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PostPosted: October 23 17, 10:13 am 
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The Family That Built an Empire of Pain
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While the Sacklers are interviewed regularly on the subject of their generosity, they almost never speak publicly about the family business, Purdue Pharma—a privately held company, based in Stamford, Connecticut, that developed the prescription painkiller OxyContin. Upon its release, in 1995, OxyContin was hailed as a medical breakthrough, a long-lasting narcotic that could help patients suffering from moderate to severe pain. The drug became a blockbuster, and has reportedly generated some thirty-five billion dollars in revenue for Purdue.

But OxyContin is a controversial drug. Its sole active ingredient is oxycodone, a chemical cousin of heroin which is up to twice as powerful as morphine. In the past, doctors had been reluctant to prescribe strong opioids—as synthetic drugs derived from opium are known—except for acute cancer pain and end-of-life palliative care, because of a long-standing, and well-founded, fear about the addictive properties of these drugs. “Few drugs are as dangerous as the opioids,” David Kessler, the former commissioner of the Food and Drug Administration, told me.

Purdue launched OxyContin with a marketing campaign that attempted to counter this attitude and change the prescribing habits of doctors. The company funded research and paid doctors to make the case that concerns about opioid addiction were overblown, and that OxyContin could safely treat an ever-wider range of maladies. Sales representatives marketed OxyContin as a product “to start with and to stay with.” Millions of patients found the drug to be a vital salve for excruciating pain. But many others grew so hooked on it that, between doses, they experienced debilitating withdrawal.

Since 1999, two hundred thousand Americans have died from overdoses related to OxyContin and other prescription opioids. Many addicts, finding prescription painkillers too expensive or too difficult to obtain, have turned to heroin. According to the American Society of Addiction Medicine, four out of five people who try heroin today started with prescription painkillers. The most recent figures from the Centers for Disease Control and Prevention suggest that a hundred and forty-five Americans now die every day from opioid overdoses.

Andrew Kolodny, the co-director of the Opioid Policy Research Collaborative, at Brandeis University, has worked with hundreds of patients addicted to opioids. He told me that, though many fatal overdoses have resulted from opioids other than OxyContin, the crisis was initially precipitated by a shift in the culture of prescribing—a shift carefully engineered by Purdue. “If you look at the prescribing trends for all the different opioids, it’s in 1996 that prescribing really takes off,” Kolodny said. “It’s not a coincidence. That was the year Purdue launched a multifaceted campaign that misinformed the medical community about the risks.” When I asked Kolodny how much of the blame Purdue bears for the current public-health crisis, he responded, “The lion’s share.”


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PostPosted: October 23 17, 10:19 am 
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In Paramedic school (1995), had an ER physician as guest instructor who said that pain was the most under treated disease today. It’s fascin to me that this was just prior to the introduction of OxyContin etc. Had the propaganda $$$ machine already started up?


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PostPosted: October 23 17, 10:28 am 
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lukethedrifter wrote:
In Paramedic school (1995), had an ER physician as guest instructor who said that pain was the most under treated disease today. It’s fascin to me that this was just prior to the introduction of OxyContin etc. Had the propaganda $$$ machine already started up?

what was the most common drug for pain prior to this?


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PostPosted: October 23 17, 11:27 am 
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Freed Roger wrote:
lukethedrifter wrote:
In Paramedic school (1995), had an ER physician as guest instructor who said that pain was the most under treated disease today. It’s fascin to me that this was just prior to the introduction of OxyContin etc. Had the propaganda $$$ machine already started up?

what was the most common drug for pain prior to this?

Alcohol. Probably still is.


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PostPosted: October 23 17, 11:48 am 
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Joe Shlabotnik wrote:
Freed Roger wrote:
lukethedrifter wrote:
In Paramedic school (1995), had an ER physician as guest instructor who said that pain was the most under treated disease today. It’s fascin to me that this was just prior to the introduction of OxyContin etc. Had the propaganda $$$ machine already started up?

what was the most common drug for pain prior to this?

Alcohol. Probably still is.

in 1990 - after surgery etc, what did people get after surgery etc.


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PostPosted: October 23 17, 11:56 am 
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Freed Roger wrote:
Joe Shlabotnik wrote:
Freed Roger wrote:
lukethedrifter wrote:
In Paramedic school (1995), had an ER physician as guest instructor who said that pain was the most under treated disease today. It’s fascin to me that this was just prior to the introduction of OxyContin etc. Had the propaganda $$$ machine already started up?

what was the most common drug for pain prior to this?

Alcohol. Probably still is.

in 1990 - after surgery etc, what did people get after surgery etc.


Probably hydrocodone which was approved by the FDA in 1943. Vicodin came out in 1978, which is hydrocodone and acetaminophen. I think OxyContin is just stronger, but they're not dissimilar.


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PostPosted: October 23 17, 12:01 pm 
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This hits home for me.

My mom was diagnosed with Lupus around 1996. The only thing that kept it under control was prednisone. This led to a major deterioration of her overall health, including bone density. They would try to take her off of it and her body would start attacking her skin again, leaving her with huge open sores and skin so thin she couldn't apply regular bandages because the adhesive would take her skin off. So back on prednisone she would go. Then came the vertebrae fractures. Sometimes just from sneezing thanks to how much bone mass she had lost. She also fell and broke her hip. So onto oxy she went. It helped of course. But it also turned her into an addict. They'd try to ween her off of the oxy and she would spiral. Eventually they had her on some sort of pain cocktail that I have no idea what was in it, but I remember her being upset because part of the pain doctor's solution was methadone, which is what they give heroin addicts. She didn't understand that that's basically what she was.

It was an awful downward spiral. The combination of prednisone and oxy might have been as bad or worse for her as the disease itself. The last 8 years of her life were pretty miserable. She made it long enough to hold her first grandchild, but she was a shell of herself by then, and was also angry that she wasn't healthy enough to really enjoy being a grandma. She wanted to babysit for us, and we had to tell her she couldn't. That broke my heart.


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PostPosted: October 23 17, 12:13 pm 
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Suboxone and Methadone are life changers. I've seen this both on a professional and personal level. There are many culprits to the opioid epidemic and IMO the answers lie within alternative medicines, less prisons and more treatment centers.

Also tying patient satisfaction surveys to doctor's pay doesn't help either.


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PostPosted: October 23 17, 12:27 pm 
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Tim wrote:
Suboxone and Methadone are life changers. I've seen this both on a professional and personal level. There are many culprits to the opioid epidemic and IMO the answers lie within alternative medicines, less prisons and more treatment centers.

Also tying patient satisfaction surveys to doctor's pay doesn't help either.


well said.
Also treating pain with the understanding that pain exists for a reason.


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PostPosted: October 23 17, 1:24 pm 
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lukethedrifter wrote:
Tim wrote:
Suboxone and Methadone are life changers. I've seen this both on a professional and personal level. There are many culprits to the opioid epidemic and IMO the answers lie within alternative medicines, less prisons and more treatment centers.

Also tying patient satisfaction surveys to doctor's pay doesn't help either.


well said.
Also treating pain with the understanding that pain exists for a reason.

Definitely.


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