In a June 24 editorial the Bangor Daily News expressed disappointment that efforts to make a more resistant alternative to OxyContin tablets would take longer than previously hoped. The manufacturer of OxyContin, Purdue Pharma, shares that disappointment. However, the experience of the last few years has taught us that there is no single or simple solution to the problem of prescription drug abuse.
As its top research priority, Purdue already has committed millions of dollars to find a formulation that will provide safe and effective pain relief to the millions who need it while being unattractive to abusers. This is a complex and difficult process for which there is no safe shortcut. Unfortunately, clinical studies showed that the abuse resistant formulation, which the Company hoped to introduce in 2003, might actually interfere with the medicine’s ability to relieve pain in legitimate patients. Obviously, this was unacceptable to both the federal Food and Drug Administration and Purdue. Purdue’s research scientists will continue to pursue this important goal.
However, those who think that an abuse-resistant version of OxyContin will solve the prescription drug abuse problem in Maine are missing the larger picture. The state’s current experience with rising overdose deaths from methadone, another frequently used prescription drug, shows that when abusers cannot get a particular drug they turn to other substances. In fact, although OxyContin has received all the publicity, methadone has been the leading cause of drug overdose deaths in Maine for the last three years. Other frequently abused prescription drugs in Maine include Dilaudid, Fentanyl, oxycodone, morphine and hydrocodone (Vicodin). Therefore, an abuse resistant OxyContin might alleviate Purdue’s problems, but it would do little to solve Maine’s problem of prescription drug abuse.
As U.S. Attorney for Maine (1993-2001), I spent much of my last two years trying to reduce prescription drug abuse. I met with Purdue executives who shared my concern about the abuse of OxyContin and shortly thereafter the Company implemented a ten point program to reduce prescription drug abuse which included: distributing free tamper-resistant prescription pads to Maine doctors; educating Maine doctors and pharmacists about how to spot drug seekers; marking tablets sold in Canada to help identify and curb cross-border smuggling; stopping distribution of the 160-milligram tablet because of the overdose danger to abusers; funding community drug abuse coalitions; and creating unique prevention education materials for middle school students in Maine schools. Recently, Purdue funded a study of prescription drug abuse in Maine through Yale University. This should yield valuable information on drug abuse and could lead to more effective prevention efforts. After I returned to private law practice, Purdue asked me to continue to work with them to reduce the abuse of OxyContin.
The prescription drug abuse problem in Maine will not just go away. It is going to require a commitment by the state’s political leaders to fund and implement a comprehensive statewide approach that includes prevention education, substance abuse treatment, additional law enforcement, and programs like computerized prescription monitoring and the electronic transcription of prescriptions which will stop drug seekers from getting the same pain prescription from several doctors. Failure by the state to make this commitment will result in an ever-escalating population of addicted opiate users.
Jay McCloskey, former U.S. Attorney for Maine, is a consultant for Purdue Pharma of Stamford, Conn.
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