States Respond to Growing Abuse of Painkiller.OxyContin Ox·y·con·tin A trademark for the drug oxycodone. oxycodone hydrochloride ETH-Oxydose, OxyContin, OxyFast, Oxy-IR, Oxynorm (UK), Roxicodone, Supeudol (CA) Pharmacologic class: Opioid agonist has been touted as a "miracle" drug for its abilities to ease chronic pain. But a growing number of addicts are obtaining it illegally because of the immediate, intense "high" it gives them. When reports first surfaced of overdoses in Kentucky, Virginia and West Virginia, some officials believed the abuse of the powerful prescription painkiller OxyContin was limited to small areas of the Appalachian mountains. Now, law enforcement agencies A law enforcement agency (LEA) is a term used to describe any agency which enforces the law. This may be a local or state police, federal agencies such as the Federal Bureau of Investigation (FBI) or the Drug Enforcement Administration (DEA). , state legislatures and health departments--as well as the drug's manufacturer--are taking steps to prevent the abuse that has been spreading in urban and rural communities across the nation. Several deaths have resulted specifically from the abuse of OxyContin in Kentucky, Ohio, Virginia and West Virgina, according to the U.S. Department of Justice's National Drug Intelligence Center. And because drug abuse knows no boundaries, officials as far away as Utah appear braced for the potential since one death in that state has already been attributed to the drug. "We were hit with this before we realized what was happening. This is a very serious problem, especially in the last year," says West Virginia Delegate Mary Pearl Compton. Called a "miracle" drug because of the relief it brings to those who suffer from chronic pain, this product made from oxycodone hydrochloride oxycodone hydrochloride ETH-Oxydose, OxyContin, OxyFast, Oxy-IR, Oxynorm (UK), Roxicodone, Supeudol (CA) Pharmacologic class: Opioid agonist Therapeutic class: Narcotic analgesic allows cancer patients and the terminally ill Terminally Ill When a person is not expected to live more than 12 months. Notes: Any gifts given out by the afflicted person at this time may be considered as a dispersion of the estate rather than a gift. respite from continual and intractable pain intractable pain Refractory pain Pain medicine Persistent pain which does not respond to at least 3 dosease of parenteral analgesics given over a 12-24 hr period; pain that does not respond to appropriate doses of opioid analgesics. unmatched by other drugs. Unlike Percocet or other oxycodone oxycodone /oxy·co·done/ (-ko´don) an opioid analgesic derived from morphine; used in the form of the hydrochloride and terephthalate salts. ox·y·co·done n. products that may require repeat dosages every four to six hours, OxyContin has time-release properties that allow patients up to 12 hours of relief. OxyContin is illicitly obtained through theft, by forging prescriptions or even armed robbery. Users crush the pill into a powder and snort the chemical or dissolve it in a liquid and inject it. The effect is said to be immediate, intense and almost as addictive as heroin. And pushing the drug is lucrative: One 80 mg tablet can fetch up to $80 on the street. "Get ahead of the game," Compton advises legislators across the nation. "Be very proactive. Require prior authorization prior authorization, n See predetermination. prior authorization Health insurance A cost containment measure that provides full payment of health benefits only if the hospitalization or medical treatment has been for all your state programs. Work with your doctors and law enforcement." State officials are launching efforts to curb illegal use of the drug. Maine's Department of Professional and Financial Regulation, which oversees medical and pharmaceutical licensing boards, issued guidelines for pharmacists and physicians prescribing OxyContin. From recommending ample questioning of patients to encouraging the use of tamper-resistant prescription pads, officials hope to stem illegal use. Maine also recently passed legislation that addressed penalties for illegal trafficking in prescription narcotics narcotics n. 1) techinically, drugs which dull the senses. 2) a popular generic term for drugs which cannot be legally possessed, sold, or transported except for medicinal uses for which a physician or dentist's prescription is required. , including possession of large quantities or high concentrations of OxyContin. In an attempt to curtail abuse by Medicaid patients, several states, including Florida, Maine, Ohio, South Carolina South Carolina, state of the SE United States. It is bordered by North Carolina (N), the Atlantic Ocean (SE), and Georgia (SW). Facts and Figures Area, 31,055 sq mi (80,432 sq km). Pop. (2000) 4,012,012, a 15. and West Virginia, require prior authorization for OxyContin--meaning prescriptions must be individually approved by the state before being dispensed. Maine, for example, requires prior authorization for all patients who do not have cancer. For these patients, doctors must show documented use of two alternative long-acting narcotics, before prescribing OxyContin. Also, some patients on high doses may be required to get a single daily dose under supervision of a doctor. Compton says, in addition to Medicaid restrictions, "there is a good possibility" that her state will require prior authorization for OxyContin for state employees covered under the Public Employee Insurance Association and recipients of workers' compensation workers' compensation, payment by employers for some part of the cost of injuries, or in some cases of occupational diseases, received by employees in the course of their work. . Vermont placed even tougher restrictions on the drug--it has become the first state to stop paying for it. Vermont's Governor Howard Dean announced that, in order to stop the "growing link to crime and addiction," the state will no longer pay for OxyContin for certain recipients of general assistance through the state's social welfare department. While the action will affect current OxyContin users, the governor is also considering halting coverage for state employees. Louisiana and Virginia adopted resolutions to study the use and abuse of OxyContin, and Virginia's study will include Ritalin, generally prescribed for hyperactive children. A bill in Kentucky was approved by the House, but was still in Senate committee when the General Assembly session ended. The author, Representative Jack L. Coleman, has prefiled a similar bill that puts restrictions on prescriptions for the 2002 session. Purdue Pharma L.P., the firm that makes the drug, has just developed a model for identifying communities most at-risk for prescription drug prescription drug Prescription medication Pharmacology An FDA-approved drug which must, by federal law or regulation, be dispensed only pursuant to a prescription–eg, finished dose form and active ingredients subject to the provisos of the Federal Food, Drug, abuse. Using the model, the company identified 100 counties, mostly on the Eastern seaboard and in Appalachia, to be targeted for special training programs to help doctors and officials spot abuse. "This is a good drug for its intended use," Compton says. But she also believes the manufacturer must further address the abuse problem and has a "deep responsibility" to all communities. Purdue Pharma's 17 years of experience manufacturing opioid analgesics Analgesics, Opioid Definition Opioid analgesics, also known as narcotic analgesics, are pain relievers that act on the central nervous system. Like all narcotics, they may become habit-forming if used over long periods. and other similar types of prescription drugs failed to prepare the company for such abuse. "Everyone's always known about the potential for abuse of controlled substances. There has always been a background rate of abuse, " says company spokesman James W. Hems. But the abuse of OxyContin has been more "poignant." The manufacturer first learned of the problem in March 2000 when reports on patterns of abuse emerged in Maine. Last year the Connecticut-based company held meetings with attorneys general from several states, U.S. attorneys and the U.S. Drug Enforcement Agency to develop action plans. The plans include, among other initiatives: * Continuing medical education continuing medical education See CME. programs to train health care professionals on proper prescription practices. * Production and distribution of tamper-resistant prescription pads to West Virginia and seven other states. * Funding and development of prevention and education programs for teens. * Underwriting of a major study to develop a model prescription monitoring program. Stephanic Wasserman tracks issues involving cancer prevention and control, including cancer drugs, for NCSL NCSL National Conference of State Legislatures NCSL National College for School Leadership NCSL National Conference of Standards Laboratories NCSL National Council of State Legislators NCSL National Computer Systems Laboratory (NIST) . 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