Saturday, August 18, 2007

Anything but Opiates!

Master Juba, from, sent us this article which he originally wrote for his site:

Anything but Opiates!

The DEA's intimidation tactics against doctors who prescribe opiates has another unintended effect; Doctors who treat narcotics like they were poison, but are quick to use a drug like Neurontin for a purpose it was not designed for, and not approved for, all on the word of a sales representative from a drug company. At least when the Perdue reps were pushing OxyContin on doctors, it was a pain medicine to be used for pain and no one billed it as a cure for high blood pressure or cholesterol. The pushing of Neurontin by pharmaceutical reps visiting doctors has been an issue for years. Even after the hubbub about the aggressive way Perdue pushed OxyContin, the folks selling and pushing Neurontin made the OC campaign look like a joke. Sales reps were interviewed on national news programs like "60 Minutes" and "20/20" saying that their management really put the screws to them to ("lie") tell doctors that Neurontin was not only the greatest drug coming down the pike for seizures, but to push the point hard to doctors that it was great for all kind of off-label uses, including chronic pain.

Congressmen and the FDA were appalled and up in arms about the whole thing... for about 3 weeks. Then it just kind of faded away, never to be heard from again. Doctors began serving it up for chronic pain in doses so high it was absurd, not to mention dangerous. And the whistle-blowing drug company reps who testified they were told to lie were fired with extreme prejudice, so no matter how loud they hollered about Neurontin poisoning, it looked like sour grapes.

Some people were actually getting some relief from Neurontin. Of course they aren't keeping track of how many folks had problems like developing seizures from taking it in high doses (and seizures wouldn't seem like an unusual thing to happen to someone on Neurontin) and there's no way to tell how many of those helped by the drug would have been helped even more by a real pain medication like a narcotic.

But society can't have narcotics handed out like candy to everyone with pain. That would never do. We can hand out seizure meds like candy though, and that's OK. If we do hand out a narcotic, we have to make sure we put a poisonous substance like acetaminophen in it, so we can show the systemic damage caused by narcotics, if the patient takes enough to try to break even with the pain.

It's a scary world where doctors would rather see someone on a medicine that's not approved for the condition, that could cause other systemic damage, that they have no real research on what it does for pain or how it works or what high doses do over the long haul, rather than to put a patient on a medication actually designed to fight pain. A medication that has been in use for the last 5,000 years, since the first poppy was picked, and has been proven effective and safe, if used properly. Neurontin was approved by the FDA in 1993 as an anti-seizure medication for epileptics. In addition, it is approved as a treatment for a condition related to shingles. Neurontin is believed to be linked to suicidal behavior, including suicide ideation and attempts.

Neurontin is manufactured by Parke-Davis, a subsidiary of Pfizer, and used to regulate the nerve activity in epileptics. To date, there are about 2 million people in the US with epilepsy. However Neurontin was prescribed for additional uses, for which it did not have FDA approval. Parke-Davis settled a criminal lawsuit related to such unapproved prescriptions. Yet, it is believed that approximately 80% of all Neurontin prescriptions were filled for unapproved medical conditions, which makes Neurontin side effects much harder to measure.

The eleven illegally promoted, unapproved uses for Neurontin include: bipolar disorder, peripheral and diabetic neuropathy, monotherapy for epileptics, reflex sympathetic dystrophy (RSD), periodic limb movement, attention deficit disorder (ADD), restless leg syndrome (RLS), trigeminal neuralgia, post-hepatic neuralgia, migraine, and drug and alcohol withdrawal symptoms.

When a patient takes a prescription for an unapproved use, the person runs the risk of having serious side effects because the medication was not tested in clinical trials for that use. The side effects could be minor to severe, but for certain, without a trial to test for interactions or preexisting conditions, the potential danger is huge.

Neurontin is believed to be linked to suicidal behavior and suicidal ideation. Evidence of suicides supplied to the FDA by the manufacturer are less than the number the FDA itself has gathered. Although the connection has not been proven decisively, no full clinical trials have been conducted for Neurontin on the unapproved uses for which it has been prescribed.

Using Neurontin for pain rather than narcotics is very dangerous. If you have been helped by Neurontin, that's great, but I wonder how much better you would feel on a real pain medication. Your doctor will never let you find out.

By Master Juba
Original article on

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