair, Hutchison also has stressed that increased enforcement should not affect pain patients, and the DEA's OxyContin Action Plan states that "these actions are not intended to impact on the availability of legitimate drug products for medical use."

But experts question the sincerity of law enforcement's dedication to those who truly need strong pain medication. There have been no mitigating laws passed in the interest of patients. Joranson, the pain policy expert, argues that in many states new prescription laws amount to simple politics: "Politicians need to be seen as doing something about drugs," he says. And others fear that Hutchison's stated attempt to protect legitimate prescribing will go unheeded. With press attention focused on doctor busts and new laws that extend police powers, authorities may not curtail their efforts, but expand them.

"While the DEA has strived to be sensitive in their central office to pain medications, I question whether that commitment has trickled down to the field," says John Giglio, one of several pain-management advocates who met with Hutchison last fall to plead the pain patients' case. "I also question whether the people in the office of diversion control have really gotten that message, much less gotten the additional training that they need to treat doctors and patients fairly."

Some patients are fighting back. Mike Schrader, for example, had his prescription switched from OxyContin to methadone a month ago. At first, the former X-ray technologist didn't mind. The methadone alleviated some of the pain he suffers in his hips and back -- the result of 14 separate surgeries -- and he was willing to give it a try. But eventually he discovered that the new pills were weaker than expected.

"My pain level before OxyContin was an 8 out of 10," he says. "With OxyContin it was on a 4-5 level. Now I'm back up around a 6."

Schrader figures that there's no reason to sit back and take the pain. He says that for as long as the methadone fails him, he'll keep asking his doctor for the same level of relief he received with OxyContin. "I'm not going to let him force me to suffer just because he's scared to write the prescription," he says.

Few victims of chronic pain have Schrader's energy or clarity of mind to protest undertreatment, so pain advocates are trying to back them up -- to little avail. "We are an opiophobic nation," says Barbara Coombs Lee, president of the Compassion in Dying Federation, a nonprofit that is suing U.S. Attorney General John Ashcroft for trying to overturn Oregon's physician-assisted suicide law. "We have a craziness about this issue and the effect is that it harms patients in pain and those at the end of their life."

Adds Murray, "If OxyContin was taken off the market right now, it would not hurt the drug addicts," she adds. "It would only hurt the people who need it. The addicts will get another drug. It's gonna be us that pays."

Note: The war on drugs is preventing many Americans from getting desperately needed pain medicine.

About the writer:

Damien Cave is a senior writer for Salon.

Source: Salon (US Web)
Author: Damien Cave
Published: April 4, 2002
Copyright: 2002 Salon
Website: http://www.salon.com/
Contact: salon@salonmagazine.com

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Clicking for a Fix: Drugs Online
http://cannabisnews.com/news/thread12115.shtml

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http://cannabisnews.com/news/thread10100.shtml


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Comment #9 posted by Lehder on April 07, 2002 at 08:23:27 PT
as promised: ALTACE
As promised in comment #3 I watched a little TV, saw the commercial again, and learned the name of the drug that can cause swollen throat, swollen tongue, swollen mouth, dizziness and light-headedness due to low blood pressure etc...etc...etc! : ALTACE. I can tell you that Jack Nicklaus swears by the stuff. I hope you will see this commercial too and watch Jack popping pills and driving balls out of sight.

I caught the last ten minutes of a program called "CBS News Sunday." The ALTACE commercial interrupted scenes from the program of a vast poppy field in beautiful yellow bloom somewhere in New Mexico.

According to the ad, the various neck and head swellings pose "AN EXTREMELY SERIOUS RISK REQUIRING IMMEDIATE MEDICAL ATTENTION." Also, it warns of taking Altace if you're pregnant as it can kill a fetus.

I was not watching so intently - I was still thinking about the poppies - to find out for you the purpose of ALTACE, what it's intended to treat, but I have the impression that the function of this drug is to take your money and to sicken or kill you. That's the message that the commercial impressed upon me.

During this commercial The Smithsonian magazine happened to be resting on a COFFEE table before me and, eager to keep my promise, I wrote the name ALTACE and the quote above on the random open page which I tore out and carried here to the computer. I see now that this page - the whole of it - is devoted to the side effects of CLARINEX: pharyngitis, dry mouth, somnolence, fatigue, influenza-like symptoms, mylagia, nausea, dizziness, and dry throat are the "adverse events reported by at least 2% of patients in placebo-controlled, multiple-dose clinical trials" for a 5.0 mg dose of CLARINEX. The obverse of this full page of fine print promises that "CLARINEX helps protect yoour body's receptors from histamine."

Let's hear it for a drug-free America!

