Wednesday, May 02, 2001

DEA asks maker to curb Oxy

Limit Rx to pain specialists, agency says

By Kristina Goetz
The Cincinnati Enquirer

        Federal drug enforcement officials have asked drug-maker Purdue Pharma L.C. to limit distribution of the painkiller OxyContin to doctors who manage pain.

        The request is part of the Drug Enforcement Administration's strategy to curb the exploding misuse of the painkiller, a narcotic derived from opium in a time-release form.

        It is the first time the DEA has targeted a specific prescription drug to curb its misuse.

        In a statement released Tuesday, Purdue Pharma officials acknowledged meeting with the DEA and the U.S. Food and Drug Administration but would not say whether the company would comply with the request.

        “As we expect to have an ongoing dialogue with the DEA and FDA, we feel it is inappropriate to go into further detail about our discussions at this time,” the statement said.

        The move has some patients in Greater Cincinnati worried about the drug's future availability.

        “It looks like that's the way it's going to go,” said Stephen Myers, a Hamilton resident who relies on OxyContin to ease his chronic pain from a degenerative spine disease.

        “The people who need it will suffer and the people who abuse it will move on to something else.”

        One Cincinnati doctor, though, thinks limiting distribution isn't a bad idea, though he says OxyContin shouldn't be singled out. All narcotics used to treat chronic pain, Dr. Neil Jobalia says, should be limited to pain specialists.

        “At least in that situation you would hope that it would be used in a context of a treatment plan,” he said.

        Federal officials say the move came because of concerns that doctors were prescribing the drug for moderate pain, and not the severe pain it was intended for. They also point to the number of stolen prescriptions as well as the incidence of “doctor shopping,” the practice of finding multiple physicians to obtain pills.

        “When it's being abused there are severe dangers,” said DEA spokeswoman Rogene Waite. “And abuse leads to addiction. It is a vicious cycle.”

        In addition to 59 OxyContin-related deaths in Kentucky and 32 in Virginia, DEA officials say there has been a sudden increase in abuse of the drug over the past two years in several states, including Ohio and Kentucky. The number of emergency room visits nationwide involving OxyContin overdoses doubled from 1996 to 1999 — 3,190 to 6,429.

        In Eastern Kentucky, the problem is still getting worse, authorities say.

        “I don't know what the answer is there,” said Det. Dan Smoot of the Kentucky State Police in Hazard.

        “Purdue Pharma is going to have to do something. It's still terrible here. We're still flooded.”

        And abuse of the drug has begun to creep into Ohio.

        “We feel pretty confident that OxyContin will be one of the No. 1 diverted drugs by the end of the year, if not the No. 1,” said Sgt. Kerry Rowland, commander of the Cincinnati Police Division's Pharmaceutical Diversion Squad.

        The DEA's Ms. Waite said the federal agency's action plan has four key components.

        The DEA's office of diversion control will:

        • Coordinate all law enforcement and intelligence agencies to facilitate efforts to crack down on the abuse.

        • Ask Purdue to voluntarily limit distribution of the prescription drug to only those physicians who specialize in pain management.

        • Seek voluntary cooperation from Purdue Pharma to help in the fight.

        • Begin a national awareness campaign about the dangers of abusing OxyContin.

        The programs will involve schools, state and local law enforcement officials, health care workers and the general public.

        State efforts are also under way.

        After a February drug bust in Eastern Kentucky yielded more than 200 indictments, Kentucky Gov. Paul Patton created an OxyContin task force to bolster existing state initiatives to curb prescription drug abuse. Task force members are expected to present Mr. Patton with a statewide plan by Friday.

        And after a multistate summit in Richmond, Va., in March, Purdue Pharma officials agreed to help educate the public and enforce proper use of the narcotic.

        Part of Virginia's plan includes using tamper-resistant prescription pads to help curb diversion and developing an education presentation on the dangers of prescription drug abuse that is geared to middle school students.

        Ms. Waite said DEA officials want to underscore that the drug has legitimate uses and that the medication should be available for people in severe pain.


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