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That's a reasonable point, although if they hadn't helped make doctors more comfortable with using them, then I may not have ever gotten them in the first place

That's a reasonable point, although if they hadn't helped make doctors more comfortable with using them, then I may not have ever gotten them in the first place as they would be stingy with them like they are now. Hard to know where I would have landed.

ethanbond 6y ago
“make doctors more comfortable with using them” is a bit of an understatement.
elipsey 6y ago
TL;DR: I think it is reasonable to blame Purdue for the reduced access to opioids we are now stuck with. Purdue caused more addiction to occur, which in turn caused reduced access to the opioids that existed prior to the creation of Purdue's nuisance product. Also, perverse incentives caused by the patent and licensing system motivated them to make OxyContin unnecessarily addictive in it's formulation and dosing schedule, in order to engage in patent "ever-greening" of an existing substance. Oxycodone has been around for a long time, but was doesed and administered more safely in older products. Purdue did some pretty perverse things to support their patent and regulatory rationale for OxyContin. To gain approval as a superior and patent-able alternative to the other extant gerneric hydrocodone and oxycodone products, it was claimed to require less frequent (but larger) doses. The result was that large numbers patients found that when taken as directed it provided superior pain relief, followed by a return of pain, in conjunction with hours of opioid withdrawals until the next dose. Early on in the product's life cycle doctors were encouraged to increase the dose but not the dosing schedule when patients complained, in part because the alternative would have undermined the rationale for the existence of the product. Although this was probably an undesired side effect from the point of view of Purdue, they could hardly have designed a better way to cause drug addiction. Millions of people took this product and many became addicted. Purdue went far out of their way to publicize people as criminals rather than address the fundamental problem with the way the product was administered. It seems to be evidenced that the more effective administration schedules of other already existing products cause less addiction, so at the margin, Purdue caused many more drug addicts to exists than would have otherwise. If they had not done this, or had been willing to adequately address the problems, we would probably still have easier access now to the opioids that already existed. The problem has grown to such a scale that it is now very hard to "put the genie back in the bottle."
- rhizome 6y ago
  I think it might be even worse than that, that everything they did rolled back pain care. Law enforcement was already on a moralizing crackdown on pain doctors in the 90s and 2000s, and any ground that was gained in justifying pain care in that context was then stomped on by Purdue. It's one thing if they burned their own bridges, but to burn the bridges of all of your customers is a new level in retail aggression. "If we aren't the ones to give it to you, you can't have it at all."
  - deleted 6y ago
    [deleted]
mtalantikite 6y ago
Did doctors not prescribe opioids for pain management before the Sacklers? My understanding was that they did but were hesitant, which considering the nature of opioids seems entirely reasonable. When I had routine surgery a few years back the doctor insisted I take a prescription for Oxy, even though I told him I was fine. I filled it at his insistence and within a couple days could feel my body building dependence and craving more. I switched to ibuprofen as it freaked me out to feel how strong it was. It seemed very irresponsible to prescribe Oxy for something as mild as my case. For debilitating chronic pain? For sure, these need to available. If anything Purdue pharma made this situation worse for those that actually need these drugs.
ponker 6y ago
The Sacklers lied to doctors and told them that OxyContin wasn’t addictive. They and their henchmen should be strapped to a gurney and sent off with a IV drip of OxyContin.

ethanbond 6y ago

“make doctors more comfortable with using them” is a bit of an understatement.

elipsey 6y ago

TL;DR: I think it is reasonable to blame Purdue for the reduced access to opioids we are now stuck with. Purdue caused more addiction to occur, which in turn caused reduced access to the opioids that existed prior to the creation of Purdue's nuisance product. Also, perverse incentives caused by the patent and licensing system motivated them to make OxyContin unnecessarily addictive in it's formulation and dosing schedule, in order to engage in patent "ever-greening" of an existing substance. Oxycodone has been around for a long time, but was doesed and administered more safely in older products. Purdue did some pretty perverse things to support their patent and regulatory rationale for OxyContin. To gain approval as a superior and patent-able alternative to the other extant gerneric hydrocodone and oxycodone products, it was claimed to require less frequent (but larger) doses. The result was that large numbers patients found that when taken as directed it provided superior pain relief, followed by a return of pain, in conjunction with hours of opioid withdrawals until the next dose. Early on in the product's life cycle doctors were encouraged to increase the dose but not the dosing schedule when patients complained, in part because the alternative would have undermined the rationale for the existence of the product. Although this was probably an undesired side effect from the point of view of Purdue, they could hardly have designed a better way to cause drug addiction. Millions of people took this product and many became addicted. Purdue went far out of their way to publicize people as criminals rather than address the fundamental problem with the way the product was administered. It seems to be evidenced that the more effective administration schedules of other already existing products cause less addiction, so at the margin, Purdue caused many more drug addicts to exists than would have otherwise. If they had not done this, or had been willing to adequately address the problems, we would probably still have easier access now to the opioids that already existed. The problem has grown to such a scale that it is now very hard to "put the genie back in the bottle."

rhizome 6y ago
I think it might be even worse than that, that everything they did rolled back pain care. Law enforcement was already on a moralizing crackdown on pain doctors in the 90s and 2000s, and any ground that was gained in justifying pain care in that context was then stomped on by Purdue. It's one thing if they burned their own bridges, but to burn the bridges of all of your customers is a new level in retail aggression. "If we aren't the ones to give it to you, you can't have it at all."
- deleted 6y ago
  [deleted]

mtalantikite 6y ago

Did doctors not prescribe opioids for pain management before the Sacklers? My understanding was that they did but were hesitant, which considering the nature of opioids seems entirely reasonable. When I had routine surgery a few years back the doctor insisted I take a prescription for Oxy, even though I told him I was fine. I filled it at his insistence and within a couple days could feel my body building dependence and craving more. I switched to ibuprofen as it freaked me out to feel how strong it was. It seemed very irresponsible to prescribe Oxy for something as mild as my case. For debilitating chronic pain? For sure, these need to available. If anything Purdue pharma made this situation worse for those that actually need these drugs.

ponker 6y ago

The Sacklers lied to doctors and told them that OxyContin wasn’t addictive. They and their henchmen should be strapped to a gurney and sent off with a IV drip of OxyContin.