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Friday, February 19, 2010

Information About OxyContin From Readers

So, the Blog post and the following Facebook discussion revealed some very interesting comments about the OxyContin problem facing the nation and particularly devastating to our Appalachian region. This post will share comments from those who read the blog entry and who responded with knowledge from various fields of employment such as the health field, the counseling profession, the military, and social service agencies. These people live and work all over the country, and I consider their unique perspectives very valuable.

If you take time to read these grass roots comments, you will be blessed with information that will allow you to seek answers for troubling questions. Thanks to the many people who cared enough to share their views and concerns. I truly believe much is to be gained by reading today's blog entry. Please read this post and feel free to add to the wealth of information here. Thank you, readers.

Jody wrote, "I see this problem every day. I work as a home care nurse. I no longer wear a uniform and carry my equipment in a grocery sack as not to identify myself as I enter a clients home for fear that my patients or I could become targets of thieves and addicts."

Yolanda said, "... as you know I founded my nonprofit Treatment Centers, Inc. I am a licensed alcohol and other drug counselor. Oxycontin is the worst I have seen. But, it's too expensive so addicts are now shooting up herion because it's cheaper. Anyone who does not feel there is a drug problem.......crawl out from under your rock, but wait, it may be safer there to stay .... when Oxy is snorted it has the opposite effect but, there have also been cases when the inside lining of the nose develops holes. Imagine what the nose would become...."

Sandy added, "Did you hear about  the kids that got suspended for having Oxy's at our Middle School?"

Barb said, "The worse thing I see is when people overdose and live, they end up on a ventilator and don't know they are in this world. They are usually young kids too, what a shame. One case I know, his friends let him lay there, didn't get any help because they were "afraid." Who knows - he might have had a chance. A lot of people I work with has either a child or other family member hooked on oxy's or Lortab and they send them to rehab over and over, it's like they can't give it up. More times than not they usually end up in prison. It is VERY prevalent in our community! Doctors give RX's for Xanax and Ativan - both very addictive. So in a sense they are drug addicts. Where do we draw the line? Who should get it and who shouldn't?"

Derby commented, "It's (OxyContin abuse) is not a new problem in schools...anywhere (it's happened at the school where I work). Kids get it from their parents', grandparents' and neighbors' medicine cabinets. They get it at parties... and yes it starts in middle school. Kids are snorting their Adderall (or friend's) some of the prescribed meds are the kid's own. They MUST be supervised. adolescent's brain isn't fully formed (the frontal lobe that handles the decision making capabilities) until age 21. So, don't always KNOW better...or make good decisions...Just look through the magazines you read...and all the ads from the pharmaceutical companies... even look through magazines that kids read... are those ads there?"

Tom said, "The country is seeing a major shift in the age that people begin abusing prescription drugs. It seems it is now beginning at the age of 12, which historically has been the age where kids began experimenting with cigarettes. One problem us as health care workers experience -- providers need to fix treating the patient for pain. Once stable on a drug such as Oxycontin less than 5% become tolerant to the pain effects that the drug is exhibiting. Yet the patient will tell the physician or other health care provider the drug is not working any more for them. Patients say this because they actually become tolerant to the euphoria and sedation effects of Oxycontin not the pain effects. As health care providers we need to realize this concept and not just increase the patient's dose of the Oxycontin or other such opioid."

Dave reported, "I wonder how much of this abuse plays into the overall costs of prescription drugs. It sounds like legalized dealing to me. What role, if any, should the government play in curbing the abuse? Should the government have greater oversight on how these type drugs are being issued and to whom and under what circumstances? Aren't these type drug prescriptions reported to the DEA? Do they maintain a database on whom is receiving what and at what frequency? Does the DEA monitor doctors who write large numbers of these prescriptions and if not, should they? Who is really at fault? The user, the physicians with revolving doors, the pharmaceuticals, the parents, etc....?" 
Tom answered, "Ohio now has what is called Ohio Automated Rx Reporting System. Pharmacies in Ohio must submit all prescriptions for controlled drugs to the State every 2 weeks. This helps detect patients who are doctor shopping and getting pain medicines early or at another pharmacy. It has certainly helped physicians and pharmacies catch and dismiss patients. West Virginian and Kentucky have similar systems. The problem is, which they are currently working on, is we live really close to these other states. With that being said it is hard to detect if a patient got a prescription filled in Kentucky or West Virginia unless they used their prescription insurance to get it. Needless to say, residents of Scioto County have figured this out. This is why they need to link the systems of Kentucky, West Virginia, and Ohio together, it would be very beneficial."

