The Patient Speaks!

An interesting article in the May 17, 2004 issue of the WALL STREET JOURNAL.  Now, before you yawn, you’d be amazed at all the medical information one can learn from the JOURNAL.  Over the years, this newspaper has become my #1 “must read” paper of the day.  Lot’s of travel info, too.  And no, I do not work for them!

The article is entitled “Narcotic Actiq’s Use and Abuse Raise Concern” written by Vanessa Fuhrmans & Leila Abboud.  The article caught my eye because I had tried Actiq (http://www.actiq.com/patients/aboutactiq/default.asp) twice with, for me,  disastrous results.  It affected me just like the Duragesic (http://www.duragesic.com) patch.  No wonder, as they both contain the same medicine: fentanyl.  Turns out I am allergic to fentanyl.  Too bad, as the Actiq lozenge is a more convenient way for those of us that occasionally require strong pain medication to self administer as opposed to the midnight run to the Emergency Room.  However, for those that can tolerate it I believe it to be a fantastic medical breakthrough.  But on to the article…

As with many medications, the reason they were initially created and FDA approved does not necessarily hold true for what the medicine is eventually used for in treatment.  A prime example for us migraine sufferer’s is the extensive use of “anti-depressants” to treat migraine.  While off-topic so to speak, anti-depressants have shown some success in treating migraine headaches.  Interesting social stigma, that.  Actiq, according to the article and Cephalon’s own Actiq website, “ACTIQ must only be used for breakthrough cancer pain, and only in people who are already taking and who are tolerant to prescription opioid (narcotic) pain medicines on a regular schedule to relieve chronic cancer pain.”  Therefore BIG problem for people like us who require strong medicine but may be denied because of the wording of the original approval.  The article goes on to say prescriptions, and therefore sales of Actiq have increased so much that some Worker’s Compensation carriers are rebelling.  California’s Medicaid program will only cover it if the doctor shows you received it for cancer related pain.  I guess a California severe migraine sufferer is out of luck.  On top of all this, apparently Actiq is fast becoming a drug of choice for the illegal crowd who take it strictly for the “high” not to mention the drug trafficker looking for some easy cash.

This all looks like a potential Oxycontin, part deux.  I can hear the calls for additional regulation and even for the discontinuance of Actiq just like we have for Oxycontin.  All this because the medicine really and truly does work for pain other than originally stated and because the “bad crowd” has figured out how to get addicted and therefore create a black market.  It just seems that sometimes the wrong – in my very humble opinion – approach is taken with issues such as this.  As for a medicine being successfully used outside the original intent: if it has a value, then amend the original paperwork making it perfectly acceptable (but then the insurance companies would wince!).  If the bad crowd is abusing the medicine, then GO AFTER THE BAD CROWD and leave us legitimate people alone to use a legal and effective means of remaining productive members of society.