Reviewing OxyContin

A recent story in The New York Times shows the abuse of the narcotic painkiller OxyContin to be neither simply a Maine problem nor, perhaps, inevitable. As the state offers treatment to the growing number of those addicted, it should also review how this powerful drug was marketed to the medical community and whether new restrictions in marketing are required.

OxyContin, introduced in 1995 by Purdue Pharma of Connecticut, combines strong painkillers free of ingredients that in related drugs risk liver damage with a time-release formula. A major problem, as Maine has learned in the last couple of years, is that people who abuse this drug can do so easily by crushing it, circumventing the time-release formula. Addiction to OxyContin is now becoming a nationwide issue – it has been a factor in at least 120 deaths – and a reason cited by Maine Department of Mental Health, Mental Retardation and Substance Abuse Services for siting new treatment facilities in Bangor and Washington County.

Doctors and patients observe that, used properly, OxyContin is a valuable drug that can reduce chronic pain and allow people to lead much more active lives than otherwise possible. But the Times’ story suggests that OxyContin may have been marketed aggressively for short-term as well as chronic pain, greatly increasing the availability of the drug and that Purdue Pharma’s free trips and paid speaking engagements for doctors in an effort to get them to prescribe OxyContin could have made the problem worse.

Though OxyContin is well regulated, Maine officials should review how the drug has been marketed to doctors. It should find out what uses drug salespeople said were appropriate for OxyContin and how the giveaways affected sales. Maine should want to know whether and how Purdue amended its marketing once it became aware of the abuse of the drug and how the company might now contribute to reducing that abuse.

Nationwide, OxyContin sales have reached $1 billion. It now represents 80 percent of Purdue’s revenue, according to the news story. But no other prescription drug in the last 20 years, says an official at the Drug Enforcement Administration, has become so abused so quickly. Maine ranks second per capita in consumption of OxyContin, according to federal authorities, and Medicaid records for 1999 show that Washington County’s average cost per client for prescription pain relievers is the highest in the state.

Most of the property crimes there related to the need for cash to buy the drugs, law-enforcement officers say. Smuggling of the drug has increased to the extent that the United States is considering placing more customs agents along the Maine-New Brunswick border.

Maine needs a better understanding of why this has happened and what it can do to prevent something similar from occurring. It needs to review the origins of the abuse and addiction of this powerful painkiller.