Narcotic Oxycontin Seen As Dangerous And Addictive Colleen Mastony
August 06, 2001
c. 2001 Cox News Service
Bobby Williams, 57, slipped down the stairs a few years ago and
broke his back. Agonizing pain left him barely able to walk or
sleep for more than an hour at a time. His doctor tried a series of
medications, two surgeries, epidural shots. Nothing worked. Relief
finally came with a drug called OxyContin.
In June, his doctor of 15 years suddenly cut Williams' dosage in
half, Williams said. The doctor told Williams that he was taking
his patients off the drug because ``too many people were dying.''
Williams protested. The doctor told him, ``The world's not fair.''
OxyContin was the only drug that relieved Williams' pain. ``With
the others, I'd be sitting there crying I'd be hurting so bad,''
said Williams, a former construction worker who lives in Fort
Pierce. Williams' doctor declined to comment. Williams says he is
now seeing a new doctor.
The story is becoming increasingly common.
``In the last four months, I've been getting one to two calls a
day,'' said Pamela Bennett, education director at Purdue Pharma,
the maker of the drug. Despite its success in treating pain,
OxyContin, a time-release narcotic for patients with cancer and
other long-term pain, has been associated with wide-spread abuse,
overdose deaths and pharmacy robberies. Abusers crush the tablet,
defeating its time-release feature, then snort, inject or swallow
it. The active ingredient, a synthetic form of morphine called
oxycodone, produces a rapid high.
Nationwide, 120 deaths have been blamed on the drug. West
Virginia has sued Purdue Pharma, saying the company coerced
physicians to prescribe it. A Jupiter, Fla. doctor was charged with
murder in July in connection with the death of a patient. At least
two of 13 lawsuits filed nationwide against Purdue Pharma are from
Palm Beach County.
As the furor rises, life becomes harder for the people who
legitimately need OxyContin. Doctors have stopped prescribing it,
and pharmacists don't like to carry it. Patients live in constant
fear of being robbed and feel they have to prove that they are not
addicts.
More than 50 million Americans live with chronic pain, according
to the American Pain Foundation. Studies have shown that more than
40 percent of cancer patients are under-treated for pain because of
concerns that narcotic painkillers like OxyContin will be dangerous
or addictive.
Judy Harper suffered for years from degenerative disc disease
and a diabetes-related nerve disorder. She remained bedridden until
a doctor prescribed OxyContin. Harper, 55, calls the drug a
``godsend.'' She was working as a nurse 10 years ago, when the
aching started in her legs. It progressed until Harper was
finishing her shifts in tears. She quit her job and eventually had
to stop driving because she couldn't feel the accelerator and brake
pedals. Even now, the OxyContin hasn't cured the pain, but it gives
her enough strength to get out of bed and go to physical therapy
three days a week.
Harper had been taking the drug for three years when state
officials announced Medicaid restrictions in July. The Medicaid
program, which covers the poor, no longer pays for prescriptions of
OxyContin that exceed 120 pills in a month or for prescriptions for
different dosages without prior approval.
When Harper tried to fill a prescription for 160 pills in July,
the pharmacist refused. So Harper's doctor dropped her dosage by a
third. Now her pain is getting worse, and Harper is afraid. ``I
don't know if there is anything else that is going to work as well
as this drug works.''
OxyContin users talked freely about their struggles with chronic
pain, their difficulty finding effective treatment and ultimately
how OxyContin changed their lives, but many did not want their
names printed for fear they will be robbed or stigmatized.
A 51-year-old Boca Raton woman injured her back in a driving
accident early last year when a truck swerved in front of her. She
hit a concrete sound barrier going 65 mph. The slightest movement
afterward sent bolts of searing pain down her back and into her
leg.
In August, burglars broke into her house, taking a gold Cartier
watch and bottle of OxyContin. The former medical professional now
hides half her OxyContin in an asparagus steamer she keeps in a wet
bar and tucks the other half inside a bag of Christmas bows she
keeps on the floor of a bedroom closet. Though she has also
installed an alarm system, she did not want her name used for fear
she could be robbed again.
A diabetes-related nerve disorder left a 60-year-old church
secretary unable to walk or straighten her legs to lie down in
1998. She spent days and nights on a corner of her couch. Her
husband had to carry her to the bathroom. After she was prescribed
OxyContin, she went from a wheelchair, to a walker, to a cane until
she could walk on her own again.
After she read about recent robberies, she moved her OxyContin
from a kitchen bread box to a locked cash box. She then locked the
cash box inside a drawer in a living-room entertainment center.
``Without the OxyContin, I know I would not be walking,'' she
said. She did not want her name used for fear of robberies and also
out of fear that fellow church-goers might think she is a drug
addict.
Shirley Parker, 77, of Palm Beach Gardens says, ``I don't
mention the word OxyContin anyplace to anyone.'' A car accident in
1995 left her husband, Claude Parker, 77, with two herniated discs
in his lower back.
When the couple goes to the pharmacy for Claude Parker's pills,
they silently hand over the written prescription. If a pharmacy
worker says the word OxyContin, ``I say, 'I wish you wouldn't use
that word. Someone could hear,''' Claude Parker says.
Patients aren't the only ones afraid of robberies. Pharmacists
are on edge, too. In January, a 26-year-old man robbed the
Prescription Shop in Stuart, Fla. at gunpoint, ordering the
employees to the floor and taking $2,600 worth of the drug. Police
arrested him a few blocks away. In June, an armed man walked into
the Medicine Shoppe in Boca Raton and demanded OxyContin. He
escaped with an unknown amount of the drug and $130.