P.S. Where are my body's receptors? Is it legal to touch them?

[ Post Comment ]

 
Comment #8 posted by goneposthole on April 05, 2002 at 10:23:21 PT
drug addicts
60,000 addicts in Baltimore are going to get their drugs today.

The DEA-th mongers could care less. Joyce Nalepka doesn't care, and why should she? Along as she can perform her shtick, all well be well. I doubt very much if she will enter the trenches of the drug addicted in Baltimore. No, she is going to make sure that her voice is heard above anything else.

If we had a sensible government that had a compassionate attitude towards those who are truly in need of medical care, things would be different. Spraying glyphosate in Colombia and denying patients needed medical services is a sign of a government that has lost its way.

[ Post Comment ]

 
Comment #7 posted by kaptinemo on April 05, 2002 at 09:29:30 PT:

Lehder, I have a problem
The problem is...I am not shocked by it...at all.

Outraged, yes. Infuriated, yes. Bloody-minded? You betcha! If I could get away with frog-marching Asa at bayonet point and force him to care for that pathetic little girl as she screams and cries in pain and begs to die, I'd do it in a heartbeat.

But shocked? Nope. And that should scare all of us that read this.

Isn't it incredible that we at CNews have seen so much of this kind of thing for the past few years that I would dare say few of us are truly surprised at this new insanity? That we've come to expect it? That when it shows up, and we read of how high-faluting policy makers create abominable laws that hurt little kids like this, that many of us are not amazed?

When you become inured to trauma, you go dead inside. I've seen it in places I can't talk about, and to friend and foe alike. People like that are dangerous, because life holds no value, anymore.

The antis are teaching us this lesson. God help us....



[ Post Comment ]

 
Comment #6 posted by Lehder on April 05, 2002 at 08:55:11 PT
shocking
I thought that after the deaths of imprisoned cancer patients and the shotgunning of children I was beyond shock at what the government might do to innocent people to maintain its propaganda and drug war. But this has been bothering me all morning. How can we tolerate this?

Seven-year-old Holly Patterson is being tortured. She must spend three or four months in unrelenting, paralyzing pain, and then enjoy a month of relative comfort, only to have the pain strike suddenly once again. Last month, when the pain hit, Patterson called her daughter's pain clinic -- a two-hour drive from her Central Florida home -- to get a prescription for Holly. The doctors didn't answer.

"Every birthday, she blows out her candles and wishes for the pain to go away," Patterson says, her voice quivering. "She constantly says that she doesn't want to live. She just asked me 15 minutes ago if she could go ahead and kill herself.

So a seven-year-old girl who ought to be making mud pies and learning to read has been rendered suicidal because the medical establishment, intimidated by the government's war on pain relief, is too fearful to prescribe her the medicine she needs.

This is the kind of story that ought to played on Baltimore TV and everywhere else for shock value, not skits with actors who offer a few paltry sophisms about the war on drugs.

[ Post Comment ]

 
Comment #5 posted by Sam Adams on April 05, 2002 at 08:18:29 PT
we've got a long way to go.....
"It is difficult to argue with laws intended to make it harder for addicts to get drugs;"

Why? Personally, I couldn't care less if an addict lays around massively tripping all day on drugs. It's not going to affect me! People on opiates aren't noisy....alcohol is what makes neighbors loud, annoying, and violent.

We're all conditioned that somehow it's the government's job to keep people from doing drugs. IT'S NOT. How about this:

"It's difficult to argue with laws that keep a fat man from going to McDonalds".

What's the difference? We creep a little closer to "1984" every day.

[ Post Comment ]

 
Comment #4 posted by el_toonces on April 05, 2002 at 06:19:52 PT:

Cannabis beats opioids.....
....by a mile. Opioids cause physical dependence and have other unwanted side effects. With cannabis, I am tapering my dose of this time release crap down as low as possible, to zero if I can, because the pancreas pain I have is better managed by cannabis. The irony is that under the drug laws, this inferior medication (Oxycontin) is allowable by prescription but hard to get, yet does not work as well as a medicine that is not allowed under the law but is superior because it is much milder and, paradoxically given its legal status, easier to get than the legally allowable but highly regulated items.

Does that make sense? Welcome to DARE-ville, Alice:).

Be well.

El

[ Post Comment ]

 
Comment #3 posted by Lehder on April 05, 2002 at 06:07:48 PT
I need to watch more television
Because I can't remember the name of the new drug I saw advertised yesterday - al* or ac* or somethiin'. But I'll see it and report back. My attention focuses on the long spiels about the side effects of advwertised drugs, and these take typically about half the ad's time. It this case it began with 'xx is not for everyone....' and proceeded to list swollen throat, swollen tongue, swollen mouth, dizziness and light-headedness due to low blood pressure etc...etc...etc! But the side effect that really stunned me was this drug's ability to kill a fetus. No need to editorialize here - those are the side effects.

