BLAMING THE DRUG ISN'T THE ANSWER

Public Should Recognize Addiction As Disease That Needs Treatment

Much has been made by the media of the recent cases of abuse of the drug
OxyContin. Now we have individuals and state agencies trying to sue the
drug's manufacturer, Purdue Pharma, for creating the problem. As someone
who has practiced in the fields of both addiction and pharmacy, I must say
enough already.

The problem is the disease of addiction, not one particular drug or drug
manufacturer. Drug addiction, although recognized as a treatable chronic
disease, still tends to be moralized by many in society.

If we are talking about alcohol, society imposes a "wet moral model,"
meaning that it's OK to drink, until you drink too much, and then the
individual is deemed to be immoral, rather than ill. With other drugs, it's
a "dry moral model," meaning any drug use is immoral.

The issue of pharmaceutical drug diversion is not a new phenomenon. The
National Institute on Drug Abuse (NIDA) estimates that 4 million Americans
are abusing prescription drugs.

Prescription drugs, including controlled substances, require a prescription
because the FDA has determined that they are too dangerous to use
unsupervised, and therefore their use requires close medical supervision.

Controlled substances by their nature have the potential for causing
addiction. In fact, they are scheduled by the Drug Enforcement Agency
according to their addictive liability, with schedule II drugs having the
greatest risk of addiction.

With opioid narcotic pain relievers, there will always be a risk of
addiction because opioids inherently produce euphoria along with pain relief.

To that end, the drug manufacturers are constantly trying to develop
formulations that provide pain relief with less associated euphoric effects.

OxyContin, when used appropriately every 12 hours, produces significantly
less euphoria than traditional opioids because the active ingredient,
oxycodone, is released over the 12 hours.

Unfortunately, drug addicts have figured out how to compromise the
long-acting properties of the drug (with assistance from the media) so they
get a 12-hour dose within minutes.

It is true that even when used appropriately OxyContin can cause addiction.
The fact that it is a schedule II drug alerts those who prescribe drugs to
that risk. But addiction can also occur with any of the opioids, schedule
II through V, used to treat pain, and in such cases should be viewed as an
problem to be monitored for, and dealt with when it occurs.

To say that this problem is unique to OxyContin is ridiculous. In most
cases however, when addiction does occur, it is because the patient failed
to take the drug as prescribed (with or without a previous history of drug
abuse), or was buying the drug on the street.

In either case this is not the fault of the drug or its manufacturer.

All the while, as the media hype the OxyContin issue, it is estimated that
50 million Americans with chronic pain go untreated every day. As someone
who treats addicts daily, I see the personal, family and societal problems
associated with addiction.

As a pharmacist, I also see the physical and emotional problems associated
with untreated pain. Long-acting opioids such as OxyContin have been true
wonder drugs when used appropriately. Not only can these drugs be effective
in giving pain sufferers their life back, but they can also do it with a
lower risk of abuse than is seen with traditional immediate-release products.

While it would be convenient to suggest that the drug is at fault, the
truth is that we as a society are the ones at fault, with our unwillingness
to treat addiction as a disease.

Until health-care professionals are better trained about addiction, until
governments respond with drug treatment combined with law enforcement, and
until we treat addiction as a disease, we will continue to have a problem
with drugs in this country.

Today it is OxyContin, yesterday it was Ecstasy and before that crack
cocaine and heroin.

It's time to start focusing on the solution, drug treatment, instead of the
problems with the drugs themselves.