Jeff Stier, an associate director of the American Council on Science and Health, has a timely opinion piece in the New York Sun about OxyContin - specifically, about not throwing the baby out with the bathwater. He reminds us that despite all the ill press around OxyContin's addictive potential, crime rings arising around its distribution, and its manufacturers "ethically challenged" marketing tactics, it's important to remember one key thing about OxyContin: for treating pain, it's very, very effective.
The quality that led some people to abuse OxyContin was a valuable attribute that made it superior to other painkillers in its class: released gradually over twelve hours, OxyContin gives patients a more steady dose and thus better, steadier relief.
Older drugs like Vicodin must be taken every three to four hours, leading to peaks and valleys in their efficacy... Cancer patients and others in severe pain, by and large, are not the ones abusing OxyContin.
Stier makes a great point near the end of the piece that touches on my post yesterday about "open source drug safety." He is concerned that all the ill press around OxyContin's risks will hamper research into improved long-acting opiate painkillers or cause renewed calls for banning the drug, and notes:
Thanks to the press and activists who think solely of the risks and unexpected side effects of medication without weighing the drugs' benefits, the general public is starting to think about drugs in the zero tolerance, no-risk way that the FDA did at its worst. This is an unrealistic and unwise standard.
Only the day before yesterday, it seems, we understood that health care is not and cannot be risk-free but that some treatments are worth the risks. Are we now to adopt the position that not only must drugs have no unanticipated side effects, but are not even fit for some people to use properly if other people abuse them?
Hmm, when you put it that way, it seems like yet another in a long line of culturally hypocritical stances on which drugs ought to be severely regulated and which ought to get a free pass. We allow alcohol to dominate society, despite clearly recognizing that alcohol's (at this point, very anticipated) side effects have clear costs. Anyway, I don't intend to beat that horse right now; mostly, I appreciated the nuance in Stier's piece. He's probably making points that are obvious to other health care professionals, but I've never had to take OxyContin for pain relief nor known someone with a prescription, and thus never really had a chance to appreciate the drug's remarkable qualities. It seems that in the proper medical context, the drug speaks for itself, but that's not the context that anyone feels like hyping.
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