Monday, October 27, 2003

Rusty Never Sleeps

Correct me if I'm wrong, but doesn't this op-ed piece essentially say that Rush Limbaugh either abused his prescription or was a victim of gross medical malpractice? Of course the author, an AEIer, doesn't purport to speak about Rusty Needle's personal circumstances, but let's all read between the lines, just this once:

The problem isn't with OxyContin itself, but with deliberate criminal misuse. OxyContin is a controlled drug in the same category as morphine. Available since 1995, the medication is now the most widely prescribed narcotic, in large part because it is taken only twice a day. Other narcotic painkillers have to be taken every three to six hours, which increases their addictive potential. The 12-hour controlled delivery keeps blood levels steady, an important feature when pain is constant and severe.

But half-truths abound:

� OxyContin is very addictive.

When abused, it most certainly is. Addicts typically crush the tablet, inactivating the slow-release feature, then snort the powder or inject it with water for a euphoric, heroin-like rush. But pain patients who take OxyContin as prescribed don't require increasingly higher doses and don't feel a high.

� Long-term use for pain equals addiction.

There is a difference. Physical dependence happens to almost everyone who takes a narcotic medication regularly for about two weeks. Your body becomes used to the drug; if it is stopped abruptly, you experience withdrawal symptoms. Doctors taper pain medication to avoid this.

Addiction, by contrast, is the compulsive use of increasing doses of a substance to regulate mood. Most people who abuse OxyContin have had problems with excessive use of alcohol, heroin or other habit-forming pills. Those abusers who have not generally are struggling with emotional demons.

Narcotics are an excellent short-term salve for depression, numbing boredom, self-loathing or fear. This is why doctors should ask patients about prior problems with drugs or alcohol before prescribing potentially addictive pain medications and carefully supervise those with histories of addiction.

If that last part's true, it's a surprise all Rusty's listeners aren't junkies.

Dr. Satel insinuates that the media's at fault for promoting misperceptions about OxyContin. But don't the misperceptions Satel identifies come from Rusty's own "heroic" description of how he got hooked, and the uncritical acceptance of that description by his wingnut pals? If what Satel says is true, the media should be faulted for not looking more critically at Rush's claims and the likelihood that those claims were false.

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