"I gave so many lectures to primary-care audiences . . . and would cite six, seven, maybe 10 different avenues of thought or avenues of evidence, none of which represented real evidence. And yet, what I was trying to do was to create a narrative so that the primary-care audience would look at this information in toto in a way they hadn't before and feel more comfortable prescribing opioids," Portenoy said in the video. "In essence, this was education to de-stigmatize. And because the primary goal was to de-stigmatize, we often left evidence behind."

The deceptions worked. Ballantyne admits she was swayed. Asked if Purdue's marketing of Oxy changed the way she thought about the drug when she first prescribed it, she said, "Absolutely."

FEAT_Oxy_Bottle_TR2

HOOKED

Within just a few years after its release on the market, it was becoming increasingly clear that Oxy was not the pain panacea Purdue claimed it was. Rather than getting better, Ballantyne said her patients were largely getting worse.

"I began seeing patients, and I had been taught that they would do better [with opioids], and they were doing really badly," Ballantyne said. "They weren't getting good pain relief, and there were a lot of behavioral problems."

OxyContin was initially approved only for relatively low doses of 10, 20, and 40 milligrams a pop, but a year after Purdue won its initial approval, the FDA approved an 80-milligram dose. Four years later in 2000, the FDA approved a whopping 160-milligram pill for "opioid-tolerant patients."

Part of Purdue's pitch for Oxy was that the pill would release little doses of the medication over time, blunting the full effect of the drug. But the medication's own label offered a handy guide to getting around that: "OxyContin tablets are to be swallowed whole, and are not to be broken, chewed, or crushed. Swallowing broken, chewed, or crushed OxyContin tablets could lead to the rapid release and absorption of a potentially toxic dose of oxycodone."

The FDA would comment later that the warning label may have "alerted abusers to a method for misuse."

By this time, reports were beginning to come in from Maine, Kentucky, Virginia, West Virginia, Pennsylvania, and Ohio that people were doing just as the label suggested: crushing the drug, swallowing, snorting, and injecting it for a quick, powerful high. Law-enforcement agencies, public-health departments, and physicians were also beginning to see addicts who had not been prescribed the drug — but had become addicted after first receiving a pill through a friend, parent, or relative. Pill addicts were flooding treatment centers, ERs, and morgues.

By March 2001, the FDA formed a response team and compelled Purdue to make minor changes to their warning label. But less than a year after the FDA began studying the growing epidemic, the agency concluded that "opioid analgesics are an essential component of pain management," and "any [risk-management program] that restricts opioid treatment may prevent their appropriate utilization."

Yet some doctors, like Ballantyne, began to worry about how Oxy was affecting their patients. She wrote a paper in 2003, arguing for limits on dosages and encouraging doctors to prescribe responsibly.

In Ballantyne's study, which appeared in the New England Journal of Medicine, Ballantyne and her colleagues exhaustively reviewed the results from Oxy's clinical trials. They didn't find any evidence to support Purdue's claim that Oxy is not addictive.

< prev  1  |  2  |  3  |  4  |  5  |  6  |   next >
Related: Photos: MassCann's 2010 Freedom Rally, Deval's Green Blues, Deval Patrick is on a second-term winning streak, and casinos might be the next payoff, More more >
  Topics: News Features , Massachusetts, Drug Addiction, Purdue,  More more >
| More


Most Popular
ARTICLES BY ERIN BALDASSARI
Share this entry with Delicious
  •   PRESCRIPTION OPIOIDS HAVE WREAKED HAVOC ON THE BAY STATE. FOR BIG PHARMA, THAT’S FANTASTIC NEWS.  |  October 23, 2012
    First there's the pain. Then comes a prescription for an opioid: OxyContin, Tylox, Percocet, Roxicodone, among others. But what often follows is a vicious cycle of tolerance, increased dosages, abuse, and addiction.
  •   BOSTON'S RAP CLASS OF 2011  |  September 29, 2011
    The announcement of  last year's Rap Class  rang so loudly that we had to step back in the arena and cause more noise.
  •   DOMO ARIGATO  |  May 02, 2011
    When Czech playwright Karel Capek first used the word "robot" nearly a century ago, it was to describe a coldly calculating machine, evil in its perfection and scornful of human frailty. And so began our fascination with the possibility of humanoid machines designed to be our underlings but destined to be our overlords.
  •   PHOTOS: SCENES FROM THE RALLY TO RESTORE SANITY  |  November 01, 2010
    With nary a pair of be-skidmarked Betsy Ross boxer shorts in sight.
  •   PHOTOS: CURREN$Y AT MIDDLE EAST DOWNSTAIRS  |  October 14, 2010
    Curren$y takes the Smoker's Club Tour to the Middle East Downstairs, along with Big K.R.I.T., Smoke DZA, and others on October 4, 2010.

 See all articles by: ERIN BALDASSARI