One Port St. Lucie pharmacist established a loose network of
area pharmacists to help identify ``doctor-shoppers'' - people who
illegally see multiple doctors so they can get multiple
prescriptions. The pharmacist did not want to be identified as the
organizer of the network. ``I could carry a handgun, but I really
don't want to put my family in jeopardy,'' he said.
Many pharmacists have been cutting back on the amount of
OxyContin in stock. ``We run out all the time,'' said Daniel J.
Carp, who owns The Medicine Shoppe in Stuart. He said he has
considered not carrying the drug. Instead, he keeps a low supply.
He advises his regular customers to call a few days before they
fill their prescription so he can order more.
With pharmacists closely eyeing prescriptions, legitimate users
of OxyContin say they sometimes feel like criminals at the pharmacy
counter. When Ralph Giaquinto, 40, went to pick up his prescription
recently, a computer error showed that it had been dispensed. The
pharmacist curtly dismissed him, Giaquinto said. ``I had my two
kids (ages 6 and 7) with me. I felt like a criminal.''
A pharmacist recently refused to fill Greg Pringle's
prescription. Suspecting a forgery, the pharmacist threatened to
keep the written prescription. Pringle needed the medication the
next day. Furious, Pringle's wife threatened to call 911. The
pharmacist relented. ``The way they look at it, it's like everyone
that does this is a drug addict,'' Pringle said. ``They don't
understand some people have pain, bad pain, the kind of pain I
wouldn't wish on nobody.''
Pringle was his way home from work at a sewage-treatment plant
when he lost control of his truck and hydro-planed into a telephone
pole. The accident left him with a broken neck and pain that would
shoot up the right side of his face, explode into his jaw and leave
the the 6-foot-7, 240-pound man weeping in agony. ``I just felt
like blowing my head off,'' says Pringle, 39. He is still
home-bound and spends most of his time sleeping, but he says the
drug allows him to survive. Without OxyContin, he says, ``I don't
think I could do it.''
Most people have simply stopped telling friends and family that
they are on the drug. ``You get reaction from, 'Oh, my God, that's
the drug that kills,' to people saying, 'Will you sell me some?' ''
said a North Palm Beach man, 45, who did not want his name used.
After 10 years as a construction worker, he has four herniated
discs. ``You almost feel like you are doing something wrong.''
There's a reason OxyContin users feel like criminals. Pharmacy
burglaries cannot account for the amount of the drug available on
the street, police say. ``The burglaries, you can count on one
hand,'' said Port St. Lucie Police Sgt. Ron Caudell, who heads the
city's anti-drug unit.
Police believe that people who have legitimate prescriptions are
selling the drug. Some may sell a few pills on the side. Others
file police reports claiming their pills were stolen and then try
to get their doctor to give them another prescription. Some alter
or forge prescriptions. Police also suspect some doctors and
pharmacists liberally dispense the medication.
The temptation to sell is high. On the street, OxyContin sells
for about a dollar a milligram. Pills come in 10 to 80 milligram
dosages. For the 80 milligram pills, a bottle of 100 will cost
about $800 at a retail pharmacy. On the street, one pill can sell
for $80. The whole bottle can sell for $8,000. ``I'm hearing they
are selling on Avenue D along with the crack,'' Caudell said.
Doctors watch their patients closely for signs that they might
be selling. ``I have to have a certain chip on my shoulder,'' said
David Glener, a pain-management specialist in Stuart. ``If someone
comes to me in pain, I have to ask myself, 'Are they playing me?'
''
Glener sees about 80 patients a week and treats 40 percent with
OxyContin. Over the past five years, he's caught about 10 patients
doctor-shopping.
A patient recently dropped his wallet in Glener's office.
Another pain doctor's appointment card, marked for that day, fell
to floor. Glener confronted the patient and then called the police.
``I tell patients, 'I'll be your greatest advocate, but if you
screw with me, I'll make it my mission to make sure you're
arrested.' ''
Nathaniel Drourr, director of the Pain Management Center at
Jupiter Medical Center, uses random urine testing to make sure his
patients are taking - not selling - their OxyContin. If the person
does not show OxyContin in their system, Drourr dismisses them from
his practice. Cases of abuse are up. Drug tests have picked up 10
patients misusing the drug in the past six months, compared with 20
cases over the past five years, Drourr says.
All this trouble is too much for some doctors. At Columbia
Hospital's Pain Care Center in West Palm Beach, three of the four
primary physicians have stopped prescribing the drug, according to
Clinical Coordinator Robert McCandless. At a lecture to a group of
100 fellow doctors in May, pain-specialist Louis Raso asked how
many had stopped prescribing the drug. Fifty percent of the doctors
raised their hands, said Raso, who runs the Gardens Pain Clinic in
Palm Beach Gardens.
Pain can be difficult to diagnose, doctors say, and that's part
of the reason it has been under-treated. Doctors take a medical
history, perform a medical exam and run X-rays and an MRI. Still,
the cause of some pain can be elusive. Doctors often have to trust
that their patients are telling them the truth.
``There's no such thing as a pain monitor,'' Glener said.
``Sometimes it's a leap of faith. You use your best judgment.'' An
attorney who filed a lawsuit recently against the maker of
OxyContin said that his ultimate goal is to see the drug taken off
the market. ``This medication has become a scourge, and if the
manufacturer won't voluntarily pull it off the market for the
benefit of consumer safety, we will try to give them some incentive
to do it,'' Louisville attorney Gary L. Gardner told The Associated
Press.
The thought haunts Judy Harper. ``Every time I reach for a pill
I think, 'This might be the last month that I get it,' and 'What's
going to happen if it is?' ''
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