The Annals of OxyContin
Purdue Pharma has humble origins: In 1952, Arthur, Mortimer and Raymond Sackler purchased the company, which was then a small, struggling drug manufacturer based in New York. For years, the company’s major products were laxatives and earwax remover. These drugs became a mere footnote in the annals of Purdue Pharma when the Sackler brothers discovered the market for pain medications. The Purdue Pharma hegemony began when they took an old drug—oxycodone—and developed a mechanism to slow its release in the body. Thus, OxyContin was born.
By rights, OxyContin should have been just a footnote in the annals of prescription drugs. It was a drug that did not satisfy an obvious need. By the time it was released in 1996, multiple opiate drugs were already on the market. In 2001, five years after its release, the Medical Letter on Drugs and Therapeutics noted that OxyContin was no better than any of the other narcotics on the market when dosed at equivalent levels.14 Subsequent studies of chronic back pain and cancer-related pain demonstrated the only advantage OxyContin had over the competition was dosing convenience.15 The safety and efficacy of OxyContin were essentially indistinguishable from immediate-release oxycodone, when taken four times daily.16
Despite these relatively unimpressive observations, the sale of OxyContin has generated over $35 billion since its initial release. This one drug is almost solely responsible for the profits generated by Purdue Pharma. Purdue Pharma may be a one-trick pony, but it’s an addictive trick.
The odds of dying of an opiate overdose in the U.S. are now higher than the odds of dying in a car accident.
Of course, the company has had help. From us. From 1996 to 2001, Purdue Pharma recruited more than 5,000 physicians, nurses and pharmacists to its national speaker bureau. For every sales representative hired by Purdue Pharma, the company recruited 10 healthcare professionals to help change prescribing practices across the country. If you remember learning in medical school that narcotics were not addictive when used to manage acute pain, or that no patient should ever experience pain, then you were probably taught by someone who was influenced by the Purdue Pharma speaker bureau.
This story does not stop at the water’s edge. On May 3, 2017, 12 members of the House of Representatives urged the World Health Organization to work to prevent Mundipharma, the international arm of Purdue Pharma, from introducing OxyContin worldwide. In an open letter, they wrote:
The international health community has a rare opportunity to see the future. Though the rate of opioid use disorder remains relatively low outside of the U.S., that can change rapidly. The rate is likely to rise if events follow the same pattern [as] in the U.S., starting with the irresponsible—and potentially criminal—marketing of prescription opioids. … We urge the WHO to learn from our experience and rein in this reckless and dangerous behavior while there is still time. Do not allow Purdue to walk away from the tragedy they have inflicted on countless American families simply to find new markets and new victims elsewhere.17
