PROSECUTE THE DRUG CRIMINALS, NOT PAIN PATIENTS

If Dr. Randolph W. Lievertz of Indianapolis is convicted of improperly
writing prescriptions for OxyContin for a drug ring and illegally
billing Medicaid, he should be punished to the full extent the law
allows. But legitimate pain patients who received OxyContin
prescriptions from Lievertz should not be punished by losing access to
a beneficial medication they desperately need.

According to the American Pain Foundation, there are 50 million to 70
million Americans who don't get the treatment they need to relieve
serious pain. Many pain sufferers resist turning to safe and proven
pain medications because they fear becoming drug addicts. And many
doctors don't prescribe these medications because of sensationalized
media reports that have frightened their patients.

The National Institute on Drug Abuse, which is part of the National
Institutes of Health, says that opioids -- standard pain-relief
medications such as morphine, codeine, OxyContin, Darvon, Vicodin,
Dilaudid and Demerol -- are safe when properly used.

As a psychiatrist for the past 25 years, I have treated many patients
suffering from terrible depression because they have chronic pain that
keeps them from holding jobs, sleeping well, walking and carrying out
other ordinary activities. Depression worsens the misery of these
people and can lead some to commit suicide.

Treating these patients with powerful antidepressant medications alone
does nothing for the pain that is causing their depression. But
treating their pain can often eliminate the depression as well,
without the use of antidepressants.

One of my depressed patients, whom I will call Gary, was a convenience
store owner in his 50s who enjoyed good health all his life, until a
bullet fired by a robber shattered his back and left him in 24-hour-a-
day pain. The wound healed to a great extent, but its pain never
faded, making it impossible for Gary to work or enjoy being alive.

Gary's doctor concluded that the opioid OxyContin was the best
medicine for Gary, but decided not to prescribe the drug because it
has been demonized in sensational media accounts that have focused on
comparatively rare cases of OxyContin abuse.

Gary came to me seeking psychiatric help to deal with his pain. I
conferred with his doctor, the doctor reconsidered, and we gave
OxyContin therapy a try instead of psychotherapy. Gary got his life
back, his pain was reduced to a manageable level and he was able to
work and resume a reasonably normal life.

I have prescribed OxyContin to more than 200 of my patients, and none
of them has become addicted. A doctor can remove a patient from an
opioid without ill effects, as long as the drug is reduced gradually.
And if needed, medications are available to allow doctors to take
patients off opioids quickly.

Abuse of OxyContin takes place when people crush large doses of the
tablets and snort or inject them so the drug enters their systems
immediately, causing a heroin-like rush. In contrast, doctors tell
pain patients to swallow OxyContin tablets so the drug can enter their
systems slowly to provide relief over 12 hours.

OxyContin, introduced in 1995, actually has far fewer side effects
than many other pain medications and provides relief for many more
hours. For example, non-steroidal anti-inflammatory drugs -- commonly
taken for arthritis pain -- can cause bleeding ulcers and other
complications that resulted in about 16,000 deaths in the United
States last year.

Those 16,000 deaths are clearly a far more serious problem than the
reported 282 overdose deaths in which abuse of OxyContin is suspected
of playing a role, even when other abused substances were found in the
same person's body.

Today, about 2 million people with chronic pain are being treated by
doctors with OxyContin, and are leading far better lives as a result.
Millions more are being treated with other pain medications.

It makes no sense to punish pain victims further by denying them
needed medications. Our legal system should focus instead on punishing
criminals who have found very bad uses for very good drugs.