| Millions of people suffer from untreated pain for a | | | | cancer patients treat their chronic pain, more |
| variety of illnesses and ailments. In fact, since 1986, | | | | prescriptions are being written to treat moderate to |
| the World Health Organization (WHO) has stated that | | | | severe non-cancer pain. The prescriptions for |
| inadequate treatment of cancer and non-cancer pain | | | | Oxycontin, particularly those to treat non-cancer pain, |
| is a serious public health concern. | | | | are growing rapidly, with nearly half of the |
| Therefore, in the face of this knowledge, the Food | | | | prescriptions being made by primary care physicians. |
| and Drug Administration (FDA) approved a new, | | | | According to the FDA, there is some concern that |
| controlled release pain reliever in 1995 called | | | | Oxycontin is being prescribed by physicians who are |
| Oxycontin. | | | | not properly trained in pain management. The FDA |
| Oxycontin (Oxycodone HCI controlled-release) is the | | | | has cited Purdue Pharmaceuticals twice for using |
| brand name of a drug that contains the opioid | | | | potentially false or misleading medical journal |
| Oxycodone, a very strong narcotic pain reliever with | | | | advertisements that violated the Federal Food, Drug |
| twice the potency of morphine. By 2001, Oxycontin | | | | and Cosmetic Act. As such, the FDA has taken |
| was the most widely prescribed brand name narcotic | | | | action against Purdue Pharmaceutical. Purdue's |
| pain medication, with sales exceeding $1 billion | | | | aggressive, and sometimes deceptive, advertising |
| annually. Originally prescribed to help treat the pain | | | | campaign promoting Oxycontin as a "general" pain |
| associated with cancer, Oxycontin was designed to | | | | reliever contributes to the cavalier attitude being |
| slowly release Oxycodone over time, allowing | | | | taken. These attitudes have led to wide spread |
| patients to use it twice daily and to retain steady | | | | abuse of this potent pain medication. Other factors |
| relief. | | | | that contribute to the wide abuse of Oxycontin |
| The opioid quality of Oxycontin works to relieve pain | | | | include: |
| by attaching to specific proteins called opioid | | | | * Availability of the drug: To those that need it and |
| receptors, which are found in the brain, spinal cord, | | | | to those that do not. |
| and gastrointestinal tract. When these drugs attach | | | | * The warning label: Warns against the dangers of |
| to the opioid receptors in the brain and spinal cord | | | | crushing Oxycontin because of the possibility of a |
| they can effectively block the transmission of pain | | | | rapid release of the potentially fatal narcotic in fact |
| messages to the brain. | | | | informed users of how to abuse the drug. All opioids |
| However, due to the potency of the drug, if large | | | | carry a risk of dependency and abuse. For example |
| amounts of oxycodone are released from the tablet | | | | heroin, a well-known narc otic, is a very potent opioid |
| all at once, there is potential for a dangerous or fatal | | | | and comes with a very high risk of dependency and |
| drug overdose. | | | | abuse. |
| Pharmacological effects of opioid agonists, including | | | | * Inadequate research: The controlled release quality |
| Oxycontin, are: | | | | of Oxycontin led the FDA to believe it would have |
| * Anxiolysis (a drug-induced state where patients | | | | less potential for abuse than other pain medications |
| respond normally to verbal commands). While | | | | of the same |
| coordination and cognitive function may be impaired, | | | | * caliber and class. However, there was an oversight |
| other functions remain unaffected). | | | | in the process of research, as the FDA did not |
| * Euphoria. | | | | consider that Oxycontin could be crushed or |
| * Feelings of relaxation. | | | | dissolved in water. Doing this disrupts the controlled |
| * Respiratory depression. | | | | release process and instead causes a rush or "high" in |
| * Constipation. | | | | the user. |
| * Miosis. | | | | Congressional hearings were held in December 2001 |
| * Cough suppression. | | | | and again in February 2002 to address the abuse of |
| Adverse effects of opioid agonists and Oxycontin | | | | Oxycontin. Both the FDA and Purdue Pharmaceutical |
| include: | | | | began to take steps to address the problems |
| * Nausea. | | | | associated with the use and abuse of Oxycontin. In |
| * Vomiting. | | | | July 2001 the FDA strengthened the warnings and |
| * Central nervous system (CNS) effects. | | | | precautions section in the labeling, issuing a "black |
| * Respiratory depression. | | | | box" warning, the highest possible warning level. |
| In addition, according to the Drug Enforcement | | | | Together with Purdue Pharmaceuticals, the FDA also |
| Agency (DEA), abuse of Oxycontin is associated with | | | | developed a risk management program to help |
| serious consequences including addiction, overdose | | | | detect the abuse of, and prevent abuse of, |
| and death. The FDA states the potential dangers | | | | Oxycontin. |
| associated with Oxycontin and, while it is approved | | | | Purdue has also initiated programs to educate health |
| for use, has classified Oxycontin as a schedule II | | | | care providers about the risks associated with the |
| controlled substance under the Controlled Substance | | | | abuse of Oxycontin. They have issued a warning in |
| Act of 1970 because it has a high potential for abuse | | | | the form of a "Dear Healthcare Professional" letter. |
| and can lead to psychological and/or physical | | | | The letter informs health care providers of the |
| dependence. Schedule II drugs have the highest | | | | potential misuse of Oxycontin and reiterates the |
| potential for abuse of any approved drugs. | | | | importance of discretion and necessity when |
| In early 2000, reports of improper and illicit use of | | | | prescribing the drug. |
| Oxycontin surfaced. Some of these reported cases | | | | The letter was distributed widely to physicians, |
| have been associated with serious consequences | | | | pharmacists, and other healthcare professionals in an |
| including death. Oxycontin, as with any prescription | | | | attempt to thwart the writing of gratuitous |
| narcotic, carries with it some risk of dependency and | | | | prescriptions and to ensure that health care providers |
| abuse. However, due to the large numbers of | | | | are communicating accurately and thoroughly the |
| prescriptions being written for Oxycontin it is difficult | | | | dangers associated with the use of Oxycontin to |
| to monitor the use and abuse of Oxycontin. Even | | | | their patients. |
| though Oxycontin was originally intended to help | | | | |