Popular pain reliever can be a killer if misused of abused/What is OxyContin?

[Max]

Popular pain reliever can be a killer if misused of abused


By STEVE BAUER
© 2002 THE NEWS-GAZETTE
Published Online December 1, 2002



CLICK TO SEE PHOTO
A popular prescription pain reliever that was involved in three Champaign County deaths and the license suspension of a former Tuscola doctor is under scrutiny nationwide.
OxyContin, a potent timed-release narcotic, is a valuable pain reliever similar to codeine, methadone and morphine in the effects it produces, according to experts, but it can be a real killer if misused.
Purdue Pharma of Stamford, Conn., introduced OxyContin in 1996 as a formula of oxycodone with a 12-hour timed release to provide continuous relief to treat chronic moderate to severe pain for an extended period.
But with the beneficial treatment of pain, there has been some abuse by people - some who abused their prescriptions and some addicts who misuse the drug to get high.
Nationwide, the use and abuse of OxyContin has exploded. It has become the No. 1 Schedule II brand, reaching sales of about $1.4 billion last year. Authorities are concerned about increased abuse, as shown in hospital emergency room data, medical examiner and coroner's reports and police reports.
In Champaign County, OxyContin was linked to deaths of three men in the past year. Coroner's records show that all three men had other drugs in their system and that two had been drinking alcohol.
The Illinois medical license of Dr. Jon R. Hays, who previously practiced in Tuscola before moving to southern Illinois, was revoked, and he was sentenced to federal prison for tampering with OxyContin prescriptions for his patients and obtaining the drug for his own abuse by fraud.
OxyContin abuse among area teens became apparent when authorities in Mahomet announced in May that 12 students had been suspended for selling or buying the drug at Mahomet-Seymour High School. An investigation showed that a ring had also been selling Ritalin, a prescription drug to control moods.
Data from the Illinois Department of Human Services show that two forms of OxyContin are among the 10 most prescribed drugs statewide. The 20-milligram dose of OxyContin ranks sixth and the 10-milligram dose of the drug ranks ninth in Illinois.
The state human services agency also reports that abuse of OxyContin has been a subject of growing concern in several states, and the federal government has issued several warnings about it. The state agency says there is little evidence of any trend of OxyContin abuse or diversion - theft by medical personnel - in Illinois, but that it is reasonable to expect some in the near future.
In May 2002, 12 students were suspended from Mahomet High School. A police investigation showed students were selling OxyContin and Ritalin, a prescription drug to control mood, at the school. The medications had been stolen from homes of some of the students.
Mahomet-Seymour High School Principal Del Ryan began the investigation after a parent called to report his son had taken OxyContin from their home to sell at school. That led to the discovery of a ring of students also selling Ritalin.
In Champaign County, coroner's records showed that three men in separate cases also had been taking other medications and two had been drinking.
"People using this drug need to listen to their physician and obey the instructions," Champaign County Coroner Roger Swaney said. "The doctor prescribes it for a purpose, but the patient thinks if one is good, two is twice as good or twice as fast. It's a shame because they are giving this drug a bad name."
A 55-year-old doctor in Florida was convicted in February on four counts of manslaughter for prescribing OxyContin to patients who died from overdoses. Two other doctors, one in California and another in Florida, also face criminal charges in the deaths of patients who took OxyContin.
On the other hand, there is concern that doctors and patients are afraid to use the drug for its legitimate purpose because of recent attention to problems with it.
"Everyone is well aware there is a problem," said Dr. James Egner, an oncologist at Carle Clinic and hospice medical director at Lincolnland Hospice of Mattoon.
