EXPERT: BAN WOULD GO BEYOND OXYCONTIN

CHARLESTON - Banning the lead ingredient in the widely abused pain-killer
OxyContin would deny cancer patients and other extreme sufferers access to
other medications as well, a pharmacist says. Tom Coffman says the bill's
sponsor, Senate Majority Leader Truman Chafin, D-Mingo, doesn't realize
oxycodone is also the active ingredient in Tylox, Percocet and other
short-term pain relievers commonly prescribed after surgery and emergency
room treatment.

"By actually asking to eliminate oxycodone, he's way beyond the OxyContin,"
Coffman said Tuesday.

Coffman says the state has a safeguard at its disposal now but inexplicably
isn't using it - the Rational Drug Therapy.

This means a physician must call the Morgantown-based private agency if the
medication is a particular brand or the dosage is outside the norm, he
explained.

Ironically, some antihistamines are guarded in this fashion by the state,
but OxyContin isn't, Coffman said.

"The state requires a prior authorization on a non-controlled pain medicine
called Ultram," the Hinton resident said.

"It's not even controlled to where addictive properties are stated the way
OxyContin is, yet it has to be prior authorized. If you get Claritin, an
antihistamine, from the Public Employees Insurance Agency, you can get one
refill, and after that, the doctor has to call and get it prior authorized.
But OxyContin? You can get all you want."

Coffman said he advised PEIA Director Tom Susman the program already is in
place and wouldn't cost the state a dime.

"All it would take is five minutes for somebody to sit down in front of a
computer terminal and input the drug code for OxyContin so that every time
a pharmacist goes to fill it, it gets stopped until the physician calls and
gets its authorized," Coffman said.

A terminal cancer patient in extreme pain would pose no obstacles, he
emphasized.

"But if you have a doctor writing 15 to 20 a day for no real good reason,
then he should either be smart enough to think, 'I don't want my name on a
database 15 to 20 times a day,' or if he's stupid, then in about a week,
the medical board ought to be in his office asking to see his files," the
pharmacist said.

Coffman said Chafin is attempting to place oxycodone into Schedule I of
controlled substances, such as heroin, which lack any medical value.

"What he is doing is one of two things - he's either in a knee-jerk
reaction or it's a bill on the last day to look good for the public,"
Coffman said.

"There's no rational reason to do what he's doing."

Because OxyContin, Percocet and Tylox are Schedule II drugs, meaning
refills are disallowed and all obtainable only via prescription, restraints
are in place now, and doctors actually can control the flow, he said.

If the computer readout at the drug store says OxyContin isn't covered by
the patient's insurance, it reverts to the doctor, he noted.

By using Rational Drug Therapy, a doctor would have to call the agency and
tell it about a patient, and then both would agree on the medication, he said.

"The physicians I talked to say it's a no-brainer," he said. "The process
is in effect. Doctors are used to doing it."

In addition to control, the money angle also figures in, he said, noting 60
tablets of a 20-mg prescription runs about $160, while 80-mg tablets would
cost nearly $500.

Coffman acknowledged the system won't work against forgeries, but said his
30-year experience in the business has given him a keen insight into the
fraudulent.

"I can tell you halfway down an aisle almost if a guy has a controlled drug
and I've got to watch for it," he said.

"We've had people say, 'I have insurance, but I want to pay for this,'" he
said. "If a guy wants to give me $400 for medication and he has insurance,
my first inclination is, I'm not filling it."

Chafin said OxyContin, already linked to more than 100 deaths nationwide,
is costing the state millions of dollars and is destroying lives of those
who abuse the time-released medication intended for those in severe pain.

"If Mr. Chafin wants to help put families back together and stop deaths in
southern West Virginia, then outlaw alcohol," Coffman said. "I guarantee
there are more alcoholics in southern West Virginia than there are
OxyContin addicts.

"There are more deaths from DUIs and more battered spouses and more broken
homes and more poverty based on alcohol than there are based on this.

"Why not do away with lung cancer by outlawing tobacco completely?"