'HILLBILLY HEROIN' PRESCRIPTIONS GET A LOOK

MD Regulator To Monitor Rise In Oxycodone Use

THE group that regulates Manitoba's doctors is considering warning
physicians that some patients may be abusing the pain drug oxycodone.
The Addictions Foundation of Manitoba has written to the College of
Physicians and Surgeons of Manitoba requesting a warning in the
college's newsletter after noticing a rise in the number of clients
using the drug to get high. Oxycodone is known as hillbilly heroin
because addicts in rural communities without access to the hard drugs
sold on city streets sometimes crush the pills, mix them with water
and inject.

College registrar Dr. Bill Pope said he will examine data on the
rising number of prescriptions recorded by Manitoba Health before
taking action.

He said the fact there are more prescriptions might be a good sign if
it means doctors are giving out smaller doses each time so they can
monitor their patients more closely.

The number of Manitobans being prescribed the drug rose from 2,022 in
2003 to 2,584 last year, but that could reflect growing acceptance
that the powerful painkiller is appropriate for chronic pain, not just
terminal patients, Pope said.

Kathryn Raymond, a spokeswoman for Purdue Pharma, which manufactures
the OxyContin brand, said oxycodone is one of only a few
controlled-release opiates that allow patients to sleep through the
night.

Many patients with long-term pain have tried all of them and settled
on the one that works for them, so eliminating oxycodone would leave
people suffering, Raymond said. Purdue has sponsored about 20
workshops for Manitoba doctors in the last year on pain management and
how best to assess which patients are at risk for addiction. Dr.
Howard Intrater, head of the pain clinic at Health Sciences Centre, is
a speaker for Purdue on pain management.

In Brandon, only one of two deaths initially believed to be related to
oxycodone turned out to be linked to the drug.

Police have charged a man with criminal negligence causing death after
he allegedly allowed a woman to try the drug he was preparing to shoot
up from his own prescription for a medical condition.

Brandon Dr. Derry Decter believes doctors and patients tend to
underestimate oxycodone, which is more potent than morphine.

Brandon police Sgt. Rick Semler said oxycodone abuse does not appear
to be widespread. There are only a limited number of people with
prescriptions who are willing to share or sell the drugs they might
need for their own pain, he said.

Pope said prescription drugs sold on the street are sometimes brought
in from other provinces. In Manitoba, unlike some of the provinces
where oxycodone abuse is more of a problem, prescriptions for
addictive drugs can be written only on special triplicate pads, which
doctors are advised to keep locked up.

One copy goes to a monitoring database, and pharmacists can do a
computer check to see if the same patient has recently received the
drug from a different doctor.

Decter wants doctors to be notified by letter of a patient's history
with oxycodone whenever they prescribe the drug, which he refuses to
do at his downtown Brandon office.

"People ask me for it all the time."

Raymond said patients are also advised to lock up their pain
prescriptions, as teens sometimes get hold of the drugs and experiment
with them.

The college's prescribing practices group is in limbo and will likely
be transferred to the Manitoba Pharmaceutical Association, Pope said.