PAIN SPECIALISTS SEE RELUCTANCE BY SOME MDS TO PRESCRIBE OXYCONTIN

Prescription-drug theft a concern

Overreacting to problems associated with potentially addictive prescription
drugs like Oxycontin might hurt those who need help most, warn some Halifax
pain specialists.

"We at the pain clinic are having trouble convincing physicians to use these
agents," said Dr. Mary Lynch of the pain management unit at the Queen
Elizabeth II Health Sciences Centre in Halifax.

"People who are in pain who need these medications will not get them."

Oxycontin is one of several "opioid" medications prescribed for chronic
pain, often for cancer. Opioids are compounds that resemble cocaine or
morphine in their addictive properties or effects on the body. When misused,
they can give an addictive high.

Industrial Cape Breton has had lots of property crime related to Oxycontin,
said Cape Breton Regional Police Const. Greg Gouthro.

He blamed the last four break-ins on people seeking the drug or money to buy
it.

"There is a big problem in Cape Breton," he said.

Dr. Lynch agreed that's bad, but said negative attention may create an
"opioid phobia" that curbs beneficial use.

"It filters over and frightens physicians from using medically appropriate
and necessary drugs."

She said medical use of Oxycontin and its misuse by addicts are "two
completely different issues."

"We don't want concerns regarding diversion (to addicts) to limit the
appropriate medical use of this group of medications."

Normally the drug is time-released into patients, with no high or threat of
addiction. Addicts magnify the effect by crushing pills into powder, mixing
it with water and injecting it.

Const. Gouthro said most Oxycontin users acquire it properly "but then
you've got the percentage that are getting it for retail (to addicts)."

He said more can be done to keep drugs away from traffickers.

"The pharmacists and the doctors, to my belief, know who's abusing it and
know who's not and they can use their own discretion on that part."

He said some local pharmacies are working with him to do that but he
wouldn't say how.

"That would sort of tip the other side."

Pharmacist Paula Kowal at the Victoria Road Pharmasave in Sydney said people
tried to fill forged prescriptions written on stolen pads three times last
year at her store.

She's also skeptical about some prescriptions people have written for them.

"I think patients are not always honest (about their pain level)," she said,
indicating some go to the doctor looking for opioids, even asking for them
by brand name.

Jessie Dufour, a pharmacist at the Glace Bay Lawton's who has also worked in
Truro and Halifax, said in her experience neither of the two mainland
centres has as many Oxycontin prescriptions.

"It is more frequently used here."

Cape Breton had 653 patients on Oxycontin, compared to 545 in Halifax,
according to a drug study released in May.

Dr. John Clark, director of the QEII's pain unit, advises doctors to screen
patients the best they can. It's difficult, since doctors rarely have the
time and often take a patient's word because "there's no good objective
measure of pain."

Doctors should look at a patient's risk of addiction, monitor any previous
prescriptions, watch for people reporting lost pills and even place patients
on a contract which, if broken, ends their prescriptions.

A doctor can also order a urine check to test if the patient is using the
drugs.

Despite all that, he said, if there's a will, addicts will find a way.

"There are many ways to beat the system. I think our job is to try and help
minimize how that might happen. I'm sure I get bamboozled occasionally, but
hopefully I don't get bamboozled very often."