Tuesday, February 20, 2001

Alliance restricting OxyContin

Hospital group to use drug only for cancer patients

By Tim Bonfield
The Cincinnati Enquirer

        The Health Alliance of Greater Cincinnati — the Tristate's largest hospital group — plans to increase restrictions on how doctors at its facilities can prescribe a powerful pain killer called OxyContin.

        After a wave of publicity about illegal trafficking and abuse of OxyContin, the alliance's drug policy committee has decided to change its standards for filling prescrip tions for the drug. Health Alliance officials refused Monday to reveal details of the new policy because they planned to notify doctors of it later this week.

        However, two Tristate doctors, including one who attended the meeting last Tuesday, say the Health Alliance intends to restrict the use of OxyContin to cancer patients, rather than allowing it for a wider range of post-surgical, orthopedic and chronic pain care.

  • 'Pain drug becomes heroin of the Midwest'
        The Health Alliance policy would directly affect what kinds of pain medications thousands of patients can get when treated at the University, Christ, Jewish, St. Luke and Fort Hamilton hospitals. It would also affect the kinds of medicines provided to low-income people treated at hospital-based clinics and the drugs patients can take home from the hospitals' outpatient pharmacies after they are discharged.

        While the policy cannot prevent doctors from prescribing OxyContin through

        retail pharmacies, some doctors say the Health Alliance policy also could have some symbolic power over how pain gets treated throughout the Tristate.

        As such, the proposed change drew fire even before details were announced.

        “I think it is wrong-headed to take away a drug that works for patients just because somebody else abuses it,” said Dr. Larry Brennan, an oncologist and medical director of the hospice program at St. Elizabeth Medical Center in Northern Kentucky.

        “Our patients need this drug. The major concern I have is if this drug becomes perceived as a street drug, we won't be able to give it to patients who need it.”

        OxyContin is a powerful and unusually long-lasting pain-control drug. It is commonly prescribed for people with cancer and increasingly used to treat other types of pain including post-surgical recovery, orthopedic treatment and chronic pain from nerve damage that sometimes lasts years after a back injury. The pill is valued among legitimate patients for its time-released design — one dose can last 12 hours while other pain medications must be taken every three to four hours. But drug abusers smash the pills to make a solution that they snort or inject so they can rapidly feel the effects of the entire dose.

        The change in OxyContin policy at the Health Alliance comes amid a flurry of publicity about growing illegal abuse. That publicity has in turn sparked a wave of calls and comments from cancer patients and others who are concerned about taking the drug.

        “We're seeing a backlash from legitimate patients,” said Dr. Rebecca Bechhold, an oncologist with Oncology and Hematology Care, a doctor group. “If I hear "heroin of the Midwest' one more time, I'll have a conniption.”

        Patients are worried about whether they will become drug addicts, whether they might become the target of drug thieves, or whether a crackdown on illegal use of OxyContin will mean they may no longer be able to get the medication.

        “We spend a lot of time trying to convince patients that it is OK to take a (narcotic) pain medication to take care of your pain,” Dr. Bechhold said. “But all this talk about OxyContin abuse is setting us back a decade.”

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