In 1996, Purdue Pharma rolled out OxyContin under the banner of 12-hour relief from pain. At the time, this was double the length afforded by generic medications. OxyContin became the most profitable painkiller in the U.S., earning Purdue over $30 billion. But according to one investigation, OxyContin does not always provide long-term relief, causing users to take more and become addicted.
Pain relief shorter than advertised
The Los Angeles Times released an investigative report earlier this month chronicling Purdue’s attempts to keep the 12-hour claim above suspicion despite mounting evidence to the contrary. The Times report cites a National Survey on Drug Use and Health statistic that over the past 20 years, 7 million Americans have abused OxyContin, and since 1999, over 190,000 users have died from overdosing on the drug.
According to the Times, physicians began prescribing the drug in shorter intervals not long after it hit the market. To stave off the erosion of its 12-hour claim, Purdue Pharma sent sales representatives to carry the message to physicians: stronger doses, not shorter intervals. The result was patients experiencing the return of pain and experiencing withdrawal.
The day the Times story was published, Purdue issued a rebuttal. For every claim made in the Times piece – 12-hour dosing issues, patients at risk, the need to inform patients of the limitations of the drug – Purdue responded with data from the Food and Drug Administration (FDA) supporting the company. The same day, the Times issued its rebuttal to Purdue’s rebuttal. The Times notes Purdue backpedaled on its claim of 12-hour relief. According to the company, most patients receive adequate relief for 12 hours per dose, but some patients owing to circumstances may have to the take the drug more frequently.
Dueling claims only hurt the patient
Purdue, which is owned by the Sackler family, has annual revenues of $3 billion, most of which comes from OxyContin. Obviously, it is in the company’s interests to stand by its claims. The Times line-by-line rebuttal of Purdue’s rebuttal makes for a compelling read but leaves the consumer wondering what is the truth.
The FDA publishes medication guides. The guide for OxyContin contains a stern warning not to exceed the prescribed dose in any 12-hour period. It warns users not to make up for missed doses. The guide also contains the following: “Do not cut, break, chew, crush, dissolve, snort, or inject OxyContin because this may cause you to overdose and die.” All of this calls into question the wisdom of prescribing the drug in any intervals shorter than 12 hours.
What the ethicists say
Geoffrey Poitras is on the faculty of business administration at Simon Fraser University in Vancouver. In his article titled “OxyContin, prescription opioid abuse and economic medicalization,” Poitras questions Purdue’s marketing of OxyContin as economic medicalization. Medicalization is the process of making nonmedical problems medical problems; economic medicalization is this process motivated by commercial gain. Poitras points to Purdue’s direct hard-sell to physicians and its relentless 12-hour dosing drumbeat.
Poitras concludes by noting Purdue’s decision in 2010 to reformulate the drug to make it more tamper resistant. Purdue heralded this as a major step toward reducing reduction. Poitras says the result was increased abuse of other opioid meds and heroin. Sales of OxyContin in 2011 exceeded $2 billion.
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About the author:
Darren Fraser is a content writer for Sovereign Health Group. He worked two and half years as reporter and researcher for The Yomiuri Shimbun until they realized he did not read, speak or write Japanese and fired him. Undeterred, he channels his love of research into unearthing stories that provide hope to those dealing with addiction and mental illness. Darren loves the Montreal Canadiens hockey club and horror films and would prefer to enjoy these from the comforts of his family’s farm in Quebec. For more information about this media, contact the author at firstname.lastname@example.org.