PAINKILLER ABUSE

Even Legal Drugs Can Be Addictive

In about 44 million American households, at least one person lives in
chronic physical pain. For about one-third of sufferers, severe pain
impedes an active life and can cost over $100 billion in treatment and lost
productivity.

Painkillers are legal. For many Americans, they provide indispensable
salves for chronic and debilitating pain. But there is a dark side of
aggressive pain management: prescription drug abuse brought home by vivid
tales of abuses of morphine derivatives such as OxyContin and Vicodin.

"A drug can be a medicine, or a medicine can be a drug," says Dr. Alan
Leshner, who heads the National Institute on Drug Abuse, an arm of the
National Institutes of Health.

While not yet a national epidemic, prescription drug abuse is a growing
problem, and its victims are people who do not fit drug abuse stereotypes.

* About 17 percent of people older than 60 are prescription drug abusers.

* Women are more likely to misuse narcotics and anti-anxiety drugs
prescribed to treat depression.

* Prescription drug abuse, including the unauthorized use of painkillers or
stimulants by 12- to 14-year-olds, has increased among people under 25.

In 1998, an estimated 1.6 million Americans abused prescription pain
relievers for the first time, a more than threefold increase from reported
first-time abuse in the 1980s. An estimated 4 million people, or about 2
percent of the population over age 12, use prescription pain relievers,
sedatives, tranquilizers or stimulants in unauthorized ways.

While there is no single villain, the links in the distribution chain must
continue to be strengthened. Doctors must closely monitor patients for
signs of drug abuse. Pharmacists must look carefully at prescriptions for
signs of forgery, and call the doctor if the prescription looks suspicious.
These standard operating procedures sometimes are overlooked.

There's a role for manufacturers as well. Purdue Pharma, the maker of
OxyContin, is conducting a pilot program in Maine and Virginia to
distribute free tamper-resistant prescription pads to physicians. The
company also has funded a "best practices" study aimed at making it more
difficult for patients to surreptitiously obtain prescriptions from several
doctors.

Ultimately, patients must become more aware of the potential dangers of
painkillers and speak candidly with their doctors and pharmacists. Also,
patients shouldn't "doctor shop" or buy drugs over the Internet where there
is little medical monitoring.

The line between use and abuse is narrow, but when crossed the consequences
can be tragic.