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Nothing to Fear but Pain Itself

Are You Opio-Phobic?

Media Overkill?

While the torrent of news stories about OxyContin abuse has certainly raised public awareness of this deadly new drug trend, it's also fanned the flames of opio-phobia, say critics.

As the point man in implementing new federally mandated pain-control measures at Johns Hopkins, Carducci says he deals daily with the results of painkiller paranoia.

"I am implementing this plan in which all patients are asked if they have pain, and then a pain care plan is started," he says. "Now it makes that job even harder because people are afraid to take drugs for pain."

New Drug, Old Fears

Many pain experts are concerned that scary headlines are making opio-phobia worse, says Daniel Bennett, MD, a Denver-based pain management specialist. Bennett, co-founder of the National Pain Foundation, recently joined other pain specialists for an international symposium on the problem of irrational fear of opioid drugs.

Much of the attention being paid to OxyContin abuse is silly because very similar drugs like "MS-Contin have been around for 10 years or longer," he says, with no attendant bad media.

The U.S. has a history of opio-phobia that stretches back to legendary newspaper publisher William Randolph Hearst, says Bennett, who used his newspapers to campaign against the dangers of opium almost 100 years ago.

In the current environment, opio-phobia is flourishing because both physicians and patients are uneducated about pain and pain treatment.

"The average physician has less than two hours of formal training in the treatment of pain," says Bennett, assistant clinical professor at the University of Colorado Health Sciences Center in Denver. "Yet, the number one reason for visiting a doctor is because of some painful problem."

Dependence Doesn't Equal Addiction

Even though pain leads people to seek medical help, too many patients suffer needlessly because they have misplaced fears about the use of opioid medicines, says Akshay Vakharia, MD, a pain management specialist at the University of Texas Southwestern Medical Center in Dallas. Those fears often stem from confusion about the difference between dependence and addiction.

Patients who are treated for long periods with opioid medicines like OxyContin -- meaning more than two weeks -- will experience physiological dependence on the drug. That means, simply put, that if the patients abruptly stopped the drug they would have symptoms of withdrawal, such as tremors, nausea, diarrhea, and sweating. In many cases the symptoms are mild and not like Diana Ross' bathroom histrionics in "Mahogany." And if the patient is gradually tapered off the drug, there are no symptoms and, most importantly, there "is no relapse, no drug-seeking behavior," says Vakharia.

Bennett says he and other pain experts want to get the message out that addiction is not a significant risk when drugs like OxyContin are used to treat pain. Moreover, he says that the whole concept of tolerance, meaning that patients get used to the drug at a low dose and then need higher and higher doses to overcome pain, is flat-out wrong.

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