SAMPLES
'LETTER TO THE EDITOR'

From: Frank B. Fisher, M.D.
Date: Tue, 02 Sep 2003 23:12:40 -0700
To:
Subject: Oxycontin Article by Guy Taylor

Dear Editor,

I am writing to complain about the tabloid style article you published on Oxycontin. It is one thing to print a drug panic type of story about an illegal drug. It is quite another, to write this kind of story about a necessary and beneficial medicine, which is used to control pain, when nothing else works. The problem is, there is an epidemic of under treated pain, which causes more disability and lost days from work than heart disease and cancer combined. A lurid drug panic story about Oxycontin, which doesn't tell this side of the story is at best unbalanced. The extent of the under treatment of pain in this country is fully documented by many sources, and available to all who are interested. This page of the American Pain Society Web site is but one example, a survey entitled Roadblocks to Relief: http://www.ampainsoc.org/whatsnew/toc_road.htm

Any reporter who ignores the under treatment of pain in this manner, is irresponsible, and contributes to a terrible problem.

Responsible reporting also should involve fact checking. The assertions about deaths from Oxycontin are not true. These sorts of wild claims have been carefully researched, and the data are now in print in a reputable peer-reviewed scientific journal. I have attached a copy of an article from the Journal of Analytical Toxicology, which show that these "Oxycontin overdoses" are usually in reality due to the reckless and willful abuse of multiple substances, including alcohol, and tranquilizers.

If you think of your newspaper as bearing any sort of social responsibility, I urge you to look into the pain issue, and print an article exploring it. This will serve to balance some of the harm the recent article is likely to cause.

Frank B. Fisher, MD

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September 16, 2003

To The Washington Times Editorial Section

Guy Taylor's September 2 article in THE WASHINGTON TIMES, "OxyContin Scourge for Users in Rural Areas," mixes sensationalism with error to lead readers to think a new scourge has been unleashed on the United States. For example, Taylor approvingly quotes ATF agent Thomas Lesnak: "when any law-enforcement officer pulls a car over and finds a prescription pill bottle in some guy's pocket, that officer ends up giving it back to the guy if it has his name on it. If it had been a gram of cocaine valued at $100 in the guy's pocket ... he would be in jail, with felony charges." Taylor seems unquestioningly to accept Agent Lesnak's apparent belief that anyone with a prescription pill bottle in his or her pocket is a criminal who should have been arrested. I, on the other hand, believe that we should still be allowed to carry prescribed medicine on our persons without being suspected of criminality.

Sloppy, sensational journalism like Taylor's has greeted each new drug to come on the US scene - from Quaaludes to methamphetamine, to crack cocaine, to steroids, to ecstasy, and now to OxyContin. Each is said to be the country's worst scourge yet. All soon go out of style as abusers move on to other drugs of choice. Meanwhile, the media, politicians and law-enforcement officials use the occasion of each media-driven furor over the latest substance to call for harsher laws, more arrests. Joseph Famularo, the US attorney for the Eastern District of Kentucky, is said to have used a news story citing erroneous "evidence" to justify "Operation Oxyfest 2001," the largest drug sweep in Kentucky history. The "evidence" was a police report that 59 Oxycontin deaths had occurred in eastern Kentucky in the year 2000-2001. But David W. Jones, Executive Director of the Kentucky State Medical Examiner's Office, stated that in fact there had been "only 27 oxycodone-related deaths in the entire state during that year." Breaking down his data, Mr. Jones said two of the 27 fatalities were caused by the interaction of two nervous system depressants, oxycodone (the active ingredient in OxyContin) and alcohol; 23 others had a "multiplicity of drugs in their systems including highly potent prescription painkillers such as Dilaudid and Fentanyl, as well as powerful illegal drugs like cocaine and heroin." In the final analysis, said Jones, only two of the 27 fatalities could be shown to have owed to oxycodone alone." Two is a long way from 59.