"Because of the history of abuse, we have to watch what's going on at home, we have to make sure there are no other problems," Egner said. "I don't think it should be removed by the legal system."
Swaney said there have been five death investigations since September 2001 where evidence indicates the people who died had OxyContin in their system, had been taking the drug or had the drug in their possession.
In one recent case, an Indiana woman drove to a Champaign motel, took prescription medications, including 17 OxyContin pills, then shot herself. "The doctors are prescribing it, and some patients are abusing it," Swaney said. "Mixed with alcohol, it's deadly."
Alcohol also was involved in two of the local fatal OxyContin cases. Coroner's juries concluded that two of the patients accidentally took too much OxyContin. In the third case, a coroner's jury ruled the death was a suicide based on the amount of the drug found in the victim's system, but the family strongly disputes that interpretation, saying it was accidental.
Swaney said prescription drugs are used to commit suicide in many cases nationwide where people have serious medical problems, including some who are terminally ill.
Reports nationwide indicate that OxyContin is being used by drug abusers to get high.
"It's a potent timed-release pill, but when abused, the user obtains a heroin-type high," Swaney said.
Drug overdose cases usually involve street drugs like cocaine or heroin, but sometimes involve prescription medications, Swaney said. Often, multiple drugs are involved when a person dies from prescription drugs, he said.
Patients are not the only ones having problems with OxyContin.
No date has been set for a final hearing with the Department of Professional Regulation in the case of Jon R. Hays, a former Tuscola physician whose license was summarily suspended by the state over OxyContin abuse.
His license to practice in Illinois was suspended in March after investigations showed that he had been abusing OxyContin, but that he had applied for a job as a physician in Vandalia.
Hays, 41, also pleaded guilty June 27, 2001, to federal charges that while living in Herrin, he tampered with OxyContin and obtained the controlled substance by misrepresentation and fraud. In May, he was sentenced to four years and three months in federal prison and fined $500.
Hays was arrested on Feb. 19, 2001, on federal charges of illegally obtaining OxyContin and of tampering with a controlled substance with reckless disregard that another person would be placed in danger of death or injury.
Hays wrote prescriptions to several patients for OxyContin, then ground up the tablets, mixed the drug with saline and injected patients with the mixture, according to the regulatory agency's complaint and the federal criminal charges,
He was practicing at Herrin when arrested, but previously helped develop a clinic at the Jarman Center in Tuscola in 1995 and, with a partner, bought the clinic in 1997. Hays left the business in March 2000.
While national, state and local officials remain concerned about possible abuse of prescription drugs like OxyContin, plans have been developed to increase awareness about the risks at the same time laws against abuse are being enforced.
Aaron Gilson, chief policy researcher and assistant director of the University of Wisconsin Pain and Policy Studies Group, said serious pain has long been undertreated by physicians.
"What we're all concerned about is that the illicit use of these drugs is going to impact their use for legitimate medical purposes," Gilson said.
Both the Drug Enforcement Agency and Purdue Pharma, the manufacturer of OxyContin, announced plans this spring to combat abuse of the drug.
Former New York Mayor Rudy Giuliani, a former prosecutor who was treated for prostate cancer, has agreed to have his consulting company, Giuliani Partners, work with Purdue Pharma's supply chain and to develop a national system to track all prescription drugs.
In a news release announcing the agreement between Purdue Pharma and Giuliani Partners, Giuliani said, "There are tens of millions of Americans suffering from persistent pain. We must find a way to ensure access to appropriate prescription pain medications for those suffering from the debilitating effects of pain while working to prevent the abuse and diversion of those same vital medicines."

