Rant - another oxycontin robbery

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Rant - another oxycontin robbery

Post  crt on Thu Aug 12, 2010 12:23 pm

The rotten thieves in my area have pulled off another oxycontin robbery. That's the third one in a few months. So far they have hit small, independent pharmacies and not the big chains, not that I'm sure it makes a difference. So far the pharmacies that got hit previously have stopped carrying oxycontin. Probably the pharmacy that got hit Tuesday will stop carrying it too.

I did some reading on the subject and I learned that pharmacies all over California are being robbed for oxycontin. Several pharmacies statewide have stopped carrying oxycontin. I understand why the pharmacies don't want to risk their staff. It's not worth it.

What makes me so angry is that the folks who genuinely need oxycontin for their chronic pain will have a more and more difficult time in finding it because of a few (&^^)+))+%!!!! scumbag lowlifes.

Perhaps even worse that that is the reaction of our local people, at least the ones who are commenting on the topic online. The consensus is that no one needs opioids or any sort of painkillers and anyone who uses them are criminals and addicts. Furthermore, all of these products should be discontinued.

Obviously none of these "haters" experience chronic pain or even after surgery pain. They would change their tune quickly. It's interesting and scary to see what the public thinks of pain medications. No wonder we have such a hard time with perception, even with the people who are close to us.

Chris
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Re: Rant - another oxycontin robbery

Post  estre004 on Thu Aug 12, 2010 12:33 pm

I think you hit it on the nail when you said these people obviously have not suffered severe pain. There is no way people that do
have chronic pain would make comments like that. If they do, they are nuts and deserve to suffer if they are turning down something that would give them a better life.

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Re: Rant - another oxycontin robbery

Post  Paradox on Thu Aug 12, 2010 3:55 pm

I already hav to drive three hours monthly because it is so regulated. I can see it getting much worse.
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Re: Rant - another oxycontin robbery

Post  CluelessKitty on Fri Aug 13, 2010 12:50 am

I remember watching our local news some time ago about one bereaved mom who lost her son to Oxycontin addiction.
She was rallying to stop prescribing, selling and whatnot Oxy at all.
She called it "an evil drug", which is even "all the more evil than other drugs because people think since it is prescribed legally by a drs it can not be "bad"", so they "trust their doctors that nothing bad will happen and then it's too late" and such crap.

As much as I felt for her losing her child and all, she made me extremely angry.

Not only because I thought exactly what you guys said- those who never felt any real pain have no clue what they talk about.
But also because I happened to visit my friends at a time and we all watched this extra bit of news together,
since these are my very close friends, of course they immediately asked me "is that what do you take for your M???" and after I explained the difference they commented "well but how many do you take in a day?

sometimes 8? well see!, that's almost one Oxycontin pill a day. you better be careful, or even better you STOP this stuff, you see yourself how dangerous it is.

It didn't help when I pointed out I wasn't taking it recreationally as the person who died from it did.
Because, they argued, he didn't start that way either.

So, not only the fact of not understanding how there are many degrees of pain out there
but that there is also the additional aggravation of having the people around you picking on you for taking "that evil medication"
while all that time you are perfectly aware the bottom line is they not understand a ZIT about the whole issue.

In the end, again, as much as my heart as a mother was breaking for the lady who lost her child
if I met her in person I'd rather would hit her with her banner over her stupid head.

It's one thing to have a need to blame something for her child unfortunate premature, avoidable death,
another to cause pain to thousands of innocent, agony suffering people because SHE needs to blame something and find an outlet for her pain.

Risa
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Re: Rant - another oxycontin robbery

Post  Cathy on Fri Aug 13, 2010 7:46 am

I have used oxycontin a few times for the migs but it didn't help like fioricet w/codeine. But I would not want it to be taken off the market because I might need it for some other kind of pain.