"Only one local police department in the country," states Taylor, "has created its own task force to battle illegal use of the drug." But rather than asking why no other police department thinks it worth having such a task force, Taylor goes on to use provocative quotes from members of that department to show the magnitude of the alleged OxyContin problem. It hasn't occurred to Taylor that other law enforcement organizations realize the OxyContin "problem" has been inflated beyond all reason.

It is difficult to find an accurate count of oxycodone-related deaths in the US, but according to the Centers for Disease Control (CDC), by 1999 annual deaths from all opiates (which include oxycodone) totaled 8,073. The CDC does report that of emergency room visit "mentions" of narcotic analgesics, oxycodone type drugs amounted to about 4% of the mentions of heroin. If that indicates anything about the frequency of deaths then oxycondone deaths may have amounted to somewhere around 323 for the year of 1999. Even if that was the case, deaths due to oxycondone totaled to less than 14 one-hundredths of one percent of the 2,391,399 deaths recorded the United States that year. Those 323 deaths were literally eclipsed by deaths in the US from smoking tobacco: 430,700 or drinking alcohol: 110,640.

Thousands of violent crimes go unsolved across this country while law enforcement spends valuable resources and staff time pursuing these issues and trying to pass laws that will class even more drugs as illegal. Well meaning, ethical doctors who try to treat real chronic pain are frightened to prescribe for their patients, many of whom are terminally ill. All this is done in the name of the failed war on drugs and the prohibitionist attitudes that brought us "zero tolerance." Prohibition didn't work for alcohol and it will never work for these drugs.

Sincerely,

Jack A. Cole
Executive Director
LEAP

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(The following regarding a website called 'For The People' advertising
for people to join in class action lawsuits against Pharma, the makers
of OxyContin.)
http://www.forthepeople.com/practice/oxycontin.html

Dear Mr. Morgan:

To date there has not been a single case of overdose or medical harm from OxyContin when taken as prescribed. Of the 1700 cases reviewed by the American Association of Forensic Pathologists, and reported in the JAMA, only one case involved OxyContin alone, and in that case the deceased had self injected it intravenously. In contrast, hundreds of thousands of legitimate intractable pain patients have been able to recover their lives though the control of pain that this drug allows.

While we all recognize an attorney's need to make a living, your efforts feed the demonization and media distortion that has threatened to take this medication away form those whose lives depend on it. Either you are completely ignorant of the facts about OxyContin (including the conclusions of last week's hearing on it at the FDA), or you are a heartless cynic, trying to score some big bucks out of the tragedies of self-medicating and medically abandoned and untreated addicts.

As the Executive Director of the National Foundation for the Treatment of Pain (www.paincare.org), I invite you to visit the patient Forum on our site and to educate yourself about the realities of intractable pain and its treatment.

Simultaneously, I am inviting our thousands of members to visit your ambulance-chasing and outrageous web site http://www.forthepeople.com/practice/oxycontin.html, to see for themselves the travesty that you are committing. I am also asking them to write you, and the judges in your area, about their own experiences, in the hope that you are educable.

Sincerely,
J.S. Hochman MD

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Dear Editor;

I had been taking 600 mg of morphine a day for some years and when I was changed over to OxyContin, it only took around 350 mg of that product to control my pain. Just over half what the morphine took and it didn't make me sleepy the way morphine did. There were NO side effects at all except the normal constipation that one would expect with such a product.

Many of the people filing suit are misled by lawyers like you, into believing the falsehood, that "Dependence" is the same thing as "Addiction". But that's just not the case. They are "Dependant" on the OxyContin the way a diabetic is "dependant" on insulin, because THEIR PAIN HAS NOT GONE AWAY, AND IF THEY ARE GOING TO BE PAIN FREE, THEY'LL NEED TO TAKE IT FOR THE REST OF THEIR LIVES!

Diabetics don't stop taking insulin because their disease has not "stopped" or "gone away". They are "dependant" on it for the REST OF THEIR LIVES!

