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Oxycontin: Painful Medicine

Monday, November 14, 2011

Katherine Eban discusses her article “Oxycontin: Painful Medicine” in the November issue of Fortune magazine. Two decades ago opioid sales were a small fraction of today’s figures, bu in recent years, doctors have started prescribing these powerful painkillers more commonly, and addiction to them has skyrocketed. Eban looks at what the strange saga of Purdue Pharma—and its $3 billion drug, OxyContin— tells us about our national dependence on painkillers.

Guests:

Katherine Eban

Comments [36]

Chris NYC from New York City

I agree completely with KP from NYC.
I had chronic pain for 16 years, which significantly limited my enjoyment of life. I tried everything from acupuncture to Zen without success -- some treatments and medications reduced the pain somewhat, but it was always there lingering in the background wherever I went and whatever I did.

Then, last summer, I broke my collarbone and several other bones in a motor vehicle accident and was given hydrocodone (generic Vicodin) during my rehab. Not only did it help control the pain from the accident, but (in very small doses) it TOTALLY eliminated my chronic pain for the first time since I was a young man.

To me now, being in a serious accident was almost worth it, because I learned about this miracle drug that has changed my life. The silly woman fanning hysteria in this interview and the others who want these drugs banned have clearly never experienced the kind of chronic, long-lasting pain that grinds a person down and limits your life. With luck you may never experience it, but if you ever do I hope for your sake the people who want to ban these drugs have not succeeded.

Nov. 15 2011 02:28 AM
Bashi from 07869

Just 1 vicodin can be addictive. One needs to be an aware & disciplined patient. I personally know of several people who died because of secret addiction & denial. I personally see fine responsible people I know becoming dependant, mostly due to back pain. I guess the thought is that since it's prescribed by a Dr., it its OK. Perhaps there needs to be a hotline that will not incriminate people.
I wanted my friend to stop but I was not close enough or pursuasive enough. Pain managemt can be costly & is an alternative that is not widely accepted. various exercises, swimming, meditation, Holistic & Eastern modalities, (Jin Shin Jyutsu)accupuncture, Chirop
ractc, in addition to meds safely used.No "one size fits all."

Nov. 15 2011 12:29 AM
jennifer l from manhattan

It's midnight and I am just getting around to listening to today's show. But I am outraged with your episode. This is an incredibly important topic--every medical expert can tell you that pain is undertreated in this country, which is also a very serious matter. Doctors are afraid to write appropriate medications, partly because the paperwork and the DEA make it such a huge burden. This topic deserves to be addressed on your show by experts in the field with a greater in-depth knowledge of this complex subject than Ms. Erban apparently possesses.

Nov. 15 2011 12:19 AM
Rob from new jersey

an oxycontin, synthetic heroin war story, and just one example of thousands why it should no longer be manufactured. my wife has long suffered with 3 herniated neck discs. 12 years ago, fearful of the extremely serious neck operation surgeons no longer advocate, she was prescribed oxycontin. after a few days of the drug, she was pain free, and given a new lease on life. within a month there was a change in her personality, and she increasingly became withdrawn, depressed, lethargic, and "spaced out". but she was surely free of physical pain. four months later she awoke one morning and told me "i have to go away", "where?", "i'm totally addicted to oxycontin, i'm no longer in control of my life, i need to get checked into a drug rehab today, right now". she was admitted that day to four winds in ny. within three weeks she kicked the drug cold turkey. it was a terrible, anxious time for her, and me. she still has those neck hernias. there is no viable surgery available. neurosurgeons advise to wait it out, that "old age" will atrophy the hernias and relieve the pressure. she copes with the pain via massage therapy, chiropractic, yoga, and positive thinking. any "pain killer" that transforms your life into a drug addicted robot shouldn't be made, let alone offered.

Nov. 14 2011 07:14 PM
alicia Kershaw from NY NY

Dear Leonard,
I hope on a follow up show you will look into the problem of under medication for pain - -your guest commentator rather cavalierly blew off the issue but it's a very serious one. Many people suffer in pain because of unfounded addiction fears, even elderly and dying people.
Also very few people on opiods for serious pain become addicts, a point a caller tried to make but was not really picked up on.

