W.Va. doctors worry about painkiller ban

By Tom Breen
The Associated Press

CHARLESTON, W.Va. -- Patients getting treated for pain could face short-term difficulties if the federal government implements a proposed rule that would ban some of the most popular prescription painkillers.
The Food and Drug Administration is considering a proposal by a panel of experts to prohibit a range of medications that combine narcotic drugs with acetaminophen, which is the leading cause of liver failure in the U.S.
That ban would include popular brand-name drugs like Vicodin, Lortab and Percocet along with generic versions.
Drugs like the first two, which blend acetaminophen with hydrocodone, are among the most commonly prescribed pain medications in the country. In 2006, there were nearly 131 million prescriptions written for products containing hydrocodone, according to the federal Drug Enforcement Administration, with the majority containing acetaminophen.
A ban, however, could have unintended consequences for people who rely on those medications, especially in states like West Virginia, which has one of the highest rates of use of prescription painkillers in the country, according to the DEA.
"The problem is, we use Vicodin and medications like that to treat what's classified as moderate pain," said Dr. Alvin "Woody" Moss, a professor at the West Virginia University School of Medicine and the director of the West Virginia Center for End of Life Care.
"Medications that are used for more severe pain might not be appropriate for those patients," he said. "It might be too much, it might make them sick, there are a number of factors to consider."
The panel's recommendation is based on the liver damage that can occur when people take overdoses of acetaminophen. The risk is increased when people mix prescription medications with over-the-counter products like Tylenol, which also contains acetaminophen.
"Taking more than the recommended amount can cause liver damage, ranging from abnormalities in liver function blood tests, to acute liver failure, and even death," according to the FDA.
In the long run, Moss said, a ban could be helpful by drawing attention to the potential hazards of combination medications and by spurring the development of new products.
Hydrocodone, for example, is not available except in combination with other drugs, mostly acetaminophen. One possible result of a ban, Moss said, could be the development of stand-alone hydrocodone products, but the lag before that happens could be frustrating for people in pain.
"It's going to make it much harder for people with pain to get treatment," said Penney Cowan, executive director of the American Chronic Pain Association.
The group plans to launch a multimedia guide to pain medication on its Web site in September with an eye toward educating people about combination products and other factors that many patients might overlook.
"When it comes down to it, it's about the user, it's not the medication," Cowan said.
The range of treatments available for people in pain, though, might mean an FDA ban has a less drastic effect, according to University of Charleston pharmacy professor Michael O'Neil.
"Bottom line, a good doctor is going to work with the patient and find the appropriate treatment," said O'Neil, who is also chairman of the state's Controlled Substance Advisory Board.
West Virginia not only has a high rate of prescription drug use, it's also been plagued by the diversion and abuse of painkillers like OxyContin and hydrocodone products. A study published in December in the Journal of the American Medical Association put the state's prescription drug related fatal overdose rate at roughly 16 deaths per 100,000 residents, more than twice the national average.
A ban on painkillers containing acetaminophen, though, would be unlikely to improve the problems with abuse and addiction, O'Neil and Moss say.
"Abuse and diversion will continue, it just means the drug that people are abusing the most is going to change," Moss said.


Well the two most popular drugs of choice here in WV are Meth and prescription pills with prescription pills killing hundreds yearly. Rather than monitoring who gets these pain meds, learning to say "NO" to those who do not have an absolute need for them ,we will just ban them all together. Ok look out WV the Meth labs are going to triple in size and we may even see more new homemade "cheap" drugs hit the streets.

Hmmmmmm I figured out just how hard it is for a person who has no money to get any type of "free" drug and alcohol treatment here. Maybe we should educate the public on the risks involved in taking these drugs.

Since sending the message that they are killing themselves does not seem to faze manyy of them let's show them that their teeth will fall out, they will be peeing and pooping in a bag for the rest of their lives, that they will eventually have no hair, that their children will be without parents etc.. Whatever it takes to hit home. And then let's offer free drug and alcohol counseling in abundance.

Let's make it easier for those who love them to perform mental hygeines on them and let's enforce keeping them in long term treatment rather than letting them walk after 5 days.

Recently a friend of mine lost her son to a prescription pill overdose. (Just this week actually). She stated to me that she had begged her son (who left 2 children behind) to get help. When I asked her if she had ever done a mental hygeine on him, she had no idea what that was................ EDUCATE ! EDUCATE! Not just those abusing them, but the families and freinds who love them.

Do not sit by and watch them die. Step in, intervene, take action!!!!!!!!!!!!!!!!

I love you Jos and I wish you would have been educated on how to save your son's life before it was too late......................