THE DRUG ISN'T THE PROBLEM

Comment From The Milwaukee Journal Sentinel

Pharmaceutical companies have been widely and often justifiably
criticized because drugs cost so much and industry profits are so
high. But they do have some strong defenses: The research expenses to
bring a drug to market frequency are enormous, and the drugs that do
get there tend to be much more effective and have fewer side effects
than their predecessors.

OxyContin, a potent, time-released narcotic painkiller that came on
the market in 1995, is one such example. Many Arnericans suffering
from severe pain caused by cancer as well as back and neck problems
consider OxyContin a wonder, drug because it has allowed them to
function again. Unfortunately, there is a dark side. The drug has been
widely and dangerously abused by some, especially young people, who
chew the pills or crush them into powder and then snort or inject it.
Over the last two years, OxyContin has been cited as a factor in more
than 100 overdose deaths nationwide.

Not surprisingly, there have been calls to restrict use of the drug or
even ban it. Six states have proposed rules to make it harder for
Medicaid recipients to get the drug. West Virginia sued OxyContin's
maker, Purdue Pharma, accusing the company of pressuring and enticing
physicians to overprescribe the drug while failing to warn of its
potential abuse; the company denies the charges.

Clearly, OxyContin abuse poses an enormous, growing problem, and many
of the official actions so far have been responsible. But overreaction
to the abuse also is risky, especially when some go so far as to
suggest the drug be taken off the market. It was approved by the Food
and Drug Administration after careful study and, when used as
directed, it is safe. Because some people make bad personal decisions
and abuse OxyContin, is it right to deny the drug to tens of thousands
of others who use the drug as directed for their very real problems?

The FDA recently stressed to doctors, in the strongest terms possible,
that the drug should be prescribed only for patients with serious
pain. Purdue Pharma, among other things, has stopped shipping its 160-
milligram pills and offered tamper-resistant prescription pads to
doctors. The manufacturer also is working on a new painkiller that
would contain a compound, called an antagonist, to combat abuse by
reducing the opiate effect if the pill is crushed. But the new drug
won't be available for a couple of years. Critics say Purdue Pharrna
could have added those antagonists initially, as some companies have
done for certain other drugs.

That's a valid criticism in hindsight.In the meantime, the responsible
course of action is to continue to support law enforcement efforts to
seek out and vigorously prosecute those doctors and others who are
dealing or stealing OxyContin. Improved public education and treatment
also are appropriate, especially in areas like Appalachia, where, some
say, abuse of the drug has reached plague proportions. But further
regulatory oversight should be left up to medical professionals,
particularly at the FDA. Removing this remarkable drug from the market
would be wrong.