I agree, I feel for this mother, but to take it away from the people who use it responsibly is wrong. Even if some of these drugs are addicting, trying to live with the pain can be impossible. And if they give someone enough quality of life to get through the pain, they should be available.

As for the thieves who are ruining it for everyone, I hope they lock them up and throw away the key if they are ever caught.

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Re: Rant - another oxycontin robbery

Post  lesherb on Fri Aug 13, 2010 10:34 am

Cathy, oxycontin cannot be taken like Fioricet for migraine pain (or any other pain). It is a continuous use drug. You take it as a preventative not as a rescue.

People abuse cold medicines in order to make methamphetamines. Anything can be abused.

Perhaps making extended release drugs by mail order only could fix this? Then the local phamacies would not have to carry it. When I get my meds (all of them) it's by mail and I have to sign for them. Of course, some enterprising abuser could start attacking letter carriers next.

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Re: Rant - another oxycontin robbery

Post  Guest on Fri Aug 13, 2010 11:14 am

That's extremely annoying. That's happened a few times in my area--especially in rural pharmacies where it's easy for a quick get away.

I get all my pain meds through the local pharmacy, along with a couple others. Most of my meds are mail-order.

My pharmacy is a chain, and it's location gets some sketchy characters.

I always watch my surroundings. Never like seeing anyong loitering around an area or sitting in a parking lot, way out in Egypt (where i park).

If it werent' for the pharmacists that have been taking care of things for years, I'd go to a couple other places that are in much nicer areas where I wouldn't have concern that I'm going to get jacked for meds--whether it's atenolol (haha, have fun on that) or a real pain med.

I do exercise my 2nd Amendment rights (and with required permits) as needed to assure my safety.

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Re: Rant - another oxycontin robbery

Post  Cathy on Fri Aug 13, 2010 11:23 am

Leslie - I didn't know that about oxycontin. I actually used some that my dad had been prescribed for back pain and thought it would help with the mig pain. That's what I get for taking someone else's meds which I know I should never do. Thank goodness the Fioricet works for me enough to take the edge off. Thanks for the info.
-Cathy

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Re: Rant - another oxycontin robbery

Post  CluelessKitty on Fri Aug 13, 2010 3:15 pm

I just remembered something I read while waiting for my Rx to fill. It may shed a light what is happening with Oxycontin, and why there is so much increasing trouble around it:

http://www.vancouversun.com/news/Gangsters+have+drug+choice/3229831/story.html

Risa

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Re: Rant - another oxycontin robbery

Post  Migrainegirl on Fri Aug 13, 2010 11:06 pm

Leslie

I do take Oxy for pain releif when I have a migraine. It is the only thing I have found that works.. I would never recommend taking it as a preventative. In fact my doctor makes sure I take it as sparingly as possible to prevent rebound headaches.

It certainly also makes me mad that it is so difficult to get just because some idiots out there abuse it. For those of us with legitimate and serious pain it just makes it all the harder to deal with the masses of basically clueless but well meaning people. It is my experience that there are some people out there who have all kinds of opinions on things that they know little to nothing about. They are best avoided if I want to keep my blood pressure under control.
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Re: Rant - another oxycontin robbery

Post  crt on Fri Aug 13, 2010 11:45 pm

lesherb wrote:
Perhaps making extended release drugs by mail order only could fix this? Then the local phamacies would not have to carry it. When I get my meds (all of them) it's by mail and I have to sign for them. Of course, some enterprising abuser could start attacking letter carriers next.

Don't think they won't! Then what? Will the letter carriers have to carry guns to protect themselves?!

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Re: Rant - another oxycontin robbery

Post  Paradox on Sat Aug 14, 2010 12:10 am

Migrainegirl,

My pain management specialist prescribed it exactly as Leslie recommends. He told me specifically that oxycontin is NOT a PRN drug. It is not effective for most people when taken PRN.

I looked it up myself (I've gotten rather anal about thoroughly researching any drug I take) and found that it is recommended to take it in conjunction with a fast acting drug for use in dealing with chronic, daily pain.

