Sunday Long Read: The Perfect Drug

America's long opioid abuse crisis continues, and no drug is more responsible for the abuse of prescription painkillers the way Oxycontin is.  A new major LA Times investigation into the company that developed it, Purdue Pharma, is a frightening look at to what lengths Big Pharma will go to when it knew it had a $20 billion drug on its hands.

Over the last 20 years, more than 7 million Americans have abused OxyContin, according to the federal government’s National Survey on Drug Use and Health. The drug is widely blamed for setting off the nation’s prescription opioid epidemic, which has claimed more than 190,000 lives from overdoses involving OxyContin and other painkillers since 1999.

The internal Purdue documents reviewed by The Times come from court cases and government investigations and include many records sealed by the courts. They span three decades, from the conception of OxyContin in the mid-1980s to 2011, and include emails, memos, meeting minutes and sales reports, as well as sworn testimony by executives, sales reps and other employees. 

The documents provide a detailed picture of the development and marketing of OxyContin, how Purdue executives responded to complaints that its effects wearoff early, and their fears about the financial impact of any departure from 12-hour dosing.
Reporters also examined Food and Drug Administration records, Patent Office files and medical journal articles, and interviewed experts in pain treatment, addiction medicine and pharmacology. 

Experts said that when there are gaps in the effect of a narcotic like OxyContin, patients can suffer body aches, nausea, anxiety and other symptoms of withdrawal. When the agony is relieved by the next dose, it creates a cycle of pain and euphoria that fosters addiction, they said. 

OxyContin taken at 12-hour intervals could be “the perfect recipe for addiction,” said Theodore J. Cicero, a neuropharmacologist at the Washington University School of Medicine in St. Louis and a leading researcher on how opioids affect the brain. 

Patients in whom the drug doesn’t last 12 hours can suffer both a return of their underlying pain and “the beginning stages of acute withdrawal,” Cicero said. “That becomes a very powerful motivator for people to take more drugs.”

The bottom line is that Oxycontin was designed to addict patients, to hook them and reel them in and line Purdue's pockets with billions of dollars.  They knew full well that the drug wore off sooner than 12 hours and left patients in crippling pain and suffering from withdrawal symptoms, and millions were turned into addicts because of it.  They pushed this poison on to doctors and patients to deal with chronic pain of all types and counted the cash rolling in.

So yeah, don't tell me that the bad guys are street corner pushers and small-time hustlers when Big Pharma is the biggest drug kingpin of them all.