Dave then admitted, "That's interesting. Sounds like they may need to nationalize the system. As automated as we are, I would think it would be fairly simple to piggy back off other national programs to monitor the abuse more closely."

Jim looked closely at the posts and stated, "The automated Rx reporting systems work only if the state(s) deploying them actually mine the reams of data they collect to put the dots together and make arrests. We also have a similar system in MS but my wife, who is a pharmacist, has never seen any of the known drug addicts who come into her pharmacy picked up by the police based on the data reported to the system. Rather, it's the pharmacist that always has to call to report the obvious doctor- and pharmacy-shoppers. This has become particularly annoying here since the legislature just passed a law requiring a prescription for pseudoephedrine so as to have it included in the reporting system (although they could have done so without making it a prescription-only Schedule III) - but this will ultimately do nothing to combat the meth problem since the state does nothing with the data."

Tom posted again, "Jim, I agree unless law enforcement acts on these people the data doesn't help. I don't know if it is true but every now and then extra state troopers from all over the state come to the county and make drug stings; rumor is that it is based off this data reported to the state. You are 100% correct though we can use the automated system to dismiss patients all we want, but without law enforcement helping out, they are going to find a way to get their drugs."

Debbie, rightly frustrated, replied, "I can't even begin to understand any drug usage (for pleasure as opposed to health, like cholesterol meds) much less addiction. I had a lot of surgery about five years ago, and once I got home from the hospital, all I took was tylenol and ibuprofen. All the other stuff, including oxyContin, made me sick. I have always been horrified of the results of drug use, ever since those books about drug use I read in middle school a million years ago. I just don't understand the attraction. What a waste of lives." 

Dave, joining in her displeasure, wrote, "We, as a society, hiding behind our 'FREEDOMS", have allowed Hollywood, and others, to glorify the abuse of drugs and other illegal and immoral activities....IMO!! Until "we the people" demand change, nothing will change!!!"

Derby further illustrated the problem as she said, "At the prescription drug conference I recently attended ( and I'm a school counselor) I learned that Kentucky, Ohio... And other surrounding states are working on linking up their systems for "doctor shopping," etc. Our issue in Kentucky seems to be the docs who don't use the monitoring system. It's free... And not hard to use. They claim it's time consuming... Seriously? Yeah... It's a pain for me to hand over my drivers license to get my zyrtec d @ the pharmacy, and I have to wait in line. But you know... I'm cool with it. And many of my docs use a computer in the exam room and fax in my scripts. If all docs could do that, they'd see a patient's script history... Maybe. But another issue are the folks flying down to Florida. Or it has been. The cheap fares on air... Like $29 each way... It's called the drug bus. And they go to the pain clinics. I think our legislature is working on that with florida's."

Yolanda confirmed, "And you have Florida with a 'pain' clinic on every corner. A lot of people from the tristate area go there to get their Oxys."

Travis read the comments and added, " you might know, my mom is the director for children's services in the county. She see's this problem everyday. She has commented to me how this particular drug is becoming a HUGE problem recently."

Ken noted, "Ever notice that as a society we try to blame our problems on a thing or an organization. I don't mean to be the bad guy here, but as I read your article, and it’s exactly what we are still doing. The billboard that had the picture of the kid saying that “Oxycontin Took My Life” may be saying a little self responsibility is what we need as a society. There have been billions of federal dollars spent over the years on “The war on drugs," and no progress so far: new generation new drug. Sorry, but it’s not the fault of the drug companies, or the oxyContin itself. KNOW WHAT YOUR KIDS ARE DOING."

And, to end the dialogue, Debbie reported, "I agree with Ken that as a society we need to stop blaming other "entities" and take responsibility for ourselves and our children. That means parents have to communicate in words to their children that substance dependence is not a desirable way to live. But they also have to communicate in actions the same message. So if you're telling your kid not to do drugs because it's bad as you're opening your fourth bottle of beer, you're sending a very mixed message.

"And I agree, Frank, that scare tactics are not the only message to be communicated, but honestly, I think there's a place for them. Kids have got to know the reality of the life substance abuse can bring them. I had no problem with showing my son the cover of NewsWeek when they featured a meth addict. He needed to see what meth can do to a person. And we talked about how easy it is to take the first step and then be sucked down a black hole you can't easily escape. 

"I use opportunities out of the paper to just point out the role substance abuse plays in crime and in motor vehicle crashes. I also point out when people are blaming other things on their drug use. He's only 13 - who knows what the future holds, but I hope I'm making an impact on him."

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