OxyContin implicated in three area deaths
Champaign County death investigations last year showed that oxycodone toxicity was the cause of death in three cases.
The therapeutic level - the target range of a drug in a person's system to be effective - of oxycodone is 10 to 100 nanograms per milliliter, according to Dr. Michael Evans, president of the American Institute of Toxicology laboratory in Indianapolis. Anything over 200 nanograms of oxycodone is normally considered to be a toxic level, he said. A nanogram is a billionth of a gram. A milliliter is a thousandth of a liter.
- Brian Henderson, 22, of Jefferson, who was visiting his brother at the University of Illinois and attending a concert, was found dead in his motel room. He was pronounced dead at 10:18 a.m. Sept. 24, 2001, at the Drury Inn, Champaign, where he had been staying with his brother and three other people.
Champaign police Detective Zane Ziegler testified at the inquest Nov. 15, 2001, that Mr. Henderson had suffered from chronic back pain and had undergone back surgery in the past. Mr. Henderson was taking medication and told companions he was going to take some extra pain pills and made the statement he "wasn't going to let the pain get to him tonight." He also had been drinking some beer, Ziegler said.
Toxicology lab results showed oxycodone at a toxic level of 1,400 micrograms per liter. That's 14 to 140 times the therapeutic level. The lab also found Diazepam (Valium) and Propoxyphene (Darvon) in his blood. The coroner's office said the cause of death was oxycodone toxicity. The jury ruled it was an accidental death.
- Thomas Cochrane, 44, of Champaign was found at his home and pronounced dead at 7:43 a.m. Oct. 19, 2001, at the Carle Foundation Hospital emergency room in Urbana.
Lab results showed a toxic level of oxycodone at 5,000 nanograms per milliliter - 50 to 500 times the therapeutic level - and a blood-alcohol level of 0.152 percent. He also had a toxic level of an antidepressant, Amitriptylene, in his blood.
The pathologist concluded in the final autopsy report that the cause of death was oxycodone toxicity with Amitriptylene and alcohol toxicity as contributing factors.
Autopsy results also showed Mr. Cochrane had blocked arteries and the forensic pathologist who did the autopsy wondered if it was due to cocaine addiction. Family members said he had problems with drug abuse 10 to 13 years earlier.
Mr. Cochrane's brother, Scott, said at the inquest that with the blockages Mr. Cochrane had, he was going to have serious heart problems real soon.
According to Deputy Coroner Duane Northrup's testimony, Mr. Cochrane's doctor reported that Mr. Cochrane had been depressed and had severe pain due to chronic pancreatitis. The doctor said Mr. Cochrane was on a lot of medication, including OxyContin and Amitriptylene.
"It's important to know that he was in incredible pain," one brother, John Cochrane, said at the inquest. "He was searching for the right treatment."
Family members said Mr. Cochrane gave no indication he wanted to take his own life. They were concerned about all the prescriptions given to him in light of serious heart conditions.
They also said he had not taken a drink in three years, and they were concerned about the accuracy of lab results. The family had everything retested, but their lab results came back with an alcohol level of 0.196, and the oxycodone level was still at a toxic level.
Mr. Cochrane's doctor told Northrup that Mr. Cochrane said he had stopped taking OxyContin because he had read how people abused the drug. Family members said he had chewed OxyContin tabs, which can cause a rapid release of the drug rather than a slow, timed release, according to Northrup.
Chief Deputy Coroner Bill Fabian also testified that Mr. Cochrane got one prescription for OxyContin from Christie pharmacy on Oct. 8, 2001, and another from a Carle pharmacy on Oct. 11, 2001. Fabian said the drugs came with warnings not to mix oxycodone (the main ingredient) with other pain killers or alcohol.
Over the family's strong objections, the coroner's jury ruled the death was a suicide.
- Bruce Cruse, 38, of Hoopeston died at 9 p.m. Jan. 30, at Carle Foundation Hospital, where he had been transferred. Northrup testified in an inquest March 21 that Mr. Cruse had back surgery to fuse his spine on Jan. 29 at St. Mary's Hospital, Kankakee.
A nurse found a bottle of OxyContin that had not been prescribed by Mr. Cruse's surgeon, and the surgeon told him to stop taking the drug, Northrup said. Family members marked the bottle to indicate how many pills were left and later discovered another pill was missing, he said.
Mr. Cruse was discharged on Jan. 30. His mother found him unresponsive that afternoon, and he was rushed to the Hoopeston Community Hospital, where his heartbeat was restored. He was transferred to the trauma center at Carle, Northrup said, where he later died.
Toxicology lab results showed a blood level of 1,100 nanograms per milliliter of oxycodone and a tranquilizer, Alprazolam (Xanax). That's 11 to 110 times the therapeutic level. Autopsy results also showed Mr. Cruse had nine undigested pills of OxyContin in his system.
The coroner's office reported the pathologist concluded the cause of death for Mr. Cruse was cardiopulmonary arrest as a result of a lethal dose of oxycodone.
Investigation showed Mr. Cruse had filled four prescriptions for OxyContin in the past month and a half. Further investigation by family members revealed that Mr. Cruse had a plastic bag with OxyContin pills tucked between his mattress and box springs.
Family members said Mr. Cruse had a previous problem with addiction to pain medication, Northrup said. In addition to the OxyContin, another doctor had prescribed other pain medication for Mr. Cruse.
"That's not uncommon, where people get addicted to pain medication and go to multiple doctors to get prescriptions," Northrup said in the inquest.
Mr. Cruse's death was ruled accidental.
OxyContin has also been linked to one death in McLean County and three in Sangamon County in the past year.
Sangamon County Coroner Susan Boone said two OxyContin-related deaths came within a month last year. Then in March this year, a 32-year-old man was found dead at home. He had been taking OxyContin for some time, and his prescription record didn't indicate any abuse, but the man's wife said he tended to take a little more than prescribed, Boone said.
"What we think was that it built up in his system," Boone said.
That was ruled an accidental death in April 2002.