I'm happy that it works for you PRN. In fact, a little jealous, but typically that is not the intent. Do a google search of "oxycontin+prn" and check out the hits.
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Re: Rant - another oxycontin robbery

Post  AuntieBubbs on Sat Aug 14, 2010 12:33 am

Interesting side note, not really related to Oxy but to thieves in general. My house got broken into a couple of months ago, and they ransacked my bathroom - and my medicine cabinet. They took stuff they probably didn't understand what they were taking, because of the obscurity of what it was (I tend to not throw out old meds that I've tried and didn't work for me, so I have old scripts of nuerontin, migranol, and other things).

But here's the weird thing. I finally got to see the nuerologist 2 weeks ago, and mentioned the thefts to him. He didn't bat an eye! And at least one thing they got was a controlled substance. I couldn't tell if his nonchalance was because he a) has heard it all before, b) didn't believe me, or c) didn't care. It's not like I asked him to give me a new script when it was stolen (ie., called the office and told him I had such and such stolen, replace the medication please), either. I mentioned it 2 months after the fact, and really only because he asked about the level of stress in my life.

Weird that the dr. just blew off the theft of a controlled substance. It makes me wonder if its more common than I was aware of.
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Re: Rant - another oxycontin robbery

Post  Paradox on Sat Aug 14, 2010 10:37 am

Auntie Bubbs,

Your story is precisely why I don't tell very many people what meds I'm on. Beside my hubby and eldest son no one in the family knows I take oxy. Only my partner at work knows, no other staff members. (and another reason for my anonymity on this site and not sharing my FB. I want to be able to discuss issues like this, and wouldn't feel comfortable were my identity known).

The other day some of my teenage nephews were at the house doing some work for us. I had to leave for awhile and felt terrible that I felt it necessary to "hide" my meds. I don't like being distrustful!! Here they were giving up their time to help us and I'm responding inside my house like they are potential criminals.

I divvy up my script, some in my purse, some in one spot home, some in another spot (I always keep them in prescription bottles. The nurse at the neuros office told me NOT to use a pill box...I could get arrested. I asked the pharmacist for additional bottles and they were happy to comply). That way if I am robbed, or get my purse stolen, I won't be completely out. The Pain Contract I signed with my neuro is emphatic that prescriptions will not replaced if stolen.

I figured out the street value of what I have using a modest estimate and it was frightening. Add on to that addicts who are desperate for the drug regardless of price and I think my secrecy is valid.

I despise that my pain level has me on this regime, but I am forever grateful that I have the regime and it allows me to have some modicum of a life back.

Such an irony that those of us who are legitimately using it never get "high". At least I never have, my Dr. only prescribes in amounts to make the pain tolerable, not eliminate it. Yet those who are abuse it are getting all the publicity, rather than those of us who it allows to lead normal, productive lives. As an example, the other night I got a raise at work. My first in three years. Prior to the chronic migraines and back pain I had received a raise every year for the past 25 years. Why did I get a raise this year? Because my pain management regime allows me to work a full day and be productive. Plain and simple.

Sorry, long winded today..... Embarassed
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Re: Rant - another oxycontin robbery

Post  AuntieBubbs on Sat Aug 14, 2010 12:16 pm

Charlotte, I know what you mean about having to hide the meds when people are in your house. I now hide everything Sad And even before the breakin, I didn't have them in the usual medicine cabinet per se, I had them in a makeup bag in an under the counter cabinet.

