OxyContin Maker Guards Its List of Reckless Doctors, L.A. Times Reports

OxyContin is the brand name for a specific form of oxycodone, an opioid narcotic medication known for its potential to trigger problems with drug abuse or drug addiction. Because of the medication’s association with increased abuse and addiction risks, sale of all forms of oxycodone are strictly controlled under federal guidelines. However, according to a new investigative report by the Los Angeles Times, the manufacturer of OxyContin—a company called Purdue Pharma—has failed to report known instances of illicit or illegal prescriptions of the medication to authorities for more than 10 years.

After the report in The Times, two state senators in California have called on the maker of OxyContin to turn over the names of California physicians it suspects recklessly prescribed its pills to drug dealers and addicts.

Oxycodone Basics

Oxycodone is a synthetic substance made in pharmaceutical laboratories from a specific chemical found naturally in a plant called the opium poppy. When it interacts with nerve cells in the body’s central nervous system (brain and spinal cord), it reduces the body’s ability to feel pain. The U.S. National Library of Medicine lists available forms of oxycodone that include liquids, concentrates, capsules and tablets. While some oxycodone-containing products are sold without additional active ingredients, other products also contain acetaminophen, aspirin or ibuprofen. In addition to OxyContin, oxycodone-based medications include Percocet, Percodan and Endocet.

The same mechanisms that give oxycodone the ability to ease pain also give it the ability to alter normal function in the part of the brain that regulates pleasurable sensations. It is the intensity of the drug’s effects on the brain’s pleasure centers that accounts for its association with profound risks for abuse and addiction. Because of the potential for misuse of oxycodone, federal regulators have placed it on a list of officially controlled substances called Schedule II drugs. All substances on this list have clear usefulness as therapeutic medications, but also present enough risks to warrant strong restrictions on their use.

OxyContin Basics

OxyContin comes in tablet form and was originally marketed as a safer, long-acting alternative to morphine, another opioid narcotic capable of reducing moderate or severe forms of pain. When the medication hit the market, its safe use was significantly undermined by its easy crushability. This crushability encouraged abusers to rapidly introduce OxyContin into their bloodstreams through IV injection or inhalation. In an effort to correct a widespread pattern of misuse, Purdue Pharma introduced a non-crushable form of the medication in 2009. Following the release of this new product, misuse of OxyContin dropped by almost 200 percent. However, significant numbers of people across the U.S. still use the medication illicitly or illegally.

New Findings

In 2002, Purdue Pharma started tracking doctors across the U.S. suspected of knowingly prescribing OxyContin to people addicted to oxycodone or other narcotic or non-narcotic medications, as well as doctors suspected of selling their OxyContin supplies to drug dealers. As of 2013, the company had identified more than 1,800 physicians believed to be participating in these activities. However, Purdue Pharma has never made a concerted effort to release their list of suspects to any federal, state or local law enforcement agency, or to a medical body responsible for disciplining doctor misconduct. In fact, the company has sometimes made efforts to deflect attention away from purposeful, improper OxyContin prescribing by publicly linking the illegal availability of the medication to such things as robberies, theft of OxyContin by family members of legitimate users, and patients’ efforts to obtain the medication from multiple doctors.

Purdue Pharma only openly revealed the existence of its internal list of misprescribing physicians in June 2013. Because of the immense profitability of OxyContin, some investigators and public health officials have openly questioned the company’s motivations for not revealing its knowledge on the issue at any point in the last 10 years. Spokesmen for Purdue Pharma counter these criticisms by asserting that, while they have never released the names of all suspected doctors, they have separately given medical groups and law enforcement officials the names of 154 of the 1,800 physicians in their database. However, since no one outside the company has seen the full list of suspected misprescribers, there is no way to independently gauge the accuracy of these statements.

Considerations

Some of the doctors under investigation for illegally prescribing or selling OxyContin have been involved in widespread distribution efforts that meet federal and state standards for drug dealing. For instance, one California physician was recently convicted of illegally selling over 1 million doses of the medication. Another doctor prescribed millions of dollars worth of OxyContin and other opioid narcotics to people known to have problems with drug addiction. Officials from Purdue Pharma state that they have no legal obligation to assist law enforcement or medical regulators in their efforts to control OxyContin’s availability.