Addiction to OxyContin is rare for those who use the drug as recommended, however, due to pharmacy break-ins, growing levels of recreational use, and increased media reports of Oxycontin abuse, the DEA heavily regulates prescriptions. Some pharmacies now no longer stock the drug and many doctors are afraid to prescribe OxyContin and other legitimate pain medications out of fear of government sanctions. This stigmatizes patients in need of pain medication and makes it more difficult for them to obtain relief.

OxyContin is a medically prescribed pill that contains Oxycodone, a synthetic opioid with analgesic properties similar to opium-derived painkillers like morphine or codeine. OxyContin is a Schedule II drug under the Controlled Substances Act (CSA), which includes legal drugs that are subject to the maximum amount of government control and regulation. The FDA approved OxyContin in 1995 and Purdue Pharma introduced the drug in 1996.

In 2001, OxyContin was the number one opioid painkiller sold and in 2000 over 6.5 million prescriptions were written. OxyContin is prescribed for patients with moderate or severe pain who need extended relief from treatment of terminal cancer and severe injuries. The time-release, long lasting formula was designed to deter abuse, yet this safety mechanism may be defeated by crushing, snorting, chewing or injecting the drug to obtain a heroin-like high.

OxyContin Abuse

A small fraction of OxyContin users abuse the drug. Nicknamed "hillbilly heroin", the first known reports of OxyContin abuse were in rural areas with common characteristics such as job scarcity and high unemployment, isolation, and a large elderly and disabled population. However, abuse of the drug has since spread.

The states with the highest abuse rates are West Virginia, Pennsylvania, Kentucky and Virginia. According to the 2001 National Household Survey on Drug Abuse, 975,000 persons were reported using OxyContin for nonmedical use. Abuse and potential abuse of the drug, especially among young people, has raised great concern. Another national survey reported that 1% of 8th graders, 3% of 10th graders and 4% of 12 graders had used the drug recreationally. The estimated street value of one 40-milligram OxyContin pill is about $40.

Drug Enforcement Agency (DEA) officials say that the drug may have played a role in 464 overdose deaths from the years 2000 and 2001. Most OxyContin deaths are the result of first-time, large dose illicit use.

Measures to Stop Abuse

The DEA is primarily concerned with over-prescription of OxyContin and has established a pilot program to monitor how OxyContin is prescribed. Local law enforcement has also been asked to combat the illegal use of OxyContin. Furthermore, FDA officials are reviewing the prescription drug review process for potential abuse.

Purdue Pharma has agreed to work with these government agencies to curb OxyContin abuse, research a new patent formula that would not produce the OxyContin "high", and has created their own anti-abuse program. The manufacturer has revised a warning label on the drug’s packaging calling attention to abuse and misuse, and describing who should and should not take the medication. Purdue educates their sales teams, creates public service announcements geared toward teens in heavy abuse areas, provides tamper resistant prescription pads to physicians in trouble areas, and recommends arresting doctors and pharmacists who facilitate abuse.

The Need for Pain Management

Natural opiate and synthetic derivatives have been lauded as excellent painkillers, while at the same time criticized as highly addictive substances. Over the last two decades, the medical community has been more attentive to pain and pain management. As a result, the use of opioid medicine has increased, especially among cancer patients who were previously under treated.

According to the American Medical Association (AMA) and the National Institutes of Health (NIH), approximately 17 million Americans suffer from unyielding pain. A 1997 report by the AMA stated that a major problem in American medicine was inadequate treatment of pain. In addition, The American Pain Foundation estimates that 50 million U.S. citizens suffer from significant pain daily.

While studies show millions are under-treated and suffering needlessly, OxyContin bridges the gap between pain management and potential addiction. The rise of OxyContin use, according to Dr. Russel Portenoy, chairman of pain medicine and palliative care at Beth Israel Medical Center in New York City, is attributed to four significant changes: attitudes about pain among the medical community; studies that show lower back pain, chronic headaches, and neuropathic pain could benefit from opioid therapy; the ease and long term benefits OxyContin offered; and the marketing effort of Purdue Pharma to advertise an opioid pill to general practitioners.

Critics say that Purdue aggressively marketed OxyContin to doctors who were unaware of addiction potential or unfamiliar with opioid therapy. Purdue maintains that their marketing campaign targeted doctors who were previously prescribing narcotic painkillers, and that sales reps did address how to spot potential abusers.

What to Do?

The National Foundation for the Treatment of Pain has concluded that OxyContin abuse is a minor problem compared to the millions of untreated, under treated, mistreated, and abandoned patients. The FDA has stated that, "Although abuse, misuse, and diversion are potential problems for all opioids, including OxyContin, opioids are a very important part of the medical armamentarium for the management of pain when used appropriately under the careful supervision of a physician." The agencies will "help to ensure that these important drugs remain available to appropriate patients."

OxyContin patients should not be stigmatized for the abuse of some and pharmacists and doctors should not be unfairly punished for legitimate distribution of OxyContin. The medical community should provide safe and effective delivery methods of the drug. Aggressive law enforcement actions contribute to the lack of treatment. Patients should have easy, direct access to the relief of their pain.

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