OXYCONTIN RECOMMENDED FOR ARTHRITIS

CHICAGO -- New treatment guidelines for osteoarthritis recommend using a
wide range of drugs, from Tylenol to the controversial painkiller
OxyContin, depending on the severity of the pain.

The American Pain Society's endorsement of opiates and heavily promoted
newer drugs like Vioxx and Celebrex is among the strongest yet from medical
groups that deal with arthritis patients, said Ada Jacox, a nurse who
chaired the guidelines committee.

According to the guidelines, acetaminophen, or Tylenol, is the first choice
for mild pain. Drugs like Vioxx and Celebrex -- known as cox-2 inhibitors
- -- are best for patients with joint inflammation or moderate to severe
pain. And opiates including morphine and oxycodone, the active ingredient
in OxyContin, should be used for severe pain that does not respond to other
drugs or treatments.

The society said the guidelines -- its first for arthritis -- are based on
studies showing that cox-2 drugs work as well as other nonsteroidal
anti-inflammatory drugs, including ibuprofen, but with less risk of stomach
irritation.

OxyContin has been blamed in highly publicized overdose deaths linked to
recreational use, but Jacox said the doses often needed to reduce severe
arthritis pain are small and unlikely to be addictive.

While opiates are usually associated with cancer treatment, pain can be
just as severe for the 20 million U.S. patients with osteoarthritis, Jacox
said.

Last year, the Drug Enforcement Administration and several medical groups
said they favored potent painkillers such as OxyContin for patients with a
legitimate need.

The guidelines were slated for release Friday in Baltimore at the society's
annual meeting.

Arthritis treatment guidelines from the American College of Rheumatology do
not favor cox-2 drugs over less expensive over-the-counter medications such
as acetaminophen.

Dr. Thomas Schnitzer, a Northwestern University rheumatologist who helped
write the American College of Rheumatology guidelines, said opiates "are
fine if people don't respond adequately" to other drugs, but that applies
to very few arthritis patients.

Dr. Gary Kaplan, medical adviser to the Arthritis Foundation, said the
foundation has guidelines similar to the pain society's, but he said
first-choice treatment for moderate pain shouldn't be limited to cox-2 drugs.

Based in suburban Chicago, the American Pain Society represents 3,500 pain
specialists, including doctors, nurses and pharmacists.