But my point is, really, if you'd reported the theft of the oxy to your dr., would he have shrugged it off, regardless of whether you were asking for script replacement? Even if you had a police report to back up your claim, you know? Mine just gave me a blank, "so what/uh huh" type stare. I mean, it wasn't oxy I had stolen, but it was a controlled substance med, along with my triptans. I just thought there'd be more concern, you know? Not that I expect the dr. to do anything after the fact, but I did expect him to express some concern (even if it's just feigned) at the theft of controlled substances. It just made me wonder if he even believed me. I kind of felt like, we as patients care more about these issues than the doctors do!
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Re: Rant - another oxycontin robbery

Post  Paradox on Sat Aug 14, 2010 1:38 pm

Either way, Bubbs, it's bad news. Either the Docs are used to their patients lying (which I kind of lean towards, since it was very specifically spelled out in my pain contract), OR, break in's and thefts have become very common place.

Sad scenario in any event.....
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Re: Rant - another oxycontin robbery

Post  CluelessKitty on Sat Aug 14, 2010 4:24 pm

I've stopped telling people long time ago what drugs I take for my M because of their criticism, and only rarely tell if I happen to seriously discuss M subject with another migraneur I may disclose what I take nowadays.

so, recently after reading this article in the 'Vancouver Sun' about Oxycontin abuse I realised how lucky I am for not "advertising" freely my P use.

I also never show my Rx'- ns to nobody, and once the pharmacist pass the stuff to me I promptly shove it into my purse
(not because I am ashamed or scared, just to have my hands free).

So, without even realising it I was doing the right thing!

The only thing I am worried about and haven't got to solving it yet is I keep all my meds, and family meds, too
in my one big safety box in the closet. Only I have the key to it.
But otherwise I would have to have a few little safety boxes all over the place with bits of meds here and there,
I don't know if that's practical... but maybe worth it, I dunno.


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Re: Rant - another oxycontin robbery

Post  sailingmuffin on Sun Aug 15, 2010 6:37 am

Hi All,

Intersting topic. I have taken oxycontin in the past, but it did not work well for me. The only long acting pain medication that has worked well is MSContin. (Though at some point, my doctors have tried me on all of them} Right now, I only have tylenol 3 for the pain, which is not great, but I am more myself on it. It is horrible that there is such a stigma to treating legitimate pain. I am sure those who are against such pain meds wouldn't last five minutes in the kind of pain that we suffer with daily.

I do keep my prescriptions in a certain place. My parents know what I take. Also, when I was in college and afterwards living with a roommate, I made sure that one of my close friend knew about the medication in case there was an accident or something, but I never had any problems with anyone taking it. One brother, who has never understood migraine, just couldn't understand.

A few years ago, I wrote a paper about the perception on prescription pain medications in the media. The paper focused more on doctors who had gone to trial for prescribing too much. Two deserved it, one didn't. However, I came to the conclusion that it is just wrong to let people suffer so much, but that drs need to be careful too. I'll be happy to post it, if anyone wants to read it.

It is sad that a medication that helps many live more productive and happier lives is abused by others and leads to a negative stigma.

Pain free days,
sailingm
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Re: Rant - another oxycontin robbery

Post  Anna on Sun Aug 15, 2010 7:20 am

An important topic-

Sailing Muffin- if you would post your paper that would be great. Or if you'd rather, could you PM it to me? I'd very much be interested in seeing it. Thanks.
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Re: Rant - another oxycontin robbery

Post  crt on Sun Aug 15, 2010 8:20 pm

paradox wrote:Auntie Bubbs,





Such an irony that those of us who are legitimately using it never get "high". At least I never have, my Dr. only prescribes in amounts to make the pain tolerable, not eliminate it. Yet those who are abuse it are getting all the publicity, rather than those of us who it allows to lead normal, productive lives. As an example, the other night I got a raise at work. My first in three years. Prior to the chronic migraines and back pain I had received a raise every year for the past 25 years. Why did I get a raise this year? Because my pain management regime allows me to work a full day and be productive. Plain and simple.

Sorry, long winded today..... Embarassed

Great message Charlotte- all of it, although I quoted only a portion here.

I was going to talk about pain drugs and not getting high. I'm glad you mentioned the topic. I never get high from pain meds . I think that is generally the case when a person is taking them for pain and taking them correctly.

