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OxyContin: Pain Relief vs. Abuse

Are worries over abuse having an impact on the drug's legitimate use as a painkiller?

OxyContin Use and Abuse continued...

According to the U.S. Department of Health and Human Services 2006 revised Substance Abuse Treatment Advisory on OxyContin, the regions most affected are eastern Kentucky, New Orleans, southern Maine, Philadelphia, southwestern Pennsylvania, southwestern Virginia, Cincinnati, and Phoenix. However, the DEA says the problem has spread across the country.

While there is special concern about teens' use of OxyContin, the percentage of 12th graders who said they had abused the drug in the past year declined in the 2006 Monitoring the Future survey of the National Institute on Drug Abuse (NIDA). The information is summarized in "NIDA Infofacts: High School and Youth Trends." Abuse of OxyContin decreased for the first time since its inclusion in the survey in 2002, from 5.5% in 2005 to 4.3% in 2006.

Drug Tolerance vs. Addiction

Chronic pain patients often confuse tolerance with addiction. They become fearful when the dosage of a narcotic has to be increased, but it's normal for the body to build up tolerance over time, says Simmonds, spokeswoman for the American Cancer Society. "Patients don't get a high, and they don't get addicted."

Simmonds, who is in private practice in Harrisburg, Pa., tells WebMD, "The tragedy is that any day of the week a patient will be in my office in real pain, and a family member will say, 'Don't take morphine.' Patients will suffer needlessly because they think they'll get addicted. We have to take time to educate them."

Kathryn Serkes, director of policy and public affairs for the Association of American Physicians & Surgeons (AAPS) in Tucson, Ariz., agrees. She says the standard of pain management care is more aggressive today than what it was just five years ago. She disagrees with some critics who would use OxyContin only as a last resort. "The phrase 'addicted to painkillers' is used fast and loose."

Treatment of Pain in Addicts

Is it inhumane, as some in pain management believe, to withhold opiates from someone in pain who has a history of addiction? No, say two experts in chemical dependency who talked with WebMD.

"Medical professionals need to be educated about addictions," says Peter Provet, PhD, president of Odyssey House Inc., in New York City. "A problem with addicts is they don't like pain of any kind. They've been medicating their emotional pain, physical pain, or familial pain. The addict is quick to ask for a pill, but sometimes we have to deal with our pain.

"All other kinds of treatment should be first considered before the physician jumps to what is the easiest solution, a synthetic opiate," he tells WebMD. "An addict or recovering addict suffering pain from cancer or after a car accident should talk with a physician well-versed in addiction. On occasion, someone who is in recovery may need a drug like OxyContin. It would need to be done thoughtfully with full knowledge of addiction, and then the treatment should be very carefully monitored."

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