Did drug maker fuel abuse by insisting that OxyContin works for 12 hours?

oxycontinOxyContin in two decades not only has become a highly profitable, exceedingly popular prescription, it also has become one of the nation’s most abused painkillers─for a crucial reason, the Los Angeles Times says. The paper investigated and found that the drug’s maker wrongly has promoted the medication as having a 12-hour effectiveness─twice that of generic medications.

That isn’t so. It wears off for many much sooner, leaving them with intense cravings and excruciating withdrawal symptoms. This leads to addictive abuse of the drug, the paper says.  The Times reports:

More than half of long-term OxyContin users are on doses that public health officials consider dangerously high. … Over the last 20 years, more than 7 million Americans have abused OxyContin, [which] is widely blamed for setting off the nation’s prescription opioid epidemic, which has claimed more than 190,000 lives from overdoses involving OxyContin and other painkillers since 1999.

The paper’s investigation details the havoc that addiction has wreaked on OxyContin users and their families, as well as the maker’s history of protecting its drug’s market by actions the Times says have been harmful to millions. For example, the manufacturer stubbornly sticks to the med’s reputed 12-hour potency, but also advises physicians to give out ever more powerful dosages if its effects don’t last for patients.

It’s worth noting that the civil justice system─and not regulators nor health care professionals─have played a critical role for advocates seeking to address the problems with OxyContin. Lawsuits have helped pry open company records and testimony by important parties about this much-abused medication.

Mandatory MD training

I’ve written before about the many steps needed to deal with the nation’s epidemic of prescription drug abuse, including the complexities of treating pain and federal regulators crackdown on the super abundance of prescriptions for opioid meds.

But like many, I guess was surprised, even a little, by doctors’ recent, expressed resistance to a federal Food and Drug Administration proposal to require them to undergo training to avert abuse of opioid and other prescription pain killers.

The New York Times has noted that the American Medical Association opposes this training, saying not all physicians prescribe these powerful drugs and it is professionally intrusive for the government to mandate it. The Wall Street Journal has reported that, despite the steep resistance and after two days of hearings, an FDA advisory panel has recommended the program. It is up to the FDA now to act. With as many as 17,000 Americans dying from prescription drug abuse, it must.

Hoosiers, hopeless, with HIV and opioid addiction

Meantime, for those who want an up-close view about desperate health conditions in the Midwest, the Atlantic has posted a wrenching story about Austin, Indiana. It’s a tiny town that has been ravaged by not only an epidemic of prescription painkiller abuse but also what is described as “the single largest outbreak in U.S. history” of HIV-AIDS.

Austin, population 4,100, has as many as 500 residents who shoot up drugs, especially opioids; in 2015, it went from having three incidences annually to 180 confirmed cases of HIV infection.

While Austin is hollowing out, economically and in spirit, its comparable neighbor is doing just fine, the author notes. He reports on what he terms the syndemic─the synergistic intertwining of ills, social, economic, and health─that has felled the small town. Public policy experts increasingly are examining how not just medical care but the provision of a range of social services affects Americans’ health and well-being.

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