Nov. 14 2011 03:54 PM
Rita Burgess from Suffolk County

As a long time listener, I depend on your show for in-depth analysis and information. I am no fan of Big Pharma; in fact, I believe they are responsible for many of the health care problems we see today. That being said, I found this segment heavy on opinion and light on facts.

I am a registered nurse with 25 years of experience, and I have cared for cancer patients and chemically addicted patients alike. I have never had a patient who was told to take all of their prescribed medication until it was finished; responsible practitioners instruct patients to take as needed and then provide patients with the education needed to evaluate pain. A common instructional aid is for patients to rate pain on a 0-10 numerical scale, and medicate for pain levels that are at or above moderate (5-6) in order to manage pain. Once you ask yourself "do I really need this pain medication?", you know you do not. Moderate pain is not vague; it is painful. Pain prevents full functioning, and the risk of addiction when the patient is an honest partner in the pain management plan is small compared to the benefit gained.

The most beneficial part of this segment was the call for continued education for practitioners with prescription privileges. Addiction and pain management is a part of current medical and nursing curricula, but it was not 23-30 years ago. A stronger focus on the need to educate senior prescribers on how to recognize addiction (as opposed to portraying most users of pain medication addicts) would have been more helpful.

Nov. 14 2011 01:00 PM

A remark made on this program needs to be corrected: Doctors insist on patients' taking a whole couse of antibiotics, because not to do so allows some bacteria to remain in the system, which then multiply and mutate to what become drug-resistant forms. In the case of a drug meant to treat pain, this danger doesn't exist and thus I suspect that at least well-meaning doctors would never counsel a patient to take the entire course of medication (and thus whatever extra pills remain are saved for another flare-up of pain -- which obviously does not multiply as it does in the bacterial model).

Nov. 14 2011 12:46 PM
Lee Michalsky

Last year I suffered a sprained back. After several days of taking hydrocodone every four hours which was not effective, I ended up on the floor in fetal position, nails dug into my palms and thanks to my wife managed to get to an E.R. where I got a morphine shot which allowed me to return home. I then took oxycodone for several weeks while doing physical therapy. Tapering off while the pain level reduced was effective and I stopped taking the medication with no problem. I couldn't understand why anybody not in pain would want to take this sturff. I am grateful for the help it gave me in recovering.

Nov. 14 2011 12:40 PM
KP from NYC

I commented early in the segment, concerned how guest appeared initially to promote hysteria and a stigma about use of this drug, even hostile toward people who genuinely benefit from this medication. As I continue to listen, I am even more horrified. This woman is the equivalent of the red scare or a witch hunt. She should be banned, not the drugs she is discussing. Admittedly, there is an addiction problem in this country, but she blames the victim in a very heartless and insensitive manner that only harms those who genuinely need the medications. One day, if she is ever in acute or chronic pain, I wonder how much she would endure before we can call her a hypocrite.

Nov. 14 2011 12:38 PM
Fred

There is a simple way that doctors can reduce addiction. Simply prescribe a non-addictive substance e.g. advil 800 or whatever and if the patient is still in pain prescribe a short-term dose of pain killers. This is especially true for dental surgery.

Nov. 14 2011 12:37 PM
Nick

As a RN working in ICU I feel you are forgetting several points regarding oxycontin.

One: reports such as this dissuade people who are in pain, particularly in my field surgical post operative patients from taking these drugs when they are in pain resulting in atelectisis, the collapsing of a patient's lungs. Which is far worse.

Two: Sufferers of chronic pain have choices for pain management, and the alternative to time released morphine based drugs are NSAIDS which if taken for a long period of time (ie. chronic pain) run the risk of GI bleeding, where I see them in intensive care.

Nov. 14 2011 12:36 PM
Elizabeth from Eastchester, N.Y.

Hello---Do you know of any effective meds for trigeminal neuralgia? This is 1 of the most painful conditions known to humankind.
Love your show, Mr Lopate.
Thank you.
Elizabeth Member WNYC/PRI

Nov. 14 2011 12:36 PM
Tim from CT

You can't believe anything Perdue tells you.

