Wednesday, February 21, 2001

Restricting drug draws praise, fire

Some doctors criticize action on OxyContin

By Tim Bonfield
The Cincinnati Enquirer

        The decision by the Health Alliance of Greater Cincinnati to limit how it fills prescriptions for the powerful painkiller OxyContin has drawn fire from some doctors, but praise from some in law enforcement.

        OxyContin is a time-released medication commonly prescribed to control severe pain in cancer patients and increasingly used to control pain from other types of injury and disease.

        Last Tuesday, the Health Alliance's drug policy committee voted to restrict the use of OxyContin to cancer patients.

        Instead, the preferred heavy-duty pain reliever to be used at Health Alliance hospitals will be Oramorph, a long-acting brand of morphine, said Marianne Ivey, corporate director of Health Alliance pharmacy services. Oxycodone, a short-duration cousin to OxyContin, also will remain on the Health Alliance formulary.

        “The committee that made this decision is physician-led. (To them) it looked like there were medications that were equally effective and equally safe as OxyContin that didn't have the po tential for abuse,” Ms. Ivey said.

        In addition to concerns about misuse of OxyContin, the Oramorph drug is less expensive for the Health Alliance, Ms. Ivey said.

        Ms. Ivey said there will be exceptions to the Health Alliance policy.

        So far, the Health Alliance is the only large medical organization in town to increase restrictions on OxyContin.

        “I think it's a positive step,” said Sgt. Kerry Rowland, commander of the Cincinnati Police Division's Pharmaceutical Diversion Squad. “The biggest thing is to make doctors aware of how serious this problem is.”

        However, TriHealth, a hospital group that includes Good Samaritan and Bethesda North hospitals, does not plan any changes to its policy.

        “We have no intention to dictate to our physicians what they can and cannot prescribe,” said spokesman Joe Kelley.

        Dr. James Molnar, a pain-management specialist, said he uses OxyContin only sparingly. However, he disagreed with the Health Alliance policy limiting OxyContin to cancer uses.

        “That's a mistake,” he said. “I have patients where that drug is the only one that seems to help.”


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