WEIGHING RISKS, BENEFITS OF OXYCONTIN

Few prescription medications have generated as much controversy as
OxyContin. The mere mention of the powerful pain-relieving medication
evokes a spectrum of emotions and opinions.

Television and print news reports have documented much of the OxyContin
fallout. A rash of pharmacy robberies that have threatened public safety,
deaths related to abuse of the drug and the devastating accounts of
addiction have made OxyContin a public enemy in the minds of many.

Despite its headline-grabbing gravitas, OxyContin is just one type of
pain-relieving class of medications known as "opioids." Its potency makes
it unique. Twice as powerful as morphine, it can replace crippling pain
with crippling addiction when abused. The U.S. Food and Drug Administration
classifies OxyContin as a Schedule II drug. Only Schedule I drugs, such as
heroin, are considered more dangerous. Those drugs have no recognized
medicinal value.

OxyContin addictions do not discriminate by race, gender or social class.
Our commission heard testimony from Salem Public Schools superintendent Dr.
Herbert Levine, whose 15-year-old son developed an OxyContin addiction that
nearly cost him his life. The Levine example demonstrates how addictions
can slip into homes and lives we might not suspect.

It was heartbreaking to hear a father recount how his son's suffering went
untreated until it was nearly too late. We have heard the stories of
parents who are mourning the loss of their children to addiction. We have
heard from the addicted, themselves. I have a friend who is trying to put
his life back together from the destruction wrought from drug addiction.
These stories are too many and the answers too few.

A recent study from the Partnership for a Drug-Free America found that t
wice as many teens (one in five) have tried Vicodin as have tried
OxyContin. It is often referred to as a "gateway drug" because it can lead
to abuse of harder, illegal drugs. We have heard from individuals who moved
on to heroin because it is cheaper and more readily available. Whereas a
single 80-miligram OxyContin tablet can cost $80 on the street, heroin
sells for $3 to $4 per bag, we are told by substance abuse experts.

A recent University of Michigan study conducted for the National Institute
on Drug Abuse found that despite a 17 percent overall decrease in illicit
drug use among teens over the last four years, there has been a 49 percent
increase in OxyContin abuse. In the Boston area, the emerging age of
OxyContin users is the 13-17 year-old age group.

We are left with the challenging task of determining what can be done to
reverse the trend of addiction and abuse.

Banning OxyContin outright may not be the most feasible option. We have
heard plenty of stories on how the drug has been abused, but we are less
exposed to cases where it serves individuals suffering from extreme,
chronic pain. Cancer sufferers, many of whom are terminally ill, comprise a
significant portion of the OxyContin market. The American Cancer Society
estimates that over 33,000 people in Massachusetts, at least half of whom
will experience uncontrollable pain during their illness.

The proper response should entail crafting tighter restrictions on how it
is manufactured, prescribed, distributed and sold. We must also invest in
drug treatment programs that can break the addicted from their downward
spiral of abuse.

We should examine whether it's feasible to encourage limiting the
prescribing of OxyContin to the treatment of severe pain, such as that
experienced by the terminally ill. We should also consider limiting the
amount of medication that can be prescribed in certain cases. Physicians
prescribing OxyContin and other pain-relieving medications should gauge
whether an individual is prone to becoming addicted.

We must do more to reduce the OxyContin-related public health threats that
have primarily come in the form of pharmacy robberies. An incident earlier
this month in Arlington led to a reported gun battle between a would-be
OxyContin thief and the pharmacy's owner. Limiting the drug's distribution
points would reduce the potential for robberies.

At the state level, we can increase our support of drug treatment programs,
especially community-based support services. Between 2001 and 2004, state
funding for the Department of Public Health's Bureau of Substance Abuse
Services budget fell from $45 to $33 million. The House plans to increase
funding for the upcoming fiscal year to $46 million, but not even that
amount will allow that state to fulfill the need for services.

There are roughly 40,000 people in Massachusetts waiting for substance
abuse services. Detox bed totals have dropped from roughly 1,000 to 550.
When the Framingham detox center closed, the MetroWest region was left
without a single location.

We must better educate ourselves about how addictions begin. Forty-four
percent of medications to which children get access are medications used in
their homes by other family members. Where children once raided their
parents' liquor cabinet, they now raid the medicine cabinet.

We cannot seek easy answers. Lawmakers, public health officials, law
enforcement agencies, and the medical community must all work together in
the coming months and years to develop solutions that are feasible and
effective. As the House chairman of the Joint Committee on Public Health, I
am committed to reaching our goals. I hope my colleagues and fellow
citizens will join me.