|The Myth of Drug-Induced Addition. Source: Parliament of Canada|
It was a fairly one sided presentation. The CBC program had a singular point of view: Oxycontin as a highly addictive, potentially deadly narcotic, over prescribed by doctors influenced by the drug manufacturer's erroneous claims of safety.
Was the fifth estate story the whole story? As a simple blogger writing from home, it is impossible for me to say. This said, I'm well into my 60s and worked for more than three decades in the media. I saw a lot of one sided stories and learned that many media stories making it into the top ten list had good hooks, played well at first, but had little staying power. A lot of drug related stories fall into this slot: Think crack babies.
W. Joseph Campbell writes:
"As I note in my latest book, Getting It Wrong, the crack baby scare 'was a media-driven myth based more on anecdote than solid, sustained research.” It turned out to be, as the New York Times put it in 2009, “the epidemic that wasn’t.' "
My years spent closely working with reporters have left me suspicious of one sided stories. Canadians, the CBC tells us, will ingest possibly 10 million grams oxycodone, the active ingredient in OxyContin, for pain relief in 2012. That's a lot of oxycodone. With numbers like these, surely there must be something good to be said.
On the growing Oxycontin problem, Campbell quotes the words of a lawyer-politician, the Florida attorney general, who said: "I’m scared to death this will become the crack-baby epidemic.” Which, of course, proved mostly an epidemic of media hype.
A little more googling turned up this positive story from Karen L. Simon:
I suffered for 20 years with an arthritic hip while being miss-diagnosed with Fibromyalgia. I finally got a doctor who cared enough to order a plain hip x-ray and I was able to get hip replacement surgery.
After the operation, my surgeon said that the femur head was half gone. Without pain medication there is no way I could have had any, I repeat, any kind of life. I was on pain medication for 20 years and went off with no withdrawal symptoms.
Your continued reports on pain medicine abuse simply make it harder for chronic pain patients to get adequate pain medicine. Believe me that if you suffered from pain 24/7, you would require medication. Please, Please report on some other better subject.
Ms. Simon is not alone in singing the praises of Oxycontin. Very little searching will turn up hundreds of positive testimonials. What I found very interesting in Simon's story was she claimed to have used pain medication for 20 years without suffering severe withdrawal. Is this possible? The short answer is: Yes.
Let me quote Richard Pacheco of the Harvard Law School, who as a third year law student he wrote a paper on the use and misuse of OxyContin.
"The physical dependence associated with some drugs can be treated by gradually reducing the dosages of the medication to the point where a patient is drug-free and has no withdrawal symptoms or craving"
You may believe Pacheco or not, but be aware that media scare stories to the contrary there are many who agree with Pacheco. And, of course, many who do not.
Still, there are areas of agreement, right? For instance, OxyContin is highly addictive. Some of my quoted sources claimed OxyContin pills when crushed and then snorted or swallowed resulted in almost immediate addiction, much like heroin. Crush it, snort it, and be left immediately needing to do it again and again. Bing, bang, boom and the addictive boom smacks the unsuspecting user.
I've read this claim before and alarm bells went off. Immediate addiction, an interesting concept seeing that addiction involves a recurrent failure to control and a continuation of a behaviour with significant destructive consequences.
It is a lot like reporting something is the first annual. If something has only been done once, it cannot be annual. Just like many "annual" events fail to be held again, many folk taking "immediately addicting" drugs, do not develop an ongoing pattern of abuse.
I can hear the protests to this line of reasoning already. Fine. But a reporter has an obligation to report the whole story and the whole story is that many do not believe in "immediate addiction."
Terms like addiction, dependence, withdrawal are not the neat, clear cut descriptive words many in the media would like us to believe. Read the following from the American Psychiatric Association (APA) discussion of an entry in the upcoming fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM).
"The term dependence is misleading, because people confuse it with addiction, when in fact the tolerance and withdrawal patients experience are very normal responses to prescribed medications that affect the central nervous system," said Charles O’Brien, M.D., Ph.D., chair of the Substance-Related Disorders Work Group. “On the other hand, addiction is compulsive drug seeking behavior which is quite different. We hope that this new classification will help end this wide-spread misunderstanding."
I don't think the media understand that there is a large group of people who would argue that dependence, tolerance and withdrawal are all very normal responses to oxycodone based pain relievers.
One person, claiming to be a legal user of OxyContin, wrote on the Net:
"To keep this within limits I will not get detailed on the benefits of Oxycontin. As you can read on the other forums it works. I take 80mg 3x a day and it works great. Been on it for 5 years now and liver test done last month was excellent.
I am tired of the bad rap this medicine gets though. There are even sites devoted to its removal by people who have lost loved ones who abused the drug. While I feel for these people, no one told anyone abuse this wonderful drug. When taken properly this medicine works excellent with little to no side effects.
It is said that you become dependent on this medicine but it is meant for long term and a good doctor will bring you down properly. So withdrawals should be minimum. This is a true wonder drug."
Let's give the last words to W. Joseph Campbell writing one of his Media Myth Alert posts.
(There is) a tendency among journalists "to neglect or disregard the tentativeness that characterizes serious scientific and biomedical research, and to reach for certainty and definitiveness that are not often found in preliminary findings."
Journalists pushed too hard on thin, preliminary, and sketchy data, and extrapolated rather extravagantly from small numbers of anecdotes. It’s a pattern that tends to repeat itself, as journalists fail to take lessons from misreported drug scares of the past.