Friday, August 17, 2001
'Epidemic of misuse' linked to OxyContin
Carilion expands help for addicts
One-third of outpatients seen daily at Carilion St. Albans Hospital near Radford are trying to kick OxyContin.
By JEFF STURGEON
THE ROANOKE TIMES
Carilion Health System announced stepped-up efforts in Radford and Roanoke to treat those who abuse the prescription painkiller OxyContin.
The dominant health care provider in Western Virginia unveiled more help for addicts and safeguards to curb prescription fraud, saying OxyContin abuse "is spreading with enough speed and intensity to create an epidemic of misuse."
Carilion's 24-hour hotline for psychological services receives one or two calls daily from people struggling with OxyContin. Some just want information. Some want to be admitted to the hospital. One-third of outpatients seen daily at Carilion St. Albans Hospital near Radford are trying to kick an OxyContin habit.
"Two years ago, this wasn't on the radar screen for us," said Dr. Richard Seidel, director of clinical programs at Carilion Behavioral Health.
OxyContin's oxycodone formula relieves pain for 12 hours. But addicts circumvent its time-release mechanism by crushing the pills and inhaling the powder or mixing it with water and injecting it for an intense, dangerous high. More than 35 people in Southwest Virginia have died from oxycodone overdoses.
Purdue Pharma, the manufacturer, disputes the number of fatal overdoses attributed to its product, but has taken steps to curb abuse while keeping the pill available to pain patients. The company announced plans this month to develop a new version that would be resistant to abuse. That could take three years.
To develop its new strategy, Carilion researchers questioned about 80 New River Valley physicians and 15 hospitals, about half of them out of state, during the past six months. Nearly 40 percent of the doctors agreed that the region needs more outlets for substance abuse help. Half agreed the region needs more pain centers.
There was no consensus on how best to treat OxyContin abusers who want help. But providers agreed that OxyContin addicts - those who have prescriptions for the drug because they're in pain and those who steal or buy it on the streets - are more difficult to help than other drug abusers.
The drug's addictive effect "is like a claw that once it gets them it doesn't let go," said Rhonda Dotson, a licensed clinical social worker with Carilion.
Carilion favors a two-step treatment approach that involves hospitalization for detoxification over three to five days, followed by outpatient psychological care.
Detoxification rids the body of drug residue and treats symptoms of withdrawal. Psychological care is designed to rid the person of cravings for their old drug-using lifestyle. Abusers spend an estimated $100 to $300 a day for their drug.
Dr. M. Anderson Douglass, a Carilion psychiatrist, said after the strategy was unveiled that most insurers won't pay for hospitalization for detoxification. As a result, some patients don't receive the care, have to pay for it themselves or leave the bill unpaid.
Spokeswoman Beth Laws at Trigon, the state's largest insurer, and spokesman Walt Cherniak at Aetna said their policies do cover such care. Douglass insisted that psychiatrists employed by the insurance companies, whose approval he needs for hospitalization, don't give it consistently.
St. Albans plans to expand methadone services for detoxication to those who obtain their OxyContin illegally. It can already give methadone to abusers who originally were prescribed the drug. Also at St. Albans, doctors will ask Narcotics Anonymous to hold more meetings.
Meanwhile, at St. Albans and the psychiatric unit at Carilion Roanoke Memorial Hospital, Carilion intends to offer auricular acupuncture, the insertion of needles into the ear, to relieve withdrawal symptoms. Licensed acupuncturists also provide the therapy.
Personnel at both hospitals have begun or soon will begin to verify all incoming patients' OxyContin prescriptions with their doctors, as well as prescriptions for similar drugs.