I have had morphine several times in the hospital for severe pain. I was far from being high. The morphine dulled the pain enough so that I could barely tolerate the pain. Before the morphine I was in that "shoot me now" state. You know the feeling. Anything seems preferable to the pain: surgery, a coma, death.

And after I was released from the hospital, it wasn't like I was craving morphine and went running around looking for it. In fact, what my mind was on was recovery from my surgery/accident. I just was and am grateful that there are drugs powerful enough to deal with "praying for death" pain.

It makes me furious that a few scumbags are threatening meds that are the only way pain patients can have any quality of life at all.

Chris

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Re: Rant - another oxycontin robbery

Post  sailingmuffin on Mon Aug 16, 2010 10:37 am

Hi All,

I am going to try and insert the paper here. It is kind of long, but here it is. Sorry, I wasn't able to break it up as much. Keep in mind this was written several years ago.

Pain free days,
sailingm




PUTTING THE PIECES TOGETHER:
PAIN, LAW, AND THE MEDIA

For the past thirty years, this country has been fighting a war on drugs. For the first twenty or so years, the focus was on stemming the flow of illegal drugs, such as cocaine and heroin, into this country. Although the DEA has been responsible for licensing physicians and other medical professionals to dispense narcotics, it rarely targeted or prosecuted physicians until the 1990’s. There was a radical shift in policy at the same time that Purdue Pharma introduced a new medication for the treatment of chronic pain called OxyContin, a controlled release form of oxycodone, a synthetic opioid. In addition to its clinical uses in the treatment of chronic pain, addicts also discovered that crushing the pills and snorting or injecting them could circumvent the time-release mechanism, producing a high. This also produced mass diversion. The media immediately began following the story of a prescription drug gone wrong- there were stories of epidemic addiction in Appalachia and other rural areas. There were also stories of doctors who ran “pill mills” or over prescribed and lost their licenses. Over the next few years, the DEA began to concentrate more on doctors who prescribed long acting opiate prescriptions culminating in the recent trials of Dr. William Hurwitz and Dr. Robert McIver. The media attention, coupled with the DEA’s investigation of physicians set the stage for society’s perception of the use of long acting opiates in our society. Many people frown on the use of such drugs due to the possible risk of addiction, and doctors, afraid of a DEA investigation often under prescribe pain medications, leaving
hundreds to suffer in silence. This paper will focus on how the DEA and mass media influence society’s perception of prescription pain in our society.

Pain itself is defined as “An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. ” Pain, in and of itself, is not a bad thing, as it notifies the body that there is a problem. However, pain can become a terrible burden as well, such as chronic pain. Chronic pain is defined as “pain that lasts more than 6 months, is ongoing, is due to non-life-threatening causes, has not responded to current available treatment methods, and may continue for the remainder of the persons life, ” according to the American Pain Foundation. It is precisely this kind of pain that causes millions of people to seek relief from medical sources and the breakthroughs that took place over the last decade are both blessings and curses. For chronic pain patients, and physicians, Purdue Pharma’s introduction of OxyContin was a blessing, as it allowed many people to function normally and easily control their pain. The drug was hailed in the media as a “medical breakthrough”. In addition, Purdue Pharma launched an advertising campaign targeting general practioners with the idea that it was a way to control chronic pain without a high risk of abuse. Due to this aggressive campaign, the drug became well known and widely used over a short period of time, during which it also became known on the street as well as in the medical field.
However, drug addicts quickly picked up on the fact that OxyContin, which contains a pure form of oxycodone within a time-release coating, could crush or inhale the medication, which for addicts produced a euphoric high. Addiction is a considered a medical disease and is defined as “A primary, chronic, neurobiological disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over medication use, compulsive use, continued use despite harm, and cravings” Addiction is a disease in and of itself. Both the media and the Drug Enforcement agency picked up on the wide spread abuse of the medication and stories about “an epidemic of OxyContin addiction” began appearing in the media. The drug was widely abused in rural areas, such as Appalachia and rural New England, earning the name “hillbilly heroin,” for the heroin like high it produces when it is abused. The Drug Enforcement Agency was faced with a new problem of dealing with widespread abuse of a legal prescription drug. In a statement to Congress the DEA stated that it had “never witnessed such a rapid increase in the abuse and diversion of a pharmaceutical product” The DEA was faced with the challenge of dealing with the diversion of a legal medication. Meanwhile, press stories about OxyContin abuse increased, as did the public’s perception that this was a dangerous medication. These two issues played off each other and the DEA began to fight the spread of abuse of a legal medication.

