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Dear Karen,     Thank you for this clarification.  I agree with you entirely that it is dangerous and irresponsible for any person to switch from oxycodone 10 mg to OxyContin 80 mg without doing so under careful medical supervision, and without careful titration of the dose in a proper clinical context.   I read recently that an FDA advisory panel has just recommended banning all compound analgesics that combine acetaminophen (APAP) with low-potency opioids and opiates such as hydrocodone, codeine, dihydrocodeine, etc., ostensibly because too many patients are taking too much APAP by stepping up their intake of these combination analgesics.  The stated goal of the advisory panel is to reduce the unnecessary intake of APAP by patients suffering from chronic pain.  If the FDA acts on the recommendations of its own advisory panel, it will effectively ban almost all of the Schedule III drugs that currently act as at least partial remedies for those patients suffering from chronic pain, whose doctors are either opiophobic or whose doctors live in fear of being prosecuted by the D.E.A. (or by state health departments) for prescribing "too many" Schedule II drugs.  If the FDA follows the advice of its own panel, then drugs such as Tylenol with Codeine #3, Tylenol with Codeine #4, Norco 10 / 325, Vicodin, etc. will all be banned.   Is this what you referred to when you stated that the FDA was considering placing even tighter restrictions on the prescription of opioids?   The results of such a ban will almost certainly be grotesque, and may well lead to a surge in the number of suicides caused by inadequately controlled chronic pain.  I do not make this statement lightly - many patients in the US who are unable to obtain adequate pain relief turn to suicide in their efforts to alleviate the pain.  At the present time, doctors who treat patients suffering from chronic pain have at their disposal a number of at least partially effective drugs that combine low-potency opioids / opiates with APAP.  These drugs are inadequate in the context of chronic, severe pain, but they are better than nothing at all.  Almost all of the Schedule III analgesics will be banned should this recommendation be implemented.   Unless the FDA issues clear, unambiguous guidelines, made binding on the D.E.A. and on state regulatory agencies, recommending that doctors be given a much freer hand in prescribing Schedule II painkillers to patients suffering from chronic pain, without having to worry about being harassed by the D.E.A. and / or by state regulatory agencies, this proposal is a recipe for utter disaster, and human suffering and misery on an appalling scale (made socially acceptable because it would be "legal").   This is an object lesson in the shambles that invariably results when the US government declares a "war" on something (whether that something be drugs, terrorism, etc.).  Whenever America declares a "war" on something, the result is invariably human misery on a massive scale.  This misery is invariably made even more grotesque by another American tendency, which is the refusal of politicians (and many of the people who they represent) to recognize and to acknowledge when such as "war" has failed.  To this day, many politicians continue to insist that the "war on drugs" is working, despite the fact that most illegal drugs are cheap, easy to obtain, and freely available.   It is working, all right.  It is working to ensure the continued and irreversible erosion of rights and liberties that we once took for granted - particularly in the realm of Fourth Amendment jurisprudence.  Searches and seizures that were considered by state and federal reviewing courts to be utterly impermissible just 20 or 30 years ago are now considered to be perfectly acceptable - and citizens who protest are frequently harassed and branded as "trouble-makers".  A generalized "drug exception" to the US Constitution (and to state constitutions) now exists, just as a generalized "gay exception" to the US Constitution existed right up until June 2003 (when the US Supreme Court handed down Lawrence v. Texas, 539 U.S. 558 (2003), thereby explicitly and bluntly overturning an earlier decision (Bowers v. Hardwick, 478 U.S. 186 (1986)) that permitted the states to criminalize gay sex even when this occurred in entirely private contexts in the homes of gay persons).  