-Caveat Lector-
From
http://www.reason.com/sullum/121801.shtml
}}}>Begin
December 18, 2001
Killing a Painkiller
The OxyContin hysteria inflicts pain.
By Jacob Sullum
Last May a Kentucky physician reported that a former patient, a
paraplegic with severe chronic pain, had killed himself. The man's
new doctor, alarmed by official warnings about the prescription
painkiller OxyContin, had drastically reduced his dose, leaving him
in agony.
Stinginess with pain medication is not a new phenomenon. For decades
pain experts have complained that many doctors are so worried about
getting into trouble with state regulators or the Drug Enforcement
Administration th
at they err on the side of letting patients suffer. The federal government's ongoing
crackdown on OxyContin, egged on by a year of hysterical press coverage, is bound to
make the problem worse.
Introduced in 1995, OxyContin is a timed-release form of oxycodone, a narcotic that
has long been available in many other medications, including Percocet, Percodan, and
Tylox. Unlike these products, OxyContin delivers a s
teady dose of the drug over a 12-hour period, which makes it a godsend for patients
with disabling chronic pain.
It has also found a niche among people looking to get high, who discovered that they
could get all the oxycodone at once by crushing the tablets and swallowing, snorting,
or injecting the powder. The habit was picked up i
n a few places around the country, especially in rural areas where other drugs are
hard to come by.
In a humane and sensible world, the fact that some people got their kicks this way
would have no bearing on whether paraplegics and cancer patients could get the drugs
they needed to relieve their suffering. But in a worl
d warped by the crusade against unauthorized intoxication, a bunch of idiots snorting
OxyContin powder can make life so unbearable for people in pain that they're driven to
suicide.
Here's how it works: Journalists hungry for a good scare story announce that OxyContin
is the "drug of choice" in, say, Appalachia or the Midwest. Alerted to the trend,
thrill seekers around the country decide to try the
pharmaceutical that gives a "heroin-like high." The increase in use feeds the press
coverage, which spreads the fashion further and reinforces the government's
determination to do something about it, as illustrated by thi
s month's congressional hearings on the issue.
Some proposed responses to the nonmedical use of OxyContin, such as limiting
production, would have a direct effect on the drug's availability to people in pain.
But even seemingly innocuous efforts to prevent diversion c
an result in needless suffering.
Last summer, for instance, the Food and Drug Administration slapped a "black box
warning"onto OxyContin declaring that it has "an abuse potential similar to morphine."
The FDA cautioned doctors to take into account "the s
everity of the pain that is being treated" before prescribing the drug.
That may sound perfectly sensible. But since the severity of pain cannot be
objectively verified, doctors have to decide whether to trust their patients. Every
new warning discourages them from taking that chance.
Even without concrete government action, the bad publicity is enough to scare already
skittish doctors away from OxyContin. Shortly after the FDA announced its labeling
change, The New York Times Magazine described the dr
ug this way: "As a pill it brings potent pain relief. As a powder it brings euphoria.
It takes about five seconds to effect the transformation--and not much longer to
create an addict."
This sort of irresponsible, hyperbolic reporting, which simultaneously stimulates
interest in the drug as an intoxicant and discourages its use as a painkiller, has
been featured by many prominent media outlets, including
Time, Newsweek, CBS, and even MTV (which recently aired "I'm Hooked on OxyContin" as
an episode of its True Life series). Such scaremongering is especially galling coming
from news organizations that also run stories bem
oaning the inadequate treatment of pain.
In the typical OxyContin story, the victims are people who choose to take the drug
because they like the way it makes them feel. Taking a similar view, the DEA defends
tighter controls by claiming that OxyContin is "a lik
ely factor" in about 300 overdose deaths since January 2000.
Such cases generally involve people who not only take a 12-hour dose
of a strong narcotic all at once but combine it with other drugs. The
message of the OxyContin crackdown, then, is that the government has
an obligation to protect people from their own recklessness, no
matter how many innocent bystanders are hurt in the process.
� Copyright 2001 by Creators Syndicate Inc.
Jacob Sullum's weekly column is distributed by Creators Syndicate. If
you'd like to see it in your local newspaper, write or call the
editorial page editor.
End<{{{
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