Other stories appearing in today's online edition:

Somewhere over the virtual rainbow
Controversy over copying machines
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IllinoisVentures gets off ground
Births and deaths

http://www.news-gazette.com/story.cfm?Number=12800

[This message was edited by Max on Dec 02, 2002 at 03:37 PM.]

[Max]

What is OxyContin?


By STEVE BAUER
© 2002 THE NEWS-GAZETTE
Published Online December 2, 2002



CLICK TO SEE PHOTO
Although there have been some problems with abuse, OxyContin - a time-release form of oxycodone - is a useful pain medication, officials say.
"OxyContin, in my opinion, is an excellent medication when used properly," said Dr. Matthew Black, a former anesthesiologist and pain management physician at Provena Covenant Medical Center in Urbana who moved to Florida earlier this year.
"Due to the misuse and abuse of OxyContin, the prescribing and legitimate use is being highly and appropriately scrutinized," Black said.
There is a difference between a physical drug habit and addiction, although tolerance and addiction are complex issues, Black said.
"Addiction to opiates used legitimately for pain management is very rare," he said. "True addiction is characterized by preoccupation with obtaining, hoarding and abusing the drug for nonmedical purposes."
OxyContin, a semi-synthetic opiod structurally related to codeine, is about as potent as morphine. It blocks the pain receptors in the spinal column.
Not every person's receptors react the same and the reaction to any drug, including OxyContin, can be affected by disease, by other medications the patient is taking or the psychology of the patient, said Dr. James Egner, an oncologist at Carle Foundation Hospital and hospice medical director at Lincolnland Hospice based in Mattoon. He said OxyContin is a useful drug and should not be forced off the market, but that its use should be limited.
"I write a fair number of prescriptions and pharmacies review them," Egner said. "I don't think they should eliminate this as one of the options."
Egner said the drug, which is intended for chronic pain when other attempts to relieve pain have failed, does make people physically dependent, so doctors and pharmacists have to watch what's going on with the patient to make sure there are no other problems.
Egner said the key to reducing abuse of pain medication is to prescribe it only if there's a clearly defined cancer or spinal cord injury or some other clearly defined source of pain. Then the potential for abuse is minimized.
He said doctors usually prescribe opiods when all other reasonable attempts to relieve pain have failed. Cancer patients or people with spinal cord damage who are not likely to die but who are in severe pain might be using OxyContin, Egner said.
Egner said family members or people giving primary care to a patient taking heavy doses of pain medication like OxyContin need to take some responsibility to see that the patient isn't taking more medicine than he or she should.
"Because of the history of abuse, we have to watch what's going on at home, have to make sure there's no other problems," Egner said. "People on this type of medication, you can't expect them to tighten it out themselves. They are impaired. You don't want them driving. You don't want them making important decisions."
OxyContin contains the highest concentration of oxycodone available and the timed-release formulation lasts 12 hours, requiring the patient to take the medication only twice a day.
The OxyContin brand of oxycodone was introduced on the market in early 1996 by Purdue Pharma, a company based in Stamford, Conn. It also makes MS Contin, a morphine-based analgesic, Senacot laxative and Betadine brand of antiseptics.
Sales of OxyContin reached $1.4 billion in 2001, up 40 percent, according to James Heins, a spokesman for the company. Part of the sales revenue increase is due to a 3 percent price increase from the $981 million in sales for 2000, he said. Sales in 1996, the first year OxyContin was approved for the market, were $44 million.
There were 7.2 million prescriptions written in 2001 - up 21 percent from 5.9 million the previous year, Heins said.
"There's a lot of people out there with untreated pain," Heins said. "The introduction of OxyContin coincided with this emphasis on pain management."
There are other long-lasting opiod drugs on the market, but with many, the pain relief tends to drop off, Heins said. OxyContin is intended to release a therapeutic level of oxycodone immediately into the bloodstream and stay there for several hours.
"You won't get the peaks and valleys," Heins said.
With immediate-release opiod analgesics, like Percocet or Vicodin, the medication is released all at once, immediately spiking in the bloodstream. Such immediate release may cause side effects like nausea, but then gradually go down to a therapeutic level where there is pain relief with no side effects. Eventually, the level then goes below the therapeutic level, so the patient has to take another pill every three to four hours. Aaron Gilson, chief policy researcher and assistant director at the University of Wisconsin Pain and Policy Studies Group, said pain has been undertreated for many years. One factor is that both doctors and patients expressed fears that patients will become addicted to medication.
"Anyone who takes an opiod will become physically dependent, but not necessarily addicted," Gilson said. "People who take drugs for pain management are not likely to become addicted in the true sense of that term."
Gilson said the spotlight thrown on OxyContin in the past year or so, including stories of abuse and doctors facing criminal charges for illegal prescriptions, all have a negative impact on the proper use of the drug for pain management.
A current study on use and abuse of drugs indicates that abuse of oxycodone, morphine and other opiod analgesics tends to be by drug users, Gilson said.
"The medical community and law enforcement agree that it's not the medical use of drugs that is the problem, it's the illicit use," Gilson said.
OxyContin is increasingly being used for medical purposes, but also has been abused, particularly in some rural areas of eastern states, including Maine, Virginia and Kentucky, according to the DEA.
The advantage of OxyContin over other pain medications of its class is the duration of action - it lasts 12 hours, according to Egner. Another advantage is that some patients may have a bad reaction to morphine.
"For reasons that nobody knows, everyone's reaction to pain is different," Egner said.
"If one controls (OxyContin's) use, tracking every little bit that is manufactured and watching and having appropriate tracking of its use, I don't think there would be any problem," Egner said.