The Drug Enforcement Agency’s main job is to stem the flow of illegal drugs in this country, and to regulate and license physicians and medical professionals to dispense controlled substances “in the course of their legitimate medical practice” . Until OxyContin’s introduction in 1996, the DEA focused its efforts on illegal drugs, attempting to stem the flow of illegal drugs, such as heroin and cocaine into the country, furthermore, many of their efforts focused on getting the cartel or person who was the source of the drug. These tactics did not translate well when dealing with a legally prescribed medication. Indeed, the DEA began to look into the prescribing practices of doctors, particularly those who wrote many prescriptions for opiates, many of who treat chronic pain. Though most diversion occurs through pharmacy theft or forged prescriptions, rather than through bad prescribing or malpractice, it is the doctors who have come to the forefront of the battle. Though even the head of though the President of the National Association of Drug Diversion officers says,” the number of doctors involved in diversion is extraordinarily small, but there is no question that one bad doc with hundreds of patients can put a lot of pills on the street.” It is doctors who have come to the forefront of the war of drug diversion, partly because they do have the license to provide the medication and partly because it is a great news story, in the h years the widely publicized trials of Dr. William Hurwitz and Dr. Robert McIver pushed the issue to forefront of the public mind.

The trial of Dr. William Hurwitz brought both public ire and support for both the physician and the DEA. Dr. William Hurwitz was a pain management physician who prescribed large amounts of opiates for his chronic pain patients. His position is similar to that of Dr. Robert McIver, the trials were similar, though Hurwitz, unlike McIver was eventually given a new trial and a lesser sentence. In addition, the DEA had another problem during the time of the Hurwitz trial. In October 2004, as the trial approached, many doctors needed to know if there was a change in DEA policy, so the Agency published a FAQ sheet detailing what physicians could and could not do when prescribing controlled substances. Physicians were reminded that they could do the following:

Prepare multiple prescriptions on the same day, with instructions to fill them on different days.
Authorize a pharmacy over the phone to fill a prescription in the face of a clear emergency.
Refill Schedule III, IV, and V medications within 6 months.
The final question and answer:
Do the number of patients in a practice who receive opiods, the number of tablets prescribed for each patient, or the duration of therapy with these drugs by themselves indicate abuse or diversion? No, and they should not be used as the sole basis for an investigation by regulators or law enforcement.

However, the document only remained on the DEA website for a short amount of time. It was taken down when the DEA discovered that one of their main medical consultants on the document would be testifying in Dr. Hurwitz’s defense. Furthermore, the DEA reversed their policy in court, using the number of pills rather than the dosage to make their point about over-prescribing. For example, if a patient was prescribed two ten-milligram OxyContin tablets to be taken three times a day, the penalty for the doctor would be greater than if he prescribed one 20-milligram OxyContin three times a day, though both equal the same dosage . For years, the amount and kind of an illegal medication has dictated DEA policy towards the penalties, as in cocaine smuggling- the larger the amount of cocaine, the larger the penalty. The DEA began to use the same formula, contradicting the statement to physicians. Due to the fact that at least one part of the statement was reversed by the DEA during the Hurwitz trial, it effectively reversed the DEA"s prescribing policy. This meant that chronic pain patients had to be seen every month rather than every three months, flooding the offices of pain physicians and causing most other physicians to take a very conservative approach when treating pain.

