LIMBAUGH ANNOUNCEMENT HIKES INTEREST IN DRUG

For some, the pain reliever OxyContin brings to mind addiction because of
its strong potential for abuse. Others consider the drug a blessing, a
much-needed tool to control patients' pain.

Dubbed hillbilly heroin for its addictive qualities and misuse in
Appalachia, OxyContin often is portrayed with a one-sided slant. In
reality, the drug has its benefits, primarily for those suffering from
acute or chronic pain.

"It's generally used very safely," said Dr. Lynn Johnson, director of
center for pain medicine at Pitt County Memorial Hospital.

Yet, the drug sometimes gains a maligned reputation, especially in
instances when the media covers addiction or dependence upon painkillers.

Conservative radio talk show host Rush Limbaugh recently announced his
addiction to painkillers, noting he plans to spend the next 30 days in a
rehabilitation center. Limbaugh said he began taking prescription pain
relievers following spinal surgery.

He said he still suffers pain in his lower back and neck due to herniated
discs. His former maid has said she obtained OxyContin, Lorcet and other
painkillers for him.

"When patients see when a celebrity becomes addicted, they become
concerned," Johnson said.

Their anxiety may lead to a cautious, skeptic attitude toward drugs like
OxyContin, which contains oxycodone, a powerful narcotic pain reliever
similar to morphine.

Addiction is certainly possible with OxyContin, as it is with any narcotic.
But used correctly, patients probably should not experience problems.

"It's not going to become addictive with short course, taking it
short-term," Johnson said. "The myth is, you take it a few times, you
become addicted."

OxyContin is an opiate, like Vicodin, heroin or codeine. It works by
attaching itself to specific proteins called opioid receptors found in the
brain and spinal cord, where it blocks pain messages to the brain.

Supplied in a controlled-release dosage, OxyContin is intended to provide
up to 12 hours of relief from moderate to serious pain. It includes a
"black box warning," the strongest type of caveat for an FDA-approved drug.
Users can abuse it by crushing the tablets, injecting it intravenously or
snorting it. They also can misuse the drug orally, taking more than required.

"When you start having it available on the street, that's dangerous,"
Johnson said. "People should not turn long-acting medication into short
activity."

Long-term use of OxyContin can result in physical dependence, a normal
adaptive state, according to the American Academy of Pain Medicine.

One who becomes physically dependent on pain medicine experiences
withdrawal symptoms when the medicine is decreased, stopped or reversed.

No withdrawal symptoms are expected if the medication is decreased, tapered
or stopped gradually under medical supervision.

Dependence differs from addiction, which represents a psychological need
for the drug. The condition is characterized by compulsive use despite harm
and decreased quality of life.

"Everybody is susceptible, but in reality, the rate of addiction is very,
very low," Johnson said. "It's very rare that a patient gets involved with
addiction."

In Limbaugh's case, he admitted to addiction. But Johnson worries that
diagnosis could be misleading, cautioning that experts should evaluate
Limbaugh first.

"He might not be addicted, just dependent," Johnson said.