The "war on drugs" makes it acceptable for state and federal government officials to fly over the homes of law-abiding citizens at low altitudes to determine whether or not the occupants of those homes are growing marijuana (see Florida v. Riley, 488 U.S. 445 (1989), in which case the dissent invoked George Orwell's dystopian novel "1984" by hoping that "...it will be a matter of concern to my colleagues that the police surveillance methods they would sanction were among those described forty years ago in George Orwell's dread vision of life in the 1980's: "The black-mustachio'd face gazed down from every commanding corner.  There was one on the house front immediately opposite.  BIG BROTHER IS WATCHING YOU, the caption said. . . .  In the far distance, a helicopter skimmed down between the roofs, hovered for an instant like a bluebottle, and darted away again with a curving flight.  It was the Police Patrol, snooping into people's windows.").  The "war on drugs" is also working to gut the Eighth Amendment, with its prohibition against cruel and unusual punishment (the Rockefeller drug laws in the State of New York mandate grossly disproportionate, lengthy terms of incarceration for both users and sellers of illegal drugs).  The "war on drugs" is also working to gut the Fifth and Fourteenth Amendments' guarantees of due process of law (see United States v. Salerno, 481 U.S. 739 (1987), in which case the US Supreme Court upheld the so-called Bail Reform Act of 1984 in the face of a due process challenge; this statute provides for the incarceration prior to trial of persons charged with certain offenses on very broad and shaky grounds of potential dangerousness to the community.  In short, the "war on drugs" has taken a wrecking ball to the constitutional structure of checks and balances that exists to protect the individual from the (virtually limitless) resources of the state.   There is a shocking tendency in America to confuse a procedure or medication with its abuse.  The furore that surrounded the abuse of a particular, very effective and useful sleeping pill is instructive in this regard.   I was born and raised in South Africa.  When the sleeping problems plagued me as a young adult, my doctor in private practice in Johannesburg prescribed a sleeping pill marketed as Rohypnol (its generic name is flunitrazepam).   May readers will recognize this drug.  It has acquired a reputation as a "date-rape" drug, because it has been used to spike the drinks of women (and sometimes men), in order to render them powerless to resist sexual assault.  However, flunitrazepam is an extremely effective sleeping pill - I know this from personal experience.  I took flunitrazepam for about two years, before immigrating to the US, and it gave me solid, uninterrupted sleep every night without fail.  However, when young men in states such as Florida imported this drug and started using it to sedate and sexually assault women, common sense flew out the window here in the US.  Whereas other nations (including South Africa) opted to impose tighter controls over this drug (it was moved from Schedule 5 in South Africa to Schedule 6 (there are a total of eight schedules in South Africa, with Schedule 8 representing illegal drugs)), the US government is currently trying to ban this drug outright!  Again, we see a tendency to confuse abuse of a drug with its entirely legitimate usage - current efforts to move flunitrazepam to Schedule I under US drug laws fly in the face of reason and definition - Schedule I drugs are by definition drugs that have no accepted medical usage and that are highly addictive.  In fact, flunitrazepam continues to enjoy usage as a powerful sleeping pill all over the world, and it is no more addictive than diazepam, lorazepam, temazepam, or any of the other benzodiazepines (I now take lorazepam for panic attacks and insomnia).   If the FDA follows the recommendations of its own advisory panel, patients who now obtain partial relief from pain may find themselves utterly without remedy.   I am glad that I no longer live in the US.  As you mentioned, my doctor in New York City was unusual in that he did not hesitate to prescribe OxyContin 80 mg and Norco 10 / 325 in generous quantities for me.  When I moved to Chicago on assignment, I found a pain management specialist who agreed to continue the regimen - but I realize that I was lucky, and that many people who suffer from chronic pain are left without medications, to suffer and to lead lives of genuine misery.   This is a national tragedy.   Only when those people who suffer from chronic pain mobilize politically and apply pressure to their political representatives will anything change.  Prior to this FDA advisory panel recommendation, it appeared that the US was slowly relenting and acknowledging the seriousness of chronic pain.  Now this has happened.   God help those ordinary men and women who are left to fend for themselves and to suffer.     PHILIP