Question 17: Is there a difference between OxyContin and other sustained release narcotic preparations in terms of abuse?

Raymond Sinatra, MD: I have one last question, it's similar to something that was raised earlier. "I have not heard of sustained release morphine preparations being abused to the degree that OxyContin has, is that true or not? Is there a difference between these two preparations that leads to one being a preferential drug of abuse?" Neil or ... you want to take that one?

Neil Jobalia, MD: I think, again, at least in my point of view it seems to be more an issue of the fact that because of the explosion in the number of prescriptions being written for long acting opioids and the fact that OxyContin happened to be the one that gained popularity among physicians that it became more available and hence the one that was abused. As I had mentioned earlier, the article that I read in the Cleveland newspaper where two teenagers that had overdosed on long acting morphine and not oxycodone, and also my personal experience with two patients with methadone and Duragesic I think speaks to the fact that any of these drugs can be abused. So that ... I'm not sure that there's any specific difference other than the availability of one over the other and again, now the notoriety as we've mentioned in this panel.

L. Jean Dunegan, MD, JD, FCLM: I really believe that there is a difference between being really up on OxyContin, really up on oxycodone, very euphoric product versus being mellowed out with dysphoria on something like morphine. But I am sorry because I don't have an article to quote for that clinical impression that I have. But I do think it makes a difference out there on the street.