Big Pharma created the legal opiate addiction epidemic and its outgrowth, rampant heroin abuse, because pharmaceutical corporations’ own addiction to profit arguably trumps any concern it may have had for patients. Though the accusation may seem harsh, the evidence has never been more apparent thanks to an investigation by the Los Angeles Times — which presents a scathing condemnation of the company behind the notorious painkiller, OxyContin.
Two decades ago, Purdue Pharma began marketing OxyContin — a chemical cousin to heroin — with the claim its 12-hour “smooth and sustained” dosing would revolutionize the treatment of pain. However, the claim is not only problematic in that its duration is often hours less than promised — leading patients to experience symptoms of withdrawal — but Purdue knew that before the painkiller ever hit the market.
As the Times discovered, Purdue’s push to market OxyContin, one of the most abused pharmaceuticals in history, flatly and continually ignored all reports from sales reps, complaints from doctors, and independent research on the drug — all in the name of profit.
Indeed, profit Purdue has — the company has reaped some $31 billion in revenue over OxyContin’s troubled 20-year stranglehold on the painkiller market. And ignoring complaints and research contradictory to its extended-relief claim is key to Purdue’s continued success with the hundreds-of-dollars-per-bottle drug, since milder opiate painkillers may, indeed, offer similar if not more effective benefits.
Because Purdue pressures doctors and sales reps to maintain the 12-hour dosing strictures, doctors often increase the prescribed potency.
“More than half of long-term OxyContin users are on doses that public health officials consider dangerously high, according to an analysis of nationwide prescription data conducted for the Times.”
In examining the Times’ report, it becomes apparent Purdue has placed striving for profit above any iota of concern for suffering patients, the cycle of abuse and addiction, or the burgeoning health crisis due to opioid medication. But it isn’t OxyContin, in itself, driving the crisis — it’s the company’s insistence on the strictures of 12-hour dosing cycles, since the drug’s effects wear off much sooner for many.
When a patient isn’t allowed relief from pain sooner than prescribed, they can suffer debilitating withdrawal symptoms — body aches, nausea, anxiety, and more — similar to that of heroin. And according to experts, the euphoria of relief heightened when the next dose is finally administered creates a cycle of addiction — the same cycle that causes patients held to such dosing to seek relief in more illicit substances.
That narcotic-fueled cycle, Washington University neuropharmacologist Theodore J. Cicero told the Times, could be “the perfect recipe for addiction.” In fact, the return of pain coupled with “the beginning stages of acute withdrawal,” can easily become “a very powerful motivator for people to take more drugs.”
Neuroscientist and physician, Peter Przekop, who oversees the treatment of painkiller-addicted patients at the Betty Ford Center in Rancho Mirage, agreed. “You are messing with those areas of the brain that are involved in addiction,” he explained, “and you are going to get the person dependent on it.”
According to the Times, as Purdue began testing patients to gain patent approval for its extended-relief formula of oxycodone in the 1990s, evidence swiftly mounted the drug couldn’t substantiate the manufacturers’ claims it ‘revolutionized’ pain relief by limiting the number of doses required.
“For example, in one study of 164 cancer patients, one-third of those given OxyContin dropped out because they found the treatment ‘ineffective,’ according to an FDA analysis of the study. Researchers then changed the rules of the study to allow patients to take supplemental painkillers, known as ‘rescue medication,’ in between 12-hour doses of OxyContin.”
“In another study of 87 cancer patients, ‘rescue was used frequently in most of the patients,’ and 95% resorted to it at some point in the study, according to a journal article detailing the clinical trial.”
Despite all evidence pointing to varied dosing required by different patients — as people react differently to opioid medication — Purdue pushed forward in only seeking the 12-hour dosing restrictions in their patent testing. And Purdue sought and received the FDA’s approval at that dosing, even though, as agency spokeswoman Sarah Peddicord explained in a written statement, “it should be well understood by physicians that there will be some individual variability in the length of time that patients respond to this drug …
“While the labeled dosing regimen is a reasonable starting point, physicians should carefully individualize their approach to patients based on how quickly they metabolize the drug.”
Purdue’s advertising stratagem for marketing OxyContin, however, focused on that 12-hour dose — with ads stating plainly, “REMEMBER, EFFECTIVE RELIEF JUST TAKES TWO.”
Indeed, the tactic worked so well, OxyContin’s profits exponentially topped those of its pharmaceutical predecessor, MS Contin — more than doubling MS Contin’s most successful profits in just its third year on the market, the Times reported. By its fifth year, OxyContin was pulling in $1 billion in profits annually, then leveling off in 2010 at $3 billion.
Purdue Pharma is owned by the ultra-rich Sackler family, who were also responsible for MS Contin, and as the Times described, the “success of OxyContin brought a whole new level of wealth. Forbes magazine last year estimated the Sackler’s worth at $14 billion, which, as the magazine noted, put the family ahead of American dynasties such as the Mellons and Rockefellers.”
As The Free Thought Project recently reported on the Sacklers’ hand in America’s opioid addiction epidemic, the “number of deaths caused by the use of OxyContin dwarfs the number of people killed during the Mexican drug war, while overdose deaths, from prescription pills, have now surpassed that of cocaine and heroin combined.”
Eventually, the Department of Justice conducted a criminal investigation concerning OxyContin and Purdue. And though in 2007, Purdue and three top executives pled guilty to fraud — paying out $635 million — for downplaying addiction risks associated with the narcotic painkiller, the issue of dosing was never addressed.
When Purdue saw doctors increasingly prescribe OxyContin in dosing more frequently than 12 hours, the company viewed the issue as a crisis — not for the drug’s lack of efficacy or concern for patients, but because “managed care plans” were “beginning to refuse to fill prescriptions” at such a steep price.
Rather than conceding to an 8-hour dosage regimen, Purdue began encouraging drug reps to tell doctors to increase the strength of doses. This strategy came with inherent dangers, however, as stronger narcotics greatly increase chances of overdose and death. But, as the Times found, that was never a topic of concern for Purdue.
Despite decades of complaints, anecdotal and scientific evidence, and testimony depicting OxyContin as the driving factor in opioid addiction and abuse, Purdue continues to reap massive profits from the painkiller — still prescribed in 12-hour dosing format. In 2014, alone, 5.4 million prescriptions for OxyContin were handed out by doctors — 80 percent of those in 12-hour doses.
As lawmakers continue to make these prescription drugs harder to obtain, the addicted masses are turning toward the black market to stifle their cravings. The result of such a deadly combination of pushing ‘legal’ addicts into the ‘illegal’ realm is manifesting through skyrocketing overdose rates, more police crackdowns, and cheaper and more dangerous heroin.
Alternatives to dangerous narcotic medications do exist, whether Purdue would admit to as much or not. A study in 2015 divulged cannabis as more effective than opioids for treating pain, and as Justin Gardner reported for The Free Thought Project, researchers are now urging doctors to steer patients toward cannabis, rather than opioids like OxyContin, for the treatment of chronic pain.
If there is somehow still any question why the United States is currently experiencing an epidemic in opioid medication addiction and abuse — and its outgrowth of heroin abuse — simply look to Big Pharma’s profit-seeking above patient care for answers.
This work by The Last American Vagabond is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License, and may be reposted as is, with attribution to the author and TheLastAmericanVagabond.com. Permissions beyond the scope of this license may be available at Ryan@thelastamericanvagabond.com.