Sunday, November 25, 2001
Critics: 'Druggies' shouldn't cause helpful drug to be pulled
Seeing OxyContin abuse firsthand pushes St. Charles doctor's petition
Dr. Art Van Zee says he has seen too many people hurt - or killed - by using the painkiller OxyContin.
By LAURENCE HAMMACK
THE ROANOKE TIMES
ST. CHARLES - The call came late on a winter night.
Dr. Art Van Zee was at home when he was asked to report to Lee County Community Hospital. A young woman had been rushed to the emergency room after she stopped breathing.
"When they called me, I didn't realize I knew this young woman," Van Zee said.
"I didn't realize it until I got up to the bedside and saw this unconscious woman hooked up to a breathing machine. I remembered then that she had been two months old when I held her in my arms at the clinic."
Two decades earlier, Van Zee had vaccinated the woman as an infant at his clinic in St. Charles, a town of 159 residents on a country road that abruptly dead-ends at a coal mine near the Kentucky border.
After being called to the hospital in January 2000, he learned the woman had suffered a nearly fatal overdose of OxyContin, a prescription painkiller widely abused in the mountainous reaches of far Southwest Virginia.
That incident alone did not motivate the small-town doctor to take on a company that sold more than a billion dollars worth of OxyContin last year.
It was all the other cases like it that eventually convinced Van Zee that OxyContin was causing more harm than good. Earlier this year, he started a petition drive asking Purdue Pharma of Connecticut to take its best-selling product off the market, or have the Food and Drug Administration order a recall of the potent painkiller.
More than 8,000 people have signed the petition so far.
Purdue Pharma says its product is dangerous only when addicts crush the tablets and snort or inject the powder for a high similar to heroin's. Recalling the drug would be a disservice to hundreds of thousands of legitimate patients, the company says.
The controversy has thrust a soft-spoken doctor from the coalfields into a growing national debate. Van Zee has been asked to testify before a U.S. Senate committee studying OxyContin abuse, and the Web site that carries his petition has attracted attention across from across the country.
Not all of the reaction has been positive.
"Are you a real doctor?" wrote one person who logged on to www.recalloxycontinnow.org. "If you are, you should not be. I wouldn't send my dog to be treated by you."
"Law-abiding pain patients should not have to pay the price for a hundred or so idiot druggies who made a bad decision," wrote another person identified only as "King of Pain."
Van Zee, whose efforts also have prompted angry, late-night phone calls to his home, said he was a little surprised at the intensity of people's feelings. While sufferers of chronic pain should not have to live in pain, he said, there are other medications just as effective as OxyContin but less prone to abuse.
The opium-based drug is so strong, he said, that one 40-milligram tablet is equivalent to eight doses of Percocet, another pain medication.
And while some people refer to OxyContin abusers as "druggies," Van Zee knows many of them as young people from good families who did not have a prior history of drug use.
Van Zee has worked in Lee County for 25 years. After growing up in small town in Nevada, he wanted to practice medicine in a rural area. He decided that St. Charles was the right place after visiting the town as part of a health fair conducted by a student organization at Vanderbilt University, where he completed his residency.
He married a coal miner's daughter - now an attorney - and settled down in a farmhouse near Dryden.
At Stone Mountain Health Services, a community-based health care organization, Van Zee often gets to know three generations of the families he treats. He can't walk down the street without bumping into patients at every turn. "They are in many ways an extended family," he said.
So it's especially painful for Van Zee to see young people steal from their parents and grandparents to feed an OxyContin addiction that usually leads them to a hospital bed, a jail cell, or in some cases an early grave.
"I don't know how many parents have sat and cried while talking to me about how painful it is to have their child become a liar and a thief in their own home," he said. "That's a level of pain and tragedy that's impossible to quantify."
While Van Zee is convinced that OxyContin is a "defective product," a recall appears unlikely. Both the Drug Enforcement Administration and the Food and Drug Administration say they have no plans to restrict the drug's availability - even though the DEA says OxyContin has been abused like no other prescription drug in recent years.
Van Zee is convinced that sooner or later others will realize the problem is not going away. That might not happen until OxyContin abuse takes hold in more urban areas, he said.
"If it's a bunch of poor folks up in the mountains, it doesn't affect them personally," he said of the bureaucrats.
Since 1997, there have been at least 55 fatal overdoses in Western Virginia in which OxyContin's active ingredient was either the direct cause or a contributing factor, according to the state medical examiner's office. Purdue Pharma says its product can't be blamed for all those deaths, because in many cases the victim was drinking alcohol and taking other drugs.
Van Zee scoffs at such a suggestion, given the strength of OxyContin compared to other prescription drugs.
"To me, that's like somebody who was shot with a howitzer and a BB gun, and you walk up and say it's a little hard to tell what killed him," he said.