Don’t blame OxyContin.
Given a litany of concerns, the drug still has a place in society and, by itself, is not to blame for negative consequences, according to Dr. Dwight Moulin, a professor at Western’s Schulich School of Medicine & Dentistry.
Moulin’s claim runs counter to a recent piece on CBC’s the fifth estate. Time Bomb, which aired March 9, featured several interviews with recovering OxyContin addicts – one a London woman – alongside an interview of a visibly medicated patient dependent on the drug to cope with chronic pain, not an addiction.
While there was one interview with a doctor adamant OxyContin wasn’t harmful, it was undercut by mentions of money Purdue Pharma, the manufacturer of OxyContin, had paid him in the past and the inclusion of another doctor’s conversion, a self-imposed ban on prescribing the drug because of its unfortunate aftermath.
While many would say prescribing the drug has the potential to cause great harm, the message of this episode can have the same effect, said Moulin, Medical Director of Pain and Symptom Management at the London Regional Cancer Program.
“There are millions of Canadians with pain and thousands who have become addicted to prescription drugs. The bigger picture is the many people in severe pain, some who benefit enormously from this drug. We need to teach doctors to select them properly, to screen them for addictive behaviour, to prescribe properly and monitor them,” he said.
Moulin was interviewed for the episode, but cut from the installment – one heavily weighted toward blaming Purdue Pharma and the drug for an addiction epidemic that has resulted in deaths and increased crime across North America.
“It was very biased. They had a slant that was totally against the use of major painkillers for people with chronic, severe pain,” Moulin said. “(Reporter) Linden MacIntyre must have asked me five times what I felt the possible role of drugs like OxyContin was with the management of chronic pain. I told him, every single time, that there is a place for these drugs in select patients who are in severe pain.”
He sent a concerned e-mail to McIntyre after the show aired, he added, but not much came of his efforts.
“I said, ‘this show has significant impact and it will make it much more difficult for patients with severe pain to access doctors willing to prescribe these medications after the slant you put on it.’ And he wrote back and said, ‘I hope you’re wrong about that.’ But I think he realized they made a mistake,” Moulin explained.
Since the episode aired, many people with opinions similar to his have contacted the show’s producers, he added. On the show’s website, hundreds of comments express Moulin’s concerns. The forum shows a debate focused on both the benefits and drawbacks of OxyContin – something the show failed to do.
And while OxyContin is no longer available for prescription, it will take time to see if OxyNeo, its replacement (harder to get and harder to consume for illicit purposes), is actually less subject to diversion and addiction, Moulin added, noting doctors will still have patients who will need and responsibly take the drug to cope with chronic pain. Blaming Oxycodone based painkillers for addiction is not the solution.
“Any drug has possible side effects and complications and physicians need to know about them but it’s all about the benefit-risk ratio. We have 15 or 20 randomized controlled trials showing that compared to a placebo, these drugs are useful,” he said.
“OxyContin diversion addiction is very tragic and that deserved to be highlighted. No one had a problem with that. It’s just that they didn’t show the other side. The main message is that there is a place for these drugs for people suffering from chronic pain.”