Kenai Peninsula residents came together March 14 and 15 to discuss ways to curb pain drug abuse. Members of the heath care, police, clergy and social worker communities hosted the summit -- "Pain Pills: Friend or Foe?" -- and came away with some starting points to begin dealing with a phenomenon that had created a reputation for the peninsula as the leading area in Alaska for painkiller abuse.
Concern over pain pills grew when OxyContin, the time-release pain medication, began being misused by both patients and those who either posed as patients or purchased the drug from patients for recreational purposes. By crushing the drug and snorting the powder, one can create a euphoric effect, much like that of heroine.
Information from the state Division of Medical Assistance showed the peninsula, while representing only 6 percent of the state's population, accounted for nearly 20 percent of the prescriptions written for the painkiller in 2001. Numbers have dropped to around 15 percent in 2002, however.
Sue Caswell, director of the residential substance abuse center Serenity House, said the peninsula needed someplace where pain management would be a focus.
"We need a pain management specialist, or a pain clinic," she said.
But there were arguments that pain specialists only prescribe more drugs. The group came to a consensus, however, that alternatives to prescribing medication for chronic pain were necessary.
Such methods that could either complement or replace medication include herbal or some traditional Chinese medicines, acupuncture, hypnotherapy, physical therapy or massage therapy. But these would require more education for doctors.
Suggestions for curbing diversion, the distribution of prescribed medication for illegitimate uses, ranged from establishing computer-based links between doctors and pharmacists to identify patients diverting drugs to developing multipaged carbon copy prescription sheets that would be filed with state medical agencies and can be used to investigate possible abuses.
Purdue Pharma, the Stamford, Conn.-based company that developed OxyContin, has been working provide information to pharmacists, doctors and consumers about how to recognize people misusing the drug and how to prevent misuse.
"Education is the way to go," said Purdue Pharma spokesperson James Heins.
The company has developed a 10-point prevention program that features, among other things, tamper-proof prescription pads that prevent the writing of bogus prescriptions. The company has endorsed the development of monitoring databases in states like Utah and Kentucky.
Medicaid won't pay to replace medicine in a shorter time than what a doctor has prescribed and requires doctors to do a prior authorization to justify why a patient is going on that kind of medicine.
But as the community focuses on one problem drug, other pain drugs are coming into view. Different prescription drugs are being used in place of OxyContin, and in deadly ways.
"People are going to methadone and dolophine," said Dr. Franc Fallico, the acting state medical examiner. "The problem with methadone, the toxins in it interact at therapeutic level, and if people mix it with alcohol or other drugs, it can have dangerous effects."
The Prescription Drug Task Force meets regularly to continue communitywide efforts to combat pain drug abuse. The next meeting will be April 15 at 8 a.m., in the Iliamna room at Central Peninsula General Hospital.
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