DEA sees OxyContin abuse as a growing problem
Abuse of OxyContin, a popular pain reliever, is a growing problem, according to the Drug Enforcement Administration.
"During the last two years, the DEA has noted a dramatic increase in the illicit availability and abuse of OxyContin," DEA Administrator Asa Hutchinson testified at a congressional hearing in December 2001.
OxyContin has become the No. 1 prescribed Schedule II narcotic in the United States. Schedule I controlled substances have no approved medical use and a high potential for abuse, according to the DEA. Schedule II controlled substances are approved for medical use and have the highest abuse potential among controlled substances approved for medical use.
Widespread abuse was reported in Virginia, Kentucky and Pennsylvania. Some jurisdictions reported increased property crimes and other crimes attributed to abuse of OxyContin, according to the DEA.
In a separate speech to doctors, researchers, pharmacists and others at the American Pain Society annual meeting in May this year, Hutchinson said the DEA has worked with the society to reduce abuse of prescription drugs.
He said OxyContin abuse is a "serious problem, one that the public and Congress and the DEA is very concerned about."
"When states like Florida report more deaths from OxyContin than from cocaine or heroin in the first six months of 2001, we become concerned," Hutchinson said.
The DEA chief said the agency must also be concerned when the people getting drug treatment mentioned oxycodone, which is the active ingredient in OxyContin, 100 percent more frequently in 2000 than in 1998.
"When, in a six-month period, the Boston area experienced 36 robberies of pharmacies involving forcible acquisition of stocked OxyContin supplies, our alarm increases," Hutchinson said. "And when we discover an organized ring of criminals in North Carolina who used computers to create forged prescriptions to divert thousands of dosage units of OxyContin to abusers, we must be vigilant to reducing abuse."
The increased abuse of OxyContin could explain a rise in the number of times people mention oxycodone when admitted to hospital emergency rooms. The Drug Abuse Warning Network, which tracks such data, showed an 89 percent increase - from 3,395 to 6,429 - between 1993 and 1999. There were 10,825 mentions of oxycodone in 2000, or a rise of 68 percent, in the most recent data available.
The DEA asked 775 medical examiners to provide reports on all deaths associated with oxycodone and/or specifically OxyContin. There are 59 products containing oxycodone available in the United States. Many also contain acetaminophen or salicylates, but there are only a few single-entity oxycodone products. OxyContin and Intensol are the only products with oxycodone dosages in excess of standard strength, according to the DEA.
Out of 803 complete medical examiner reports, the DEA found 296, or 37 percent, to be likely related to OxyContin, including 117 deaths where the drug was verified with discovery in the patient's digestive system.
The study showed that the majority of deaths involved patients taking more than one drug at a time. While this matches with the behavior of drug addicts, many chronic pain patients take more than one medication to manage pain and deal with "flare-ups" not controlled by their usual medicine.
Jim Heins, a spokesman for Purdue Pharma, the maker of OxyContin, said the company has also conducted studies of deaths reported in the media associated with the drug. Preliminary analysis shows that as has been the case for many years, drug overdose deaths typically involve not just one medication but multiple substances, often including alcohol and illicit drugs.
Many media reports blaming OxyContin for fatal drug overdoses were exaggerations that could not be verified by the DEA or Purdue, Heins said.
"Because of the presence of multiple drugs, it is often impossible in these cases to say with confidence whether OxyContin or any specific drug caused or contributed to death," Heins said. "This is true even in the 14 percent of cases where the DEA determined that OxyContin was the source of oxycodone."
The DEA notes that standard OxyContin treatment often goes along with other prescriptions in long-duration treatment of pain for such things as cancer, severe arthritis or chronic pain syndrome. In such chronic pain cases, "rescue medications" are sometimes used for incident pain or to prevent breakthrough pain.
Hutchinson testified that the DEA does not intend to restrict legitimate use of OxyContin or prevent doctors from prescribing it for patients with legitimate medical purposes.
"The DEA recognizes the best means of preventing the diversion of controlled substances, including OxyContin and all other drugs, is to increase awareness of the proper use and potential dangers of the products," Hutchinson told Congress.
"The DEA is taking a measured, reasonable approach to dealing with OxyContin and other drugs of abuse, and is committed to ensuring that there are adequate supplies of pain medications for those with legitimate needs while we strive to protect the public from the consequences of abuse," he said.




