oxycontin

History of OxyContin & How It Got Started

Posted on November 8th, 2017

OxyContin is the brand name for an extended-release form of oxycodone, a prescription opioid painkiller that is one of the most overprescribed and misused medications in the United States. Highly effective, but also highly addictive in both the immediate-release and extended-release forms, OxyContin and oxycodone are prescription narcotics with opium-like effects.

How is OxyContin made and where does it come from?

OxyContin is a semi-synthetic opioid made by modifying morphine, which is derived from opium. OxyContin’s active ingredient, oxycodone, is said to be twice as powerful as the opiate heroin and just as addictive. OxyContin is produced, marketed and distributed by Purdue Pharma, one of the most profitable pharmaceutical companies in the United States.

How OxyContin Works

Fast-acting oxycodone — commonly prescribed as a generic and also under the brand names Percocet, Percodan, Roxicodone, Xtampza ER and Oxaydo — is intended to treat moderate to severe pain, while long-acting or extended-release OxyContin treatment is intended for the longer-lasting pain associated with late-stage cancer.

Both oxycodone and OxyContin work by binding to opioid receptors in the brain and body — a process that blocks pain signals and stops pain. The same process that blocks pain signals also triggers “feel-good” signals by causing an upsurge in levels of certain neurotransmitters that deliver a sense of pleasure or euphoria. The entire pain-diminishing and pleasure-increasing process can lead a person to become dependent on the drug, making OxyContin treatment habit-forming.

With drug dependency, a person needs increasing doses of the medication to feel the same pain-relieving effect. Depending on the strength of the medication dose and the duration of treatment, drug dependency can escalate to addiction in a surprisingly short span of time, causing withdrawal symptoms (including heightened pain) when the drug is stopped.

How OxyContin Prescribing (and Overprescribing) Got Started

In an exposé for the October 2017 edition of The New Yorker, writer Patrick Radden Keefe reveals how the Sackler family, the owners of Purdue Pharma, strategically and relentlessly marketed OxyContin to physicians as a safe choice for pain treatment starting with the drug’s release in 1995.

Whether independently or as a direct result of advertising by Big Pharma, in the 1990s the U.S. medical community decided it needed to do a better job of managing chronic pain for patients with cancer and other diseases. Pharmaceutical companies had been developing more effective painkillers, and doctors began prescribing opioid painkillers at increasing rates in a concerted effort to help more patients better manage their pain and, thus, enjoy a better quality of life.

Although this effort may have been motivated by good intentions on the part of most doctors, it had an inherent problem — the opioid painkillers that were being marketed to doctors as the most effective were also the most addictive. OxyContin, oxycodone and hydrocodone soon became some of the most highly prescribed medications of any type in the U.S., and by the end of the 1990s, many people were addicted.

“Few drugs are as dangerous as the opioids,” said David Kessler, the former commissioner of the Food and Drug Administration, in The New Yorker. Other experts interviewed for the article said that Purdue’s marketing strategies for OxyContin correlated with a general shift in opioid painkiller prescribing practices among doctors. More than one expert commenting on what started the current opioid epidemic in the U.S. pointed a finger at Purdue Pharma and their mid-1990s marketing campaign for OxyContin.  By all accounts, OxyContin has generated roughly $35 billion in revenue for Purdue, but has also been associated with hundreds of thousands of deaths.

According to Keefe’s article, Purdue reportedly funded the research and paid doctors to discuss OxyContin favorably by saying that concerns about opioid addiction were overblown, and that OxyContin could be used to safely treat a wide range of pain types and levels.

As further confirmation of this claim, in October 2017, Joe Rannazzisi, an ex-DEA agent, stepped forward as a whistleblower, informing CBS News correspondent Bill Whitaker in a segment for “60 Minutes” that the current opioid crisis in the United States has been fueled in large part by the pharmaceutical industry, which has been aided and abetted (sometimes unwittingly) by the U.S. Congress.

Sources

The Family That Built an Empire of Pain. Patrick Radden Keefe. The New Yorker, October 2017.
https://www.newyorker.com/magazine/2017/10/30/the-family-that-built-an-empire-of-pain

Ex-DEA agent: Opioid crisis fueled by drug industry and Congress. Bill Whitaker. CBS News, 60 Minutes, October 2017. https://www.cbsnews.com/news/ex-dea-agent-opioid-crisis-fueled-by-drug-industry-and-congress/

Oxycodone vs. OxyContin. Healthline, 2016. https://www.healthline.com/health/pain-relief/oxycodone-vs-oxycontin#overview1

Narcotic Analgesics. Drugs.com, 2016.
https://www.drugs.com/drug-class/narcotic-analgesics.html

You Want a Description of Hell? OxyContin’s 12-Hour Problem. A Times Investigation. Harriet Ryan, Lisa Girion, Scott Glover. The Los Angeles Times, May 2016. http://www.latimes.com/projects/oxycontin-part1/

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