Dr. Robert McIver’s trial was recently detailed in the New York Times Magazine, in an article entitled, “When is a doctor a drug pusher?” As Dr. McIver’s trial has followed a similar pattern to that of Dr. William Hurwitz, is more recent and not as widely known, it seems reasonable to use this trial to demonstrate the flaws occurring in the system of treating the often complex and very difficult problem of chronic pain in both the medical and legal realms.

Dr. Robert McIver came to the medical field later in life, he traveled and taught for twenty year before attending Michigan State University and graduating with a degree is osteopathy, or a D.O. An osteopath has all the rights and privileges of a medical doctor. He began treating chronic pain patients in 1988 in Columbia, South Carolina and moved his practice to Greenwood in 2000. In addition to prescribing medications for pain, he also prescribed physical and occupational therapy, gravity inversion treatments, and other holistic treatments for pain. One of the problems with treating chronic pain patients is that many pain problems are invisible such as reflex sympathetic dystrophy, chronic back pain, migraine, and many other forms of pain. In addition, Dr. McIver took a radical approach. Most pain patients are told to rate the pain, with 0 being no pain and 10 being ‘the worst pain you have ever experienced’, according to either the Wong-Baker pain scale or the faces pain scale. (See attached pain scale). Most chronic pain managers want their patients pain to decrease to at least a 5/10 on the scale, this means that one may still have pain, but it moderate and the patient is able to function with it. Dr. McIver felt that a 5/10 was too high and wanted his patients to get down to a 2/10, relatively little to no pain. This meant that many of his patients would be taking more medication than usual and they would be taking higher doses of pain medication. He even told one patient,
“As long as you are not having side effects, do not be afraid to take the doses you need to get out of pain. The number of milligrams does not matter. What matters is the number on the 0-10 scale.”

Basically, he focused on the number of the pain rather than the dosage of pain medication. His goal was to get his patient’s pain under control so that they could function and do the same things they used to do. This meant that he frequently prescribed larger doses of opiates than most pain specialists. This turned out to be a blessing for some of his patients. This was certainly true for a patient named “Ben.”
Ben was injured in an accident, underwent surgery to fuse his spine, he was left with debilitating chronic pain. He was a rancher, a job that requires a great deal of physical work. His previous physicians had not treated his pain and referred him to Dr. McIver. He began seeing Dr. McIver and was placed on opiod therapy, titrating up to a dose of 4 80mg tablets of OxyContin a day. He stated the following about Dr. McIver’s treatment:

I never felt high. They helped my pain. I could get out and work, use the bulldozer. I was working a 250-head cattle herd. I was doing everything relatively pain free because of the drugs. They gave me my life back.

Dr. McIver’s philosophy of pain treatment is controversial, as most doctors simply try to get patient’s pain under control, but few physicians try to completely take the pain away, mostly due to side effects, increased tolerance to medication and other risks. Though there is a small population of chronic pain patients need very large doses to control pain, it is the exception rather than the rule.

Treating chronic pain is a complex process. In many cases, before chronic pain treatment begins, most patients have tried many other methods of pain control before being referred to a pain doctor. Contrary to public perception, most patients who are on long acting opiates for chronic pain will become dependent on the medications. Physical dependence is defined by the American Pain Society as “a state of adaptation that is manifested by a medication class specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the medication, and/or administration of an antagonist” This simply means that most patients will need to taper off pain medications rather than stopping abruptly. Pain patients also need to be carefully monitored when beginning treatment and the dose must be slowly raised until the pain is controlled without side effects, known as titration to effect. Most patients will develop a tolerance to medication over the years, and the dose may need to be raised over time. However, very few pain patients require large doses of opiates in a short period of time. In Dr. McIver’s practice, he often prescribed higher doses of opiate medications than most physicians would. In the end, his prescribing practices were his downfall. Dr. McIver came to the attention of the DEA when an insurance agent was going over the file of a pain patient, Larry Shealy, who was on large doses of OxyContin. The agent recommended that the plan discontinue covering OxyContin and then called the DEA. Though this prompted the investigation, the final nail in the coffin came when Larry Shealy died at age 58, with large doses of OxyContin, xanax, and percocet in his system , despite the fact that the cause of death was listed as heart failure, it certainly forced the DEA to take a closer look at McIver’s practice.