These are legalized drug dealers.

Whenever you hear of Dr's prescribing, Perdue pays those doctors. When you read positive feedback, Perdue has paid for it. I guarantee people on this board are planting positive reports of use.

This family will buy anything -- one of them bought himself a Knighthood.

They are nothing but drug dealers. They own poppy fields, they lied in their marketing, they lied on their patent application!, they paid dr's to prescribe and continue to do it and they pay governments all of the world to let them get away with it.

Drug dealers.

Nov. 14 2011 12:36 PM
Janet Moyers from south plainfield NJ

My 13 year old grand-daughter told me yesterday that a friend of hers at school takes an ADD med that has an opium derivative in it. Is this common?

Nov. 14 2011 12:34 PM
Bob from Chelsea

This is typical old fashioned American hysteria.

Could you ask your guest to comment about meth, which last i heard was working its way East to kill us all.

Nov. 14 2011 12:33 PM
Louise Mowder from North Brunswick

There are sufferers of incurable, intractable pain,such as neuopathy and Central Pain Syndrome, who can only survive by use of opioids.

Yet doctors refuse to prescribe them in many cases, because they are hyper-vigilant about abuses..

What is Ms. Eban doing to make the public, and the medical profession, aware that there are legitimate, unspeakably awful pain conditions, that absolutely require treatment with opioids when nothing else works? I personally know of dozens of CPS sufferers who are treated like criminals when they seek some help for the incurable, awful pain.

Nov. 14 2011 12:32 PM
Dee from Montclair

Drug companies accept fines because of huge profits. It's all in the risk assessment. Say you make 10 m in profits, the FDA fine is 500 k, you still make 9.5 m. That was explained to me by my boss in the pharmaceutical industry. That's why faulty birth control, hip replacements etc. are still on the market.

Nov. 14 2011 12:30 PM
Nina from Queens

Has the speaker heard of BACLOFEN? is it an effective drug to wean people off of opiods?

Nov. 14 2011 12:30 PM
John from Rockaway Beach

Since marijuana testing started in the FDNY, Oxy abuse has skyrocketed. People do not get addicted to marijuana. http://vimeo.com/johnveit/greenbloodblacksnow
A comedy about Vitamins and Oxycontin

Nov. 14 2011 12:30 PM
leslie tunstall from New Jersey

I cannot imagine becoming addicted to Oxycontin, Oxtcodone or their derivatives for one simple reason: the times I have taken these drugs-- usually for a broken bone or post-operative pain-- even 2 or 3 doses, well-spaced apart, made me PROFOUNDLY sick to my stomache and everyone I know says they same thing. How can anyone get addicted to something that makes you violently ill??

Nov. 14 2011 12:29 PM
Jim from Brooklyn

The coverage is getting even further skewed. First we have the alarmist journalist, then an addiction doctor. How about some patients who are not abusing the products. I took them ten years ago as a result of serious hip infections. I was in excruciating pain for months, but then surgery was finally able to fix the underlying problem, my pain was resolved, and I stopped taking oxycontin w//o problem.

Nov. 14 2011 12:29 PM
jm

amalgam, you cannot un-see that movie! o_O

I'll fully admit to taking Vicodin once in a while during a particularly painful day of menstruation (thankfully only every few months). I like having access to an opioid for this condition, since it not only eases the pain but takes care of the temporary hormonal despair.

Then again, marijuana also takes care of this condition nicely. As of now, there are no over-the-counter solutions that truly help women during challenging periods.

Nov. 14 2011 12:29 PM
ed

If you are addicted, look into kratom. It works, and is in trials in new Zealand. Good luck all.

Nov. 14 2011 12:29 PM
Amy from Manhattan

How common is the opposite problem: refusal to prescribe/supply pain drugs to patients who genuinely need them, as described in a couple of comments below? Wasn't the time-release formulation in part an attempt to counteract this reluctance?

It does happen, despite Ms. Eban's skepticism. As a medical editor, I've read articles about what is actually called "pseudo-addiction," & some patients in severe pain have been denied medication by doctors who assume they're addicts in withdrawal.