http://www.news-gazette.com/story.cfm?Number=12807

[dejerine]

Okay, Kurt cobaine's diary showed he killed himself because he knew his docs would not be willing to give him enough pain meds to control his stomach pains. He preferred death to a surreptitious buyer of drugs. Is it just me or is this a huge indictment of baloney like is being published that Oxycontin is a "killer". It is a strong narcotic, but so what? A person could just take two of something else. The whole country is in a witch hunt over a perfectly good drug and the Prosecuting attorney's who make a name for themselves yanking the licenses of compassionate doctors who risk wrath of witch hunt do-gooders who know nothing about pain, can explain their crummy sadistic acts on judgment day. If they had pain, they would be medicating the daylights out of themselves. And what is this bogus thing about someone taking 17 Oxycontins and then shooting themselves. They probably drove a certain brand of car to get the drugs, but it was the GUN which killed them. Pain can do that, folks. Lets not get excited about meds designed to kill pain. Lets just improve them, by finding neurotransmitters to stop pain without relying on narcotics. Number one side effect of narcotics, nausea, second constipation, third headache, fourth respiratory despression. Only the last is likely to kill, and naloxone is an instant reverser, so why not let them have the meds, but make someone with some naloxone administer it and quit calling it a killer. What does Oxycontin have to do with guns. Give me a break. If you really believe pain meds are killers, go to the dentist and let him drill without medicine. There are people who die every year from reactions to dental analgesia, especially kids. None of these are Oxycontin. There are probably a thousand people who got drunk and shot somebody. What does this article prove and how ignorant and superstitious can people get. Oxycontin is just an oral form of morphine type drugs. These have been in use for four thousand years or more. People with addictive tendencies shouldn't use these drugs, unless they have genuinely severe pain and then it should be responsibly prescribed. So why does that make Oxycontin a real killer. So is any narcotic if you aren't responsible in its use.

[firesmurf]

i couldn't agree more dejerine!!knock the drug abuser not the drug.without this med I would just curl up in a ball and want to die.marcia

[LaoziSailor]

I tought Courtney Love killed Kurt.

[razzle51]

Hey Sailor how come it says you sent this message at 3:49 PM . Its barely 11am here . central . Where are you????????????

[LBUSH49]

I got hurt in 1985 at work when a convayor fell on me I've had 7 back operations and a total of 22 operations , I have arthritis in my spine and right now my Dr. said I have Degenitive disc disease and have 2 more byulging discs ,I've been on Oxcontin 20 MG 3x's a day and Percocet 1or2 every 4 hours , I take a total of 14 medications , I also have a seziure disorder and I'm still in pain , I am going tomorrowthe 22nd to a pain clinic to see why I'm in so much pain if it wasn't for the oxcontin I couldn't even imagine how much pain I would be in ,. All my back operations has caused me to have a Nerurogenic Bladder and my pain in my back is right at the kidney area , but they ran all the test to rule out kidney stones , I'm just afraid I have another herniated disc then I don't know what I'll do then again being on all these medications for 3 and 1 / 2 years maybe it's time for a look at something else for pain but I've been suffering since 1985 and it makes life hard and people don't know what it's like unless they have had some type of spinal injery themselves then they would understand