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Right. The core problem with Oxycontin wasn't that it was an opiate: it was that Purdue sold it as an opiate that resisted addiction. This meant doctors prescri

Right. The core problem with Oxycontin wasn't that it was an opiate: it was that Purdue sold it as an opiate that resisted addiction. This meant doctors prescribed it more readily and were less concerned about monitoring patients afterwards.

samatman 7y ago
This wasn't the first opiate which was touted to be less addictive than morphine. That would be heroin. Our institutional memory is woefully short.
refurb 7y ago
“Resisted addiction”? Do you have a source for that? My understanding is the FDA would never let the say that. My understanding is that they said opioid addiction (in general) was a relatively minor problem and it shouldn’t stop doctors from prescribing them.
- FussyZeus 7y ago
  I said they sold it as that, not that it was that and that was the source of the issue. “Delayed absorption as provided by OxyContin tablets, is believed to reduce the abuse liability of a drug.” That's what the FDA allowed them to publish. Possibly the most dangerous single sentence in the history of medicines.
  - refurb 7y ago
    Ahhh, that makes sense. It is actually true though. Delayed release would be expected to reduce abuse liability. That doesn’t mean OxyContin is not addictive, it just means it’s expected to be less addictive than immediate release oxycodone.
    - jdblair 7y ago
      People figured out pretty quickly that if you crush the pills, you absorb the oxycodone quickly. It was the coating that delayed absorption.
      - FDSGSG 7y ago
        Are there any slow release drugs that you can't do this with? Shouldn't this be obvious to the doctors?
        FussyZeus 7y ago
        As a general rule Doctors trust the documentation given to them by the pharmaceutical companies, which in turn is approved after several rounds with the FDA, so one would think that the documentation would be pretty reliable. The source of the issue really is just how hard Purdue was fudging their data. And I mean, you can say that a drug company shouldn't be the sole tester of it's own drugs and I'd agree with you, but good luck getting average people to want to pay for it by funding the FDA.
        FDSGSG 7y ago
        I wonder if it is normal for slow release drugs to come with warnings telling you that you can crush them up and abuse them?
      - refurb 7y ago
        This is true, so users were pretty quickly able to get around it. Although manufacturers have created a tamper proof version, but that just led users to move to heroin.
        FussyZeus 7y ago
        Yes and no. The first fault is that even the studies done by Purdue prior to release did not indicate anything close to the 1% addiction rate they advertised, it was more like 8-12%. The second, most Oxycontin users who aren't well off eventually move to heroin, because the effects are very similar, and the street price for Oxycontin is much higher. Ironically, where Marijuana was demonized for a nonexistent gateway property in the original war on drugs, Oxycontin was actually demonstrably a gateway drug for heroin. There's a very well researched episode of the podcast "Behind the Bastards" hosted by Robert Evans that drills down exactly into all of Purdue's dirty little secrets surrounding Oxycontin. Once you realized just how many numbers were fudged, how many studies fiddled with, it becomes clear just how much had to be made to go wrong in order for this epidemic to really kick off. It's quite damning.
- dillondoyle 7y ago
  the article submitted specifically address this and cites figures that Purdue marketed from one incredibly flimsy sentence to claim 1% addiction rates, when reality according to the article is 8-12%
  - refurb 7y ago
    Right. Purdue claimed opioids in general were less addictive, not that oxycodone itself was less addictive.
    - FussyZeus 7y ago
      No no, Purdue claimed that Oxycontin's time-release formula was believed to reduce it's addictiveness. Which yes, is a pretty logical follow through, but also you'd expect more rigorous proof than "we think it'll do that" for medicines.

samatman 7y ago

This wasn't the first opiate which was touted to be less addictive than morphine. That would be heroin. Our institutional memory is woefully short.

refurb 7y ago

“Resisted addiction”? Do you have a source for that? My understanding is the FDA would never let the say that. My understanding is that they said opioid addiction (in general) was a relatively minor problem and it shouldn’t stop doctors from prescribing them.

FussyZeus 7y ago
I said they sold it as that, not that it was that and that was the source of the issue. “Delayed absorption as provided by OxyContin tablets, is believed to reduce the abuse liability of a drug.” That's what the FDA allowed them to publish. Possibly the most dangerous single sentence in the history of medicines.
- refurb 7y ago
  Ahhh, that makes sense. It is actually true though. Delayed release would be expected to reduce abuse liability. That doesn’t mean OxyContin is not addictive, it just means it’s expected to be less addictive than immediate release oxycodone.
  - jdblair 7y ago
    People figured out pretty quickly that if you crush the pills, you absorb the oxycodone quickly. It was the coating that delayed absorption.
    - FDSGSG 7y ago
      Are there any slow release drugs that you can't do this with? Shouldn't this be obvious to the doctors?
      - FussyZeus 7y ago
        As a general rule Doctors trust the documentation given to them by the pharmaceutical companies, which in turn is approved after several rounds with the FDA, so one would think that the documentation would be pretty reliable. The source of the issue really is just how hard Purdue was fudging their data. And I mean, you can say that a drug company shouldn't be the sole tester of it's own drugs and I'd agree with you, but good luck getting average people to want to pay for it by funding the FDA.
        FDSGSG 7y ago
        I wonder if it is normal for slow release drugs to come with warnings telling you that you can crush them up and abuse them?
    - refurb 7y ago
      This is true, so users were pretty quickly able to get around it. Although manufacturers have created a tamper proof version, but that just led users to move to heroin.
      - FussyZeus 7y ago
        Yes and no. The first fault is that even the studies done by Purdue prior to release did not indicate anything close to the 1% addiction rate they advertised, it was more like 8-12%. The second, most Oxycontin users who aren't well off eventually move to heroin, because the effects are very similar, and the street price for Oxycontin is much higher. Ironically, where Marijuana was demonized for a nonexistent gateway property in the original war on drugs, Oxycontin was actually demonstrably a gateway drug for heroin. There's a very well researched episode of the podcast "Behind the Bastards" hosted by Robert Evans that drills down exactly into all of Purdue's dirty little secrets surrounding Oxycontin. Once you realized just how many numbers were fudged, how many studies fiddled with, it becomes clear just how much had to be made to go wrong in order for this epidemic to really kick off. It's quite damning.
dillondoyle 7y ago
the article submitted specifically address this and cites figures that Purdue marketed from one incredibly flimsy sentence to claim 1% addiction rates, when reality according to the article is 8-12%
- refurb 7y ago
  Right. Purdue claimed opioids in general were less addictive, not that oxycodone itself was less addictive.
  - FussyZeus 7y ago
    No no, Purdue claimed that Oxycontin's time-release formula was believed to reduce it's addictiveness. Which yes, is a pretty logical follow through, but also you'd expect more rigorous proof than "we think it'll do that" for medicines.