Oxycontin; The Making of an Urban Legend Philip Fisher DO, PhD Physical Medicine Pain Management

Myths Versus Reality  Oxycodone is exceptionally addicting.  Oxycodone is commonly abused.  Oxycontin is easy to abuse.  Oxycontin is a “Poor Man’s Heroine”.  “The Patch” is safest.  Oxycodone is no more addicting than Hydrocodone.  Hydrocodone is abused 9 times more often than Oxy  Oxycontin’s slow release mechanism is difficult to defeat.  Heroine is FAR cheaper than Oxycontin.  Fentanyl Patch is easy to abuse. Just add heat or cold.

More Myths vs Reality  Oxycodone is much stronger than Hydrocodone.  Hydrocodone preparations are safer than Oxycodone preparations.  Hydrocodone = Oxycodone mg:mg (Hydro MAY be 10% Stronger!)  Hydrocodone preparations all contain toxic APAP or Ibuprofen whereas Oxycodone is available in non-toxic “pure” forms.

Still More Myths vs Reality  If Oxycodone S.R. forms are taken off the market, we still have plenty of good choices for long term chronic pain medications.  There are only 3 other S.R. pain medications. Each have significant drawbacks.  Fentanyl Patch  M.S. Contin  Methadone

Myths Due to Stupidity  Oxycontin is responsible for 59 deaths is Kentucky since Feb  UPI reporter was told of 27 overdoses in KY. 2 were due to Oxycodone  API reporter was told of 27 overdoses. 2 were due to Oxycodone.  Added all together = 59  25/27 were polypharmacy including Dilaudid, Hydro, Fentanyl, Heroine, etc.

What can we do to protect our practices?!  Tamper-resistant Rx’s WITH CARBONS!  Photograph all Patients  Know your patients well!  Controlled Substance Contract signed by all patients should include:  Release waiver to share any/all information.  Summary Dismissal option at YOUR discretion.  Use only ONE DOC and ONE PHARMACY.  Release waiver to inform Authorities if violated.