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History of Drugs: OxyContin

OxyContin is the brand name for the drug oxycodone and is an opioid (man-made narcotic) that is derived from the poppy flower. So, basically, a man-made version of heroin. It is a narcotic analgesic used to treat moderate to severe pain.

History of Oxycodone

Oxycodone was first synthesized in 1916 at the University of Frankfurt in Germany, a few years after the German pharmaceutical company Bayer had stopped making heroin for the treatment of pain, due to harmful and problematic use and dependence. The idea was that this new drug would retain the pain-killing effects of morphine and heroin but with less dependence. To some extent this was achieved, as oxycodone does not have the same “rush” of an immediate ‘high’ that heroin or morphine does.

The first clinical use of oxycodone was documented in 1917, the year after it was first developed. It was first introduced to the US market in May 1939. In the early 1960s the United States government classified oxycodone as a schedule II drug.

In 1995, the Federal Drug Administration approved the manufacture of OxyContin, a time-release version of oxycodone. When the drug was released, concerns and reports of illicit use and abuse began to increase exponentially. Before the release of OxyContin, all formulations of oxycodone contained an NSAID, which limited its potential for abuse. The NSAID component of the drugs also restricted the routes of administration to oral ingestion. When OxyContin was released, abusers realized that they could crush the pill to release pure oxycodone (up to 80mg in one pill), which allowed larger doses and by additional routes of administrations such as intravenous and intranasal. Due to the widespread abuse, especially in rural areas, OxyContin came to be known as “Hillbilly Heroin,” and reports of its abuse flooded the media.

The nickname “hillbilly heroin” came about because the rural counties of Appalachia were the first to get eaten alive by pill addiction. This was not a coincidence. For years,  coal miners relied on medication just to keep their bodies on the job.  Even after the mines dried up, the pro-pill culture was already decades old. Purdue aggressively marketed OxyContin to doctors in regions where the economy  ran on manual laborers.
The drug quickly spread to Florida, well-known for having some of the most lax prescription laws in the U.S. Shady pain management operations, or “pill mills” began popping up all over the state, and users began travelling to Florida en-masse to get prescriptions.

In 2004, Purdue Pharma, the manufacturer of Oxycontin, settled a case filed by the attorney general of West Virginia. The suit charged them with misleading and overly aggressive marketing of Oxycontin in the state. In addition to challenging Purdue’s marketing, the suit had accused Purdue of purposely hiding from doctors the extent to which OxyContin’s morphine like qualities could lead to addiction. The settlement involves a $10 million sum paid over a four-year period to drug abuse and education programs in West Virginia.

Perdue was brought up on federal charges in 2007 and ended up paying one of the largest penalties ever paid by a drug company in such a case- $634.5 million dollars. Perdue pled guilty to criminal charges that it had misled doctors and patients when it claimed the drug was less likely to be abused than traditional narcotics.

In 2011, to try to curb abuse of the drug, manufacturers added additional binders to the formulation to prevent the grinding of tablets for insufflation or injection, and to maintain OxyContin’s extended release characteristics. The added binders greatly reduced the recreational value of OxyContin, because they were not easily broken down. Also, the bad press caused many doctors to stop prescribing it. Big Pharma responded to the decrease in OxyContin use with the release of Roxicodone (short-acting, immediate release form of oxycodone) and an even newer and more powerful prescription narcotic: Opana. Officials are unable to pass legislation quickly enough to stem the tide of doctors writing illegitimate prescriptions and prescription drug manufacturers releasing new kinds of narcotic pain medication.

Statistics

The International Narcotics Control Board estimated 11.5 tons (23,000 lbs) of oxycodone were manufactured worldwide in 1998 and, by 2007, this figure had grown to 75.2 tons (150,400 lbs). United States accounted for 82% of use in 2007 at 51.6 tons. To give you an idea of how outrageous this statistic is, consider this: Canada, France, Australia, and Germany combined accounted for 13% of oxycodone use in 2007. According to the International Narcotics Control Board, the all-time high of oxycodone consumption was in 2009 at 135.9 tons. There was a decrease the following year with 122.5 tons of oxycodone being manufactured.

OxyContin and the U.S.

In the United States, more than 12 million people abuse painkillers. In 2010, there were 16,652 deaths that were directly related to overdose on narcotic painkillers such as OxyContin. In September 2013, the FDA made new labeling guidelines for long acting and extended release opioids requiring manufacturers to remove the term “moderate pain” as an indication for prescribing, instead stating the drug is for “pain severe enough to require daily, around-the-clock, long term opioid treatment.” However, this updated labeling doesn’t restrict doctors from prescribing OxyContin for moderate, as needed.

According to the US Department of Health and Human Services, about 11 million people in the U.S. will OxyContin or oxycodone recreationally. In the U.S., about 100,000 men or women per year are admitted to the hospital as a cause of misuse of this powerful painkiller, making it the most widely abused drug in America. In 2008, oxycodone misuse caused 14,800 deaths. If you or someone you love is struggling with painkiller substance abuse or painkiller addiction, or any other addiction, please call toll-free 1-800-951-6135.

 

 

 

 

 

 

 

Sources:

http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/AnestheticAndLifeSupportDrugsAdvisoryCommittee/UCM248776.pdf

http://www.cdc.gov/homeandrecreationalsafety/overdose/facts.html

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