More MS news articles for Aug 2001

OxyContin: Tighter regulation worries those it helps

http://www.courierpress.com/cgi-bin/view.cgi?200108/20+tighterregulation082001_health.html+20010820

Monday, August 20, 2001
By HILARY WALDMAN, The Hartford Courant
 
Since Pam Herms started taking OxyContin to treat her cancer pain seven months ago, she has returned to the golf course and is enjoying the time she has left with her family and friends.

She does not sugarcoat her vision of life without the controversial prescription painkiller, which has drawn fire for causing overdoses and death among abusers of the drug.

“If I didn’t have this, I would probably be bedridden and possibly in hospice and on a morphine drip,” said Herms, 54, who has an incurable form of cancer that has spread from her pancreas to her liver and bones.

While lawsuits are being filed against the manufacturer, Purdue Pharma L.P. of Stamford, Conn., and while Connecticut Attorney General Richard Blumenthal calls for stricter regulation of the drug, cancer doctors and patients are silently hoping that their access to the medicine will not be restricted.

At the same time, news accounts of depravity and death by abusers, who crush the time-release tablets and snort or inject the powder, are making some pain patients think twice about swallowing the tablets whole, as directed.

Crushing a tablet destroys its time-release feature, giving the user 12 hours’ worth of oxycodone, the addictive synthetic opiate that is the medication’s only active ingredient, in one jolt.

“Lately, I’ve prescribed OxyContin for some patients, and they are a little concerned that they are going to get addicted,” said Dr. Zia Rahman, an oncologist at St. Francis Hospital and Medical Center in Hartford, Conn.

In fact, he said, the drug is not addictive when swallowed every 12 hours as prescribed.

Rahman cited a 39-year-old patient, whose colon cancer had spread into her pelvic bones, causing unbearable pain. At one point the woman was taking 1,200 milligrams of OxyContin twice a day, 30 times the normal dose.

Eventually, anesthesiologists were able to surgically block the nerves in her abdomen, permanently stopping the pain.

The day after surgery, she was off OxyContin, Rahman said.

Although many patients taking OxyContin are in the end stages of their disease, the drug allows them to return to normal activities.

“It’s been wonderful for our patients who have chronic pain. It’s allowing patients to have their lives back,” said Dr. Andrew L. Salner, director of the cancer program at the Helen and Harry Gray Cancer Center at Hartford Hospital.

Patrick J. Shaughnessy said OxyContin has enabled him to return to work at the state Department of Education unimpeded by the incessant dull pain in his hips and lower back caused by a cancer of the smooth muscle that has invaded two parts of his body.

He said the drug does nothing but take away the ache.

“I’m never woozy, never fuzzy. I never feel, ‘Boy, I’ve got to have another,’ or ‘If one is good, two is better,’ ” said Shaughnessy, 66. “It just allows me to function.”

Herms started taking OxyContin last winter after shorter-lasting painkillers failed to sufficiently ease the sharp pain in her legs, shoulders, arms and hands caused by the cancer in her bones.

Since she started taking the drug, she is back to her Thursday golf league and has resumed her volunteer work with her church and with the National Multiple Sclerosis Society. She also is driving again.

She said her pharmacy already tightly controls distribution of the drug, allowing her to take home only a one-month supply, even though her insurance will pay for three months’ worth at a time.

She said she feels no high or euphoria from OxyContin and is only tempted to take more than the prescribed twice-a-day dose when the pain starts creeping back early.

She never does, because if she takes extra pills, she will be left without any at the end of the month — a scary prospect, she says.

To make OxyContin less attractive to street users, Purdue Pharma intends to reformulate its slow-release drug so that the oxycodone would be deactivated if crushed into a powder, but the new formula is at least three years away.

Meanwhile, Blumenthal has written a letter to the manufacturer urging it to limit distribution of the drug to certain pharmacies and to earmark a portion of OxyContin profits for addiction treatment.

Herms doesn’t want to sound cold, but she has little patience for the addicts.

“Drug abusers will find something else,” Herms said. “For me, there is nothing else.”