Now this pill, like so many others that are pushed on TV, is a prescription medication. Why are prescription medicines advertised to the public at all? Would it not make sense for the manufacturer to keep physicians informed without advertising to everyone? The patient should present the physician with a complaint; then the complaint can be treated with whatever is indicated. Well, that would make medical sense, but not financial sense. The drug companies want patients to present their physicians with a request for a specific drug, and by brand name. A problem patient like me who can't remember the brand name can just sing or whistle the little jingle from TV and then any good doctor would know what's indicated.

[ Post Comment ]

 
Comment #2 posted by kaptinemo on April 05, 2002 at 05:46:35 PT:

But that's the idea
"When I went in to her office, her receptionist explained to me that it was the DEA that was the problem and that my doctor was scared of getting in trouble," she says. "I told them that this was dangerous. People on OxyContin finally have something that keeps the pain away, and if the pain comes back they're going to commit suicide." and:

"I'm on Medicaid and I'm scared that the state's going to stop paying for OxyContin," says Sarah Murray, a 51-year-old Louisiana woman on Medicaid who suffers from multiple cysts in her kidneys and liver. "I know in some states they've stopped paying. And if they stop paying here, I'm dead."...

Once patients get their drugs, they are frequently limited to a maximum of one month's supply. That means they run out faster, and then, because pharmacies can no longer carry large supplies, they struggle to find a pharmacy to refill their prescriptions. A further limitation, which is another direct result of the painkiller crackdown, is that many patients are being forced by their doctors to sign contracts in which they promise never to visit another doctor or pharmacy for prescriptions. So, if the pharmacy specified in the agreement doesn't have what the patient needs, the patient has to decide what is worse: to violate a contract by going to another pharmacy? Or to forgo medication that makes life livable?

Sara Patterson was forced to make such a choice just last month. Her daughter Holly, who is 7, suffers from damaged nerves and a degenerative spinal disorder. Essentially, says Patterson, "her body doesn't regulate the pressure of her spinal fluid, and the fluid puts pressure on her damaged nerves, which causes the pain."...

... Meanwhile, Patterson says she fears that Holly will commit suicide.

"Every birthday, she blows out her candles and wishes for the pain to go away," Patterson says, her voice quivering. "She constantly says that she doesn't want to live. She just asked me 15 minutes ago if she could go ahead and kill herself. Right now she doesn't understand what it means to terminate her life. But what happens when she gets older? She might actually succeed. Our time is running out."

A 7 year old child - wants to kill herself. Because some idiot in Washington wants to look tough on drugs. And because companies that manage health care don't want to pay for her meds.

Ask yourself this question: with a health care system on the ropes, with people talking about 'managed care' like it's triage at a battlefield, do you really think the insurance companies want to pay for her pills? Especially when you multiply it by the millions of people out there suffering from chronic pain...which incapacitates them so much they cannot offer society any labor in return?

That's exactly what it is: triage. Social triage...designed to cull out the industrially useless - and economically spent - from those still able to slave in corporations.

Any way you slice it, this is effin' torture. And people like Joyce, oh-so-concerned for the welfare of children, wouldn't have the guts to stand in front of Sarah Patterson and explain why her child must suffer...for the good of all children that she's trying to 'save'.

Not all the loonies reside in the bin; some are free and making drug policy...

[ Post Comment ]

 
Comment #1 posted by Ethan Russo MD on April 05, 2002 at 05:35:11 PT:

The View from Here
This is a good article, but it does not address a couple of important points. The problem with OxyContin is not the oxycodone. It is that the company made the drug without safeguards to ensure that it remains a time-release preparation. By crushing it, a person can snort or inject it for the high. Some become addicted, or even overdose and die due to respiratory depression.

Sure this preparation is a problem. Several years ago, before the craze, a nurse in our office was selling prescriptions for OxyContin on the black market with my forged signature. Was I angry? You bet. However, I still recognize the utility of the preparation for chronic pain patients who really need it. I do not think that it should be banned. I do think that doctors and patients should be reasonable in its use, but more legislation by ignorant politicians rarely helps.

Now, the real point: Who out there thinks that clinical cannabis will be more problematic than OxyContin, an approved and legal drug? I'm trying to count the hands, but I don't see any up right now. Just what I thought. It's time that cannabis be part of the medical arsenal for chronic pain and other indications.

[ Post Comment ]


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