More MS news articles for July 2002

Doctors wary of prescribing

People in pain are getting a raw deal from doctors who are nervous about overprescribing painkillers, one chronic pain sufferer says

July 10, 2002
By: ANNA GARBER, Staff Writer

On one hand, Sevier County is in the grip of an epidemic of painkiller abuse. OxyContin, most typically prescribed to relieve the pain of cancer, has become a street drug; so have other Schedule ll drugs such as hydrocodone (Vicodin, Lortab), a morphine-like drug.

In Sevier County General Sessions Court recently, Judge Jeff Rader dealt with three prescription drug abuse cases in the space of 20 minutes. In the first, a pregnant woman addicted to oxycodone pleaded guilty to trying to pass a forged prescription.

Next up was a husband who had changed his wife's prescription from eight Lortabs to 80. He admitted taking some of the pills himself.

Then a young man who had stolen items from his mother's house to raise money for his OxyContin habit pleaded guilty to theft.

On the other hand, there are people like Tina Davis of Pigeon Forge.

Davis has had pain problems since she was 14. She's now 38.

Here's how she describes her plight:

"I have multiple sclerosis. I am in pain every day of my life. Some days it is excruciating. The pain is in my back and legs, my hands and feet tingle, I itch beyond belief, my memory is affected, my eyes get blurry, I have balance and walking problems, I am bedridden for weeks to months at a time, I cannot drive a car due to dizziness, my hands tremble so bad the food falls off the fork more than it stays on, and I have muscle spasms that cause my limbs to jerk and fling. If I have to walk for any distances I have to use a wheelchair."

She has endured pain so bad that "I have honestly prayed to die," she said. Her doctor is prescribing MS drugs but not painkillers.

"While my doctor agrees I need the pain meds at times, he has to weigh the consequences to him. He has me on the one hand" and drug enforcement officials on the other, she said.

If her doctor neglects her, he has the chance of a malpractice suit against him - but if he writes her a prescription he may some day have to defend it to law enforcement officers.

Davis says that the arrests of doctors who overprescribe are needed, but people like her are also being damaged in the war on drugs.

"The doctors are afraid," she said. "They are afraid because they think somebody's going to come down on them.

"There are a lot of people like me in pain left out here in limbo getting along the best they can," she said.

Some days, she has to tell her 11-year-old son, "No, I can't do this today because I hurt too bad." And, she said, "It's awful that an 11-year-old has to understand this."

One maker of Schedule II drugs, Purdue Pharma, which manufactures OxyContin, is trying to come up with an abuse-resistant form of the drug.

When swallowed whole, OxyContin can provide up to 12 hours of relief from severe pain. But if it is chewed, or crushed and then inhaled or injected, the full effect of the drug is felt at once, producing a heroin-type high. It has killed more than 100 people, according to an Associated Press article. Some critics want the drug banned.

For Dr. Alyene Reese, founder of the Mountain Hope Good Shepherd Clinic in Sevierville, "It's a matter of judgment."

"Nobody would hesitate" to prescribe OxyContin for cancer pain, she said. But for chronic back pain, "this is like putting a Band-Aid on," she said.

The cause rather than the symptom needs to be addressed - and that requires a partnership between patient and physician. "The patient has to accept some pain, and work with the doctor," she said.

She said she would rather let her patients suffer some pain and not get hooked. A friend of hers was prescribed OxyContin for knee pain by another doctor and became addicted to it, she said.

For example, Reese said narcotics should not be prescribed for migraines. "If it's a real frequent occurrence, it's too easy to get hooked," she said.

She said physicians can often spot pill seekers. For a physician, the bottom line is "I think you need to know your patient," Reese said. Lots of Sevier County patients go to the hospital emergency room or clinics and don't have a regular relationship with a doctor, she said.

©The Mountain Press 2002