PARALLEL TRENDS IN PRESCRIPTION DRUG ABUSE

The number of deaths caused from accidental overdose of opioid pain relievers nearly quadrupled from 1999 to 2007, according to Dr. Leanard Paulozzi of the Centers for Disease Control and Prevention. Visits to the emergency room for opioid pain killers increased by 242 percent while the visits for illegal drugs declined slightly. (Drug Abuse Warning Network).

From 1991 to 2004 deaths from opioid abuse doubled in Ontario Canada according to a 2009 study led by physicians at St. Michael’s Hospital and the Institute for Clinical Evaluative Sciences (ICES).

The DEA reported that sales of pain killers almost doubled between 1997 and 2005.

The Rise Of An Epidemic

Prescription drug abuse is now described as an epidemic, but the epidemic did not start over night. In fact the statistics and growth of prescription drug abuse somewhat parallel the history of one particular drug – Oxycontin.

In 1995 Purdue Pharmaceutical was granted a patent for Oxycontin – time release oxycodone. Given the limitations of Oxycodone products, Oxycontin seemed like the answer to those in chronic pain who needed more than a 5 mg pill of Oxycodone could provide. (Oxycodone is the pain opioid pain relieving ingredient in Oxycontin.) Oxycodone formulations were comprised of aspirin or acetaminophen and 5 mg of Oxycodone. Because too much aspirin or acetaminophen can be toxic, patients were limited in how many pills they could take safely each day.

Oxycodone is effective for only four hours and the slow release Oxycontin was a “solution” for those needing continuous round the clock pain management at higher doses. Physicians could provide high dose oxycodone in 12 hour release pills for continuous 24 hour pain management. The dosages could be increased safely and the side effects, compared to other opioids, were apparently not as severe.

The Allure Of Oxycontin

But there was one side effect that wasn’t being considered. Oxycontin is not only an effective pain medication, but it creates a euphoria that is apparently very desirable – so desirable that street sales, along with pharmaceutical sales soared over the years. Also, those who were taking it legitimately for pain developed a tolerance over time and got addicted in the process. Hence the world saw individuals like Rush Limbaugh doctor shopping and getting his pain pills from questionable sources.

How did the word get out so quickly on the “virtues” of Oxycontin? In the late 1990s Purdue pharmaceutical company representatives started promoting pain killers aggressively, especially Oxycontin. In the first year through aggressive marketing, Purdue saw a billion dollars in sales. As more people were prescribed it, the popularity of the Oxycontin euphoria grew. Many who were prescribed Oxycontin became addicted and others got it from their friends and wanted more. Since it was safer to get it legally, pain clinics started to pop up all over the place.

It wasn’t necessary to buy Oxycontins on the street (why when you could get it from a doctor). For a while, law enforcement agents in Indiana had to deal with Oxycontins brought into the state from Kentucky pain clinics. Kentucky was able to get rid of their pain clinics, but then individuals started driving to Florida pain clinics and bringing Oxycontins back to Kentucky. Even with ease of pain clinic prescriptions, some people were buying too many Oxycontins and their pharmacists noticed. A new breed of drug addict was born, the “drug seeker”. Dental offices and other practitioners who could prescribe soon learned the tell tale signs of those seeking out drugs to feed their addiction.

The problem grew more silently than the same growth of illegal drugs would – it wasn’t grabbing the attention of law enforcement like methamphetamine labs. Not really – until too many people became addicted and some died.

Legal Action Taken Against Drug Companies

• In 2002 several lawsuits were filed by person who claimed that they had become addicted to Oxycontin, alleging that Purdue had aggressively marketed Oxycontin to pharmacists, doctors and patients without warning individuals about the appropriate use and adverse effects of Oxycontin. The law suits were dismissed. Purdue responded by ceasing the distribution of the 160 Mg. tablets, but it seems that little else was done. Sales of the drug continued at a billion dollars a year.
• In 2004 consumer groups filed a lawsuit against Purdue for “fraudulent patents”, “illegal marketing” and “blocking generic alternatives”. The lawsuit alleged that Purdue falsely received its patent by claiming that it was effective at very low doses, when there was no evidence to support this claim. While this suit was primarily about consumer rights versus the pharmaceutical industry profit-seeking behavior, there were other rumblings in the Oxycontin world. These lawsuits also went nowhere.
• In 2007, the FDA finally acted and announced the results of an investigation by the Office of Criminal Investigations (OCI). The findings stated that Purdue had participated in a long-term conspiracy to generate as much money in sales as possible through illegal schemes. Sales personnel were trained to represent to health care providers that Oxycontin was less addictive than morphine and did not create euphoria.

The U.S. Attorney’s office prosecuted the case. Purdue pled guilty to a felony count of misbranding. The company agreed to pay more than 700 million to resolve the charges and liabilities connected with the illegal schemes. Michale, Friedman, Howard Udell and Dr. Goldenheim pled guilty to illegal promotion of Oxycontin as a drug that was less addictive, less likely to create tolerance and less likely to be abused. Purdue was fined 600 million dollars, which included a criminal fine and restitution.

That was in 2007. Yet since that time, this country has seen more pill mills, doctor shopping and overall abuse – much of it fueled by Oxycontin and similar drugs. Prescription monitoring programs are in 37 states and recently the federal government announced plans to do its part to stem the tide of the epidemic. Part of the plan involves educating doctors and creating a national data base to monitor prescriptions. However, recent history has shown that as long as there are pills to be bought, they will be sold.

The gush of any geyser can only be halted by blocking it at the source.

Michael Bonds, Bauder College About The Author Michael Bonds is a Criminal Justice Senior at Bauder College in Atlanta Georgia. He is currently doing his externship at Narconon of Georgia. He is an Activist and former Youth Counselor from Boston Massachusetts. He is the author of “Gunz, Poems & Rosez, the Experience Strength and Hope of Michael Warrior Bonds” and is an avid writer.  Read more from Michael at his web site. (Read more …)