OXYCONTIN'S VALUE

Ordinarily, a legislative hearing on the abuse of a medication like
OxyContin would have the whiff of Beacon Hill grandstanding about it, but
in this case the complexities of the problems associated with the popular
painkiller justify such a session. The Joint Committee on Public Safety has
invited the drug's manufacturer, physicians, pharmacists, police, the
attorney general, and state regulators to consider how best to deal with
misuse of the drug.

Even if no new legislation emerges from the hearing Wednesday, it will be
useful to get so many of those involved with the drug's use together. One
goal for their deliberations should be to ensure that protections against
the drug's misuse do not unduly interfere with its legitimate use by patients.

OxyContin's signal feature is its slow release, which means that patients
can take one dose and experience relief from their chronic pain for 12
hours, permitting many the rare pleasure of sleeping through the night. The
drug has won strong support from patients, physicians, and pharmacists and
has been a big seller for its maker, Purdue Pharma.

But the drug has also been popular among illegal users, who typically crush
the pills and then inject or inhale the powder. Since its introduction in
1996, it has been linked to at least 120 deaths nationwide. In eastern
Massachusetts, 34 pharmacies have been robbed in the past six months by
thieves seeking OxyContin.

In addition, there is concern that people fake or exaggerate symptoms to
get physicians to prescribe it. The US Drug Enforcement Administration has
questioned Purdue's practice of promoting and distributing the drug not
just to specialists who regularly treat patients with severe pain but also
to general practitioners, who might be less able to ensure that it is used
by the chronic-pain patients it was designed for. Purdue, for its part,
says it is working on a reformulation of the drug that would make it less
vulnerable to misuse.

The state Division of Medical Assistance could put the drug on a list,
including Viagra, that require prior approval for Medicaid patients, but it
would be premature to do so without evidence it is being improperly
prescribed for these patients.

Thefts of the drug have spurred debate among pharmacists on the pros and
cons of stocking the drug or making it available only by special order.
After the Shaw's and Star supermarkets announced they would sell the drug
only by special order, no longer keeping it in stock, the state Board of
Pharmacy quickly - and properly - ruled that this would violate state law
requiring pharmacies to carry all commonly used pharmaceuticals.

Physicians have long been criticized for not dealing more aggressively and
compassionately with patients' pain. It would be a step backward now if
measures to end the misuse of OxyContin get in the way of its proper use,
which has proved beneficial to many.