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oxycontin and pain management

The Dangerously Flawed History Behind OxyContin and Pain Management

The drug epidemic within our country has seemed to only worsen as time goes on. Many substances have been reformulated for increased potency, which has contributed to more people developing addictions to them. One of the most problematic types of substances in this epidemic has been opioid pain medications. Of course, these substances have a valuable purpose within the medical realm, but they can also be quite dangerous and come with a huge risk of addiction. OxyContin has been a massive problem in particular since it was introduced in 1996.

Interesting Facts About OxyContin

Some of the most interesting facts about OxyContin and a large part of the issue was in the way that it was marketed. OxyContin was originally manufactured and launched by Purdue Pharma, and they had claimed that a single dose of the medication would relieve pain for 12 hours, which was more than double that of generic medications and this is what set it apart from many of the medications in use. Purdue was telling doctors that patients would not have to wake up during the night to take their medications, as it would only require one dose in the morning and one at night for regular pain control.

From the above premise, OxyContin came to be the best selling pain medication in America, also allowing Purdue to receive revenue to the tune of $31 billion. Unfortunately, this rapid and huge success was disguising a hidden truth, which was that the medication was actually wearing off earlier than what was claimed by many people. Chemically, OxyContin is related to heroin, and when it does not last the time periods necessary, individuals may go through burdensome withdrawal symptoms. The individual can then begin experiencing intense cravings, which contributes to people developing an addiction and is also why OxyContin is one of the most abused drugs in our country.

An LA Times investigation into this matter actually found quite a lot of interesting facts about OxyContin, including the deceit and misdirection surrounding it. In fact, based on reviewed confidential documents from Purdue and various other records, they found that earlier clinical trials had shown that the 12 hour claim was not true for many patients and that the company had even been confronted with further evidence, reports from sales reps, independent research, and complaints from doctors regarding this. Yet, Purdue continued to hold on strong to the 12-hour pain relief claim, likely in large part to keep the revenue flowing. Realistically, OxyContin does not offer much advantage over other less expensive pain medications without the 12-hour claim. There was even a point in the late 90’s where doctors had begun prescribing OxyContin in shorter intervals, which prompted Purdue to send a flurry of sales reps to get them back onto the 12-hour dosing regimen. Purdue recommended prescribing stronger doses instead of more frequent ones, which can increase the risks of overdose, addiction, and death.

OxyContin Abuse and Dependence

Over time, the problem of OxyContin abuse continued to grow rapidly, with the National Survey on Drug Use and Health stating that more than 7 million Americans abused OxyContin over the past 20 years. This contributed heavily to the rates of an overdose on OxyContin and various other pain medications. Many of those abusing it may have even fallen into that pattern of behavior due to the claim of 12-hour pain relief. If a person’s medication wears off early and they begin to experience withdrawal symptoms and cravings, this could lead to them taking another dose for a reprieve. When this continues, it can bring about a repetitious cycle of addiction and dependence.

The issue of OxyContin not lasting 12 hours for many people was well known by Purdue, but they simply used the select favorable results to promote this claim. In fact, for them to secure FDA approval, Purdue had to show that OxyContin was effective and safe like other medications on the market and to establish the desired length of duration, they had to demonstrate that the medication lasted 12 hours for a minimum of half of the patients. To adhere to these guidelines, Purdue submitted a study from Puerto Rico that did display this, but this also effectively neglected the several other studies that did not show what they wanted. Although, their skewed findings worked well enough and they were able to secure FDA approval in 1995.

The Financial Gains of OxyContin

The creation of OxyContin was a two-sided venture, as it was developed as a way to better mitigate pain but it was also a solution to a financial problem. Previously, one of the largest money makers for Purdue was a medication called MS Contin, which was a morphine medication for cancer treatment. In the late 80’s, the patent for this medication was about to come to an end, which was going to place Purdue at a disadvantage because of generic versions driving the price of their proprietary medication down. Then in 1990, the vice president for clinical research suggested the development of a second pain medication that was also a controlled-release form. Purdue had already discovered a way to extend the duration of a medications release, which was used in MS Contin and made it last around 8 to 12 hours. They looked into the form of opiate known as oxycodone, which generally lasts around 6 hours. When looking at the normal duration, they theorized that their extended release method could make it last 12 hours. Purdue then began development of OxyContin, with this lasting about a decade and cost them over $40 million.

Now, back to the marketing techniques used by Purdue during the rollout of OxyContin. Realistically, they seemed to put everything into this medication, including massive amounts of time and money. After all, this was supposed to be their solution to the generic flooding of the market, so they needed people and professionals to be fully on board with their new medication. This included Purdue working to break out of the cancer-only market. OxyContin and Purdue resulted in somewhat of a paradigm shift, as prior to its release, doctors were very aware of the dangers of narcotic pain medications and they were mainly considered to be for the terminally ill and cancer patients.

The change in this scene came with the push from Purdue and their new release. Employees of the company were told by a marketing executive that they did not want OxyContin to be just for cancer pain. They then went on to double their sales team and pump $207 million into the launch of OxyContin. Sales reps were convincing doctors that the medication was even for lesser conditions like knee or back pain, with the 12-hour dosing being the hook. Prescribing doctors were given gifts covered in a “Q12h” logo and doctors were brought to seminars and weekend events at hotels. Of course, the intent of these events being to bring doctors on board for prescribing their medication and encouraging colleagues back home to do the same. Unfortunately, these marketing and sales techniques were quite effective for Purdue, with OxyContin sales quickly dwarfing their MS Contin sales.

Down the line in 2002, a lawsuit was brought against Purdue regarding their exaggeration of the duration. Much of this case was kept under wraps due to sealed court documents and Purdue’s attempts to keep it from going to trial. Realistically, a lot of questions would have been directed at Purdue during a trial and sealed evidence would have been laid bare for numerous officials. This prompted Purdue to take any action necessary to avoid this, which in the end, included them paying a $10 million settlement on the eve of the trial. This settlement money was used for the funding of programs discouraging drug abuse.

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