You are asking many people who are "dependant" on a product, to give up that product at GREAT HARM to themselves in many many cases and causing great damage to the rest of us who NEED to be on that product for the rest of our lives! You're also getting points form the Evil DEA that will tell any lie under oath they need to, in order to "cover up" what they've been doing to pain patients, their doctors, and "the truth" for a long time!

Your actions has already effected millions of people because they can't get OxyContin anymore. It was the BEST pain medicine ever developped by mankind up until the "lawyers got involved." And as we all know, lawyers cause a lot of trouble and outright "damage" for this country. Why Bush hasn't stopped thise frivilous and deceptive lawsuits long ago. But there needs to be some backlash and counter suits against the people who "bite the hand that feed them" and kept them out of pain at a time when they needed it desperately." All they see is dollar signs. I don't know the answer yet, but it may be a class action suit against all "the class action lawyers" that ruined the most effective pain medicine humans ever had! OxyContin. It's a life saving medicine.

Many doctors have committed suicide over the FALSE charges put against them by the DEA becuase they were controlling the pain of victims. And the suicide rate for pain patients is about 900% above the average, thanks to the DEA and your law firm. Tens of thousands are dying of under treated pain each year because of what you're doing to pain patients and Purdue for a few bucks in this life that is very short.

Sincerely,
Skip Baker

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Dear Editor:

The under treatment of pain in this country is a well-documented public health disaster, which is driven by the fear generated by this sort of media hysteria. Your reporting of this story is not responsible, because it entirely overlooks the larger and more compelling issue. This is the fact that thousands of patients die each year from the effects of under treated pain, which causes more preventable disability than heart disease and cancer combined.

The way you are reporting this story is irresponsible and harmful, because you are unwittingly (I hope) playing into the Drug War propaganda machine, which is desperately trying to prop up its disastrously failed War on Drugs, at the expense of pain sufferers everywhere. This will result in more suffering. What doctor do you think will be foolish enough to try to treat suffering patients, in the environment of regulatory oppression this sort of story promotes?

Frank B. Fisher, MD

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Dear Editor,

Thank you for your balanced coverage, starting today, concerning the government's case against Dr. Hurwitz. This balance is welcomed, because it is the only socially responsible thing to do in the cases of pain doctors accused of drug dealing. Under treated pain is the largest single health problem our country faces, and the fact that legitimate pain doctors can be mistaken for drug dealers is largely responsible for this ongoing public health disaster. Under treated pain is such a problem that Congress has declared this the decade of pain control.

I would like to suggest that you look into the accelerating phenomenon of criminal prosecutions of pain doctors around the country, because this social phenomenon is exerting an increasingly chilling effect on the availability of effective medical care to patients suffering from chronic pain. A nationwide campaign is gearing up to begin educating medical students about how to manage pain, but this will come to naught if doctors remain afraid to prescribe effective treatment. Keep in mind the fact the that American Association of Physicians and Surgeons has advised its membership to discontinue the treatment of chronic pain with opioids.

This issue is personal for me, because in 1999 I was accused of the same sorts of things as Dr. Hurwitz, and worse, by the California Attorney General. He turned out to be mistaken, and ultimately the case against me was dismissed, on the first day of trial. I predict that Mr. Ashcroft and his employees will turn out to be just as mistaken about Dr. Hurwitz.

A word of criticism if I might. Please ask your reporters to refer to Dr. Hurwitz as such, rather than as "Hurwitz". Regardless of the accusations he faces, he is a graduate of a prestigious medical school, and one of the most respected figures within the field of pain management. As the story of his innocence unfolds, this approach will preserve his dignity, as well as your own.

I invite you to use me as a source of information regarding the science of pain management, and how these terrible mistake about our most courageous pain doctors continue to occur. You might consider doing a story about my own ordeal, in order to illustrate, and further balance what appears to be going on here.

Sincerely,
Frank B. Fisher, MD

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