At some point, every pain doctor will encounter “drug seekers” or addicts in the course of their practice. Despite this fact, the majority of pain patients are neither addicted nor seeking drugs, but they are seeking relief from crippling chronic pain, a disease in and of itself. Though there are some “red flags” to separate drug seekers from legitimate patients, in the end it comes down to trust. “Drug seekers” may drive long distances to see the doctor, may have a history of abuse, and will often ask for a drug by name. In the end, it comes down to the physician-patient relationship, and common sense. Patients must trust their doctor to provide the right treatment for their condition, and physicians must trust in the fact that is in the patient’s best interest to be honest with the physician. Dr. McIver often gave patients, even those who may have had problems in the past, the benefit of the doubt, trusting that the patient was telling the truth about his condition. Indeed, several addicts and drug seekers were treated by Dr. McIver for a significant amount of time, as was the case with Leslie Smith, who was abusing OxyContin. He told a plausible story, he had had surgery on his wrist in the past and had scars on his wrist, and said that OxyContin had helped him in the past. He was given a prescription on the first visit. Smith was addicted to both OxyContin and Dilaudid, going so far as to inject them. He used make-up and long sleeves to cover track marks. Smith was not the only patient who took advantage of Dr. McIver’s generous prescribing practices. Another patient Seth Boyer was eventually dismissed from the practice because he changed the prescription so he could get an early refill. Another patient, Kyle Barnes, who has fibromyalgia, kept insisting that her OxyContin did not help enough; she was eventually taking 16 times her previous dose of pain medication, and paid out of pocket for medications. All of these patients the same pharmacy and the pharmacists reported it to the state medical board, though no action was taken at the time. These patients all testified against McIver, blaming him, in part, for their addiction. Dr. McIver was found guilty of distribution and manslaughter.

There is clearly a place in the medical field for the treatment of chronic pain, and too many pain patients are under-treated for pain. Others do not want to deal wit the stigma that comes with the medications for chronic pain. Furthermore, it is the small minority of physicians and patients, who abuse the system that hurt those in genuine pain. Every trial of a physician who has over prescribed pain medication has been completely covered by the media. Every pain patient is forced to come to grips with the grey area surrounding the medications and doctors who attempt to relieve their pain. Still, it is the media who paints the picture of the pain doctor as criminal, and of the pain patient as a drug seeker, when this is not the reality of the situation at all. Indeed, in the case of chronic pain treatment, medicine and media are stuck side by side as the stories are dissected, the need for pain control realized or denied, and this, more than anything shapes the public’s perception of pain.
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sailingmuffin

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Re: Rant - another oxycontin robbery

Post  AuntieBubbs on Mon Aug 16, 2010 11:07 am

Sailing M,

I am going to read your paper when my head is in a better place. Smile Been in an odd cycle for the past week. Never used to get rebound headaches from triptans before, but I think treximet is giving me rebound. But that's a different discussion!

Anyway, wanted to agree with Charlotte's statement. The public's perception that chronic pain sufferers get "high" from their pain meds is just bollocks. I've never experienced a high from any of the pain medications I've ever been prescribed, not the ones I've been on long term or the ones I've tried and decided they didn't help, and not the stronger ones I was given inthe ER. "High" is the last word I'd use to describe how pain meds make me feel!
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AuntieBubbs

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Re: Rant - another oxycontin robbery

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