Nov. 14 2011 12:25 PM
anonyme

While considered an epidemic, CANCER is no longer seen as a terminal diagnosis, but as a long term diagnosis. I learned this from, among other doctors, my doctor, a top guy at Memorial Sloan Kettering. I think he knows a little more than any journalist about this! So please don't make people scared by saying it's terminal!!! Stage IV doesn't even mean terminal! It's a challenging diagnosis but not a fatal one!!!

Nov. 14 2011 12:24 PM
John A.

Used prescribed Oxycontin (or, as named Percoset) for a broken leg. In under a week I experienced diminishing results with hgh agitation - addiction, I believed. Was able to stop use at that point, but, very strong and very fast negative effects.
-
I have used it once again as KP says - sometimes needed. Used 1 pill.

Nov. 14 2011 12:21 PM
Katharine908 from Indiana

I agree with the other writers about antibiotics.

No one with legitimate pain would take more opioids than they needed--what if they didn't work next time?

It is important that abrupt withdrawal can induce seizures. Users should taper off.

Nov. 14 2011 12:20 PM
JMS in BKLYN from Brooklyn

Wow, lots of bad information in this segment.

$80 for one Oxycontin pill on the street!?!?

No way.

Also, LL's comment about "taking all the prescribed pills" is what they say about antibiotics; pain killers are usually prescribed "as needed."

Opioid use does not "always" lead to addicition. Used properly, they're the best treatment for pain.

There is a great problem with undertreatment of pain, mostly because physicians are afraid of the stigma and the legal liability associated with opioids.

Check your guest's "facts"!

Nov. 14 2011 12:20 PM
Leslie from LES

I'm not a cannibus proponent but is this kind of pain mitigated by it? If so why are there not pills?

Nov. 14 2011 12:20 PM
popejon from Ridge, NY

Why did it take Florida so long to crack down on this epidemic that was out in the open for everyone to see? Did the AMA and pharmaceutical lobbyists help or hurt with this crackdown?

Nov. 14 2011 12:19 PM
amalgam from NYC by day, NJ by night

If you want to see the firsthand ravages of oxycontin in Appalachia, watch the tragic-humorous-terrifying documentary, _The Wild and Wonderful Whites of West Virgina_.

http://wildandwonderfulwhites.com/

Has your guest seen this? It's truly something to behold.

Nov. 14 2011 12:16 PM
el from Long Island

Leonard
When doctors tell you to take the full prescription, they are talking about antibiotics. Pain killers are usually prescribed to take "as needed"

Nov. 14 2011 12:15 PM
Kate from Brooklyn

The ease of getting opioids doesn't match my experience at all. My father in New Orleans had terminal cancer, and every time we tried to get him adequate painkillers to assuage his pain, we faced many obstacles. Even the nurse visiting him on a regular basis was frustrated by how hard it was to get the right dosage. He suffered more than he had to because the doctors were so reluctant to up his prescription, even though he had stage 4 lung cancer. Where was the risk?

Nov. 14 2011 12:15 PM
Tom from Toronto

Leonard, I believe the "finish your prescription" advice typically applies only to antibiotics, and not pain killers!

There is a huge difference.

Nov. 14 2011 12:14 PM
Sara from Brooklyn, NY

My doctor once gave me a prescription of codeine and tylenol for a really bad arthritis flare up. The first dose I took made me feel warm and fuzzy and pain free. It was then I understood why people get addicted to opiates. It felt amazing.

Nov. 14 2011 12:13 PM
KP from NYC

I suffer from chronic pain, a bad disc in my lower back. I take prescribed Oxycontin as needed, one tablet, not more than once a day, or every other day. It has been a miracle drug for me, made the difference between being able to function or not, to be happy or not, to be able to think clearly. To be in chronic pain is a horrible situation, and I really resent the hysteria, the stigma, and fear mongering this speaker is reproducing. Responsible use of this medication is a life saver for many. To blame or judge those who rely on it is incredibly insensitive.

Nov. 14 2011 12:12 PM

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