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posted by Fnord666 on Monday May 22 2017, @07:11AM   Printer-friendly
from the prescription-for-a-disaster dept.

Arthur T Knackerbracket has found the following story:

Patients would no longer have to wake up in the middle of the night to take their pills, Purdue told doctors. One OxyContin tablet in the morning and one before bed would provide "smooth and sustained pain control all day and all night."

When Purdue unveiled OxyContin in 1996, it touted 12-hour duration.

On the strength of that promise, OxyContin became America's bestselling painkiller, and Purdue reaped $31 billion in revenue.

But OxyContin's stunning success masked a fundamental problem: The drug wears off hours early in many people, a Los Angeles Times investigation found. OxyContin is a chemical cousin of heroin, and when it doesn't last, patients can experience excruciating symptoms of withdrawal, including an intense craving for the drug.

The problem offers new insight into why so many people have become addicted to OxyContin, one of the most abused pharmaceuticals in U.S. history.

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 wear off 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."

-- submitted from IRC


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  • (Score: 4, Informative) by takyon on Monday May 22 2017, @07:30AM (19 children)

    by takyon (881) <reversethis-{gro ... s} {ta} {noykat}> on Monday May 22 2017, @07:30AM (#513377) Journal

    The OxyContin Cartel: Billionaire Family 16th Richest in the US

    Over the last two years or so, opioid production in yeast [wired.com] has moved from hypothetical [wired.com] to experimental success [wired.com]. It could take years before industrial quantities of opioids are produced from yeast but re-assurances have been made that home-brew heroin won't [soylentnews.org] become commonplace [soylentnews.org]. With or without yeast opiates, fentanyl and [soylentnews.org] carfentanyl are causing an increasing number of deaths [soylentnews.org] and these occur disproportionately among rural, white, formerly middle-class men. In the US, supermarkets and pharmacies increasingly sell opioid antagonists like cough medicine [soylentnews.org] but this has little effect on the 46 people per day dying from prescription painkiller overdoses [thefix.com]. Purdue Pharma paid a massive US$635 million for fraudulent mis-representation of opioid addiction. However, that's against revenue of US$31 billion, so this 5% cost of doing business has not prevented the controlling Sackler family from becoming the 16th richest in the US [soylentnews.org]. (Source [latimes.com].)

    In addition to repeatedly being discussed by members of SoylentNews, opioid addiction was the topic of HBO's Last Week Tonight with John Oliver in Oct 2016 [youtube.com] and in Mar 2017, in a break from the usual format, the second half of Keiser Report episode 1049: Trail of American Carnage names and shames the Sackler family [youtube.com]. (More episode details here [maxkeiser.com] and here [rt.com].) Although John Oliver makes some tasteless jokes about opioid overdoses, it is otherwise a concise primer about the situation. In particular, he finishes by noting that people with chronic or terminal illness expect continued prescriptions of opioid painkillers and therefore an outright ban is problematic.

    Original Submission [soylentnews.org]

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  • (Score: 3, Informative) by Anonymous Coward on Monday May 22 2017, @09:23AM (18 children)

    by Anonymous Coward on Monday May 22 2017, @09:23AM (#513404)

    John Oliver is a douche, to wit:

    "In particular, he finishes by noting that people with chronic or terminal illness expect continued prescriptions of opioid painkillers and therefore an outright ban is problematic."

    I have stage 4 PCa, with bone mets all over the place. It hurts. A lot. I take Tramadol when necessary, but only in extremis because most terminal cancer patients know what's coming near the end. It's best to keep the tolerance down so it still works when I really need. Addiction is kind of meaningless when your life expectancy is short. That said, Tramadol is considered low-risk in terms of addiction compared to oxycodone and hydrocodone.

    What John Doucheiver doesn't seem to get is that late-stage cancer treatment is almost exclusively palliative. i.e.pain management. That means pain killers. Strong ones.

    I hope the son of bitch gets a big fat adenocarcinoma in his colon. It would, by proximity, metastacize to his head.

    Then let's see what his problematic expectations are.

    • (Score: -1, Troll) by Anonymous Coward on Monday May 22 2017, @09:31AM (3 children)

      by Anonymous Coward on Monday May 22 2017, @09:31AM (#513407)

      So, maybe, you should just die, instead of being a lowlife drug addict? Just saying, as one AC to Another. Sorry, bro!

      • (Score: 0) by Anonymous Coward on Monday May 22 2017, @09:54AM (2 children)

        by Anonymous Coward on Monday May 22 2017, @09:54AM (#513418)

        I will. And so will you. Hopefully, with more pain as a brave non-addicted AC.

        • (Score: 1, Interesting) by Anonymous Coward on Monday May 22 2017, @10:35AM (1 child)

          by Anonymous Coward on Monday May 22 2017, @10:35AM (#513432)

          This is the best that all of us can hope for, to die as free persons, in debt to no New York Real Estate developer, or Pharmaceutical Corporation.

          • (Score: 3, Insightful) by J_Darnley on Monday May 22 2017, @12:22PM

            by J_Darnley (5679) on Monday May 22 2017, @12:22PM (#513454)

            I need a +1 depressing moderation option.

    • (Score: 5, Interesting) by Runaway1956 on Monday May 22 2017, @09:57AM (3 children)

      by Runaway1956 (2926) Subscriber Badge on Monday May 22 2017, @09:57AM (#513419) Journal

      "Addiction is kind of meaningless when your life expectancy is short."

      Exactly. If a person has high blood pressure, and his blood pressure pills enable him to continue living, then he is "addicted" to those pills. Withdrawal symptoms include - death.

      So, another person has a condition which causes him severe pain. Pain pills enable him to function normally, or close to normally. Without the pills, he cannot function. It's really that simple, he has to have the pain medication. He is, by definition, "addicted". Just like any drug addled criminal in the back alleys, he can't face life without his drugs. Purdue pulled the wool over the nation's eyes, by changing the definition of "addiction". Supposedly, a terminally ill patient cannot be an addict - BUT HE IS!!

      AC above has justification for being addicted to his pills. It's not an illicit thing, he suffers, and he needs his pain pills to function. But, he's an addict.

      An outright ban of any drug is going to be counterproductive. The least used drugs in the world have their uses, or they wouldn't exist. The most used drugs are being abused, to be sure, but they came to exist because there are legitimate uses for them.

      There should be a ban, though. The pharmaceuticals should be banned from advertising their wares on television, radio, and the internet. The latest thing I'm hearing, is for EPI - some kind of digestive disorder. In the commercial, people are urged to discuss the problem with their doctors, and to name the specific EPI treatment specifically. Like - doctors have never heard of digestive disorders before, and they'll only learn of them if the patient teaches the doctor about them.

      Ban big pharma from advertising, and a lot of our addiction problems will start curing themselves. Take doctors back about two or three decades, when they were reluctant to prescribe opioids, but they would do so with justification. Of course we need opioids, but you don't pass them out like candy to every person who stubs his toe, or whacks his thumb with a hammer. Fek, that's stupid.

      And, oh yeah. "I hope the son of bitch gets a big fat adenocarcinoma in his colon. It would, by proximity, metastacize to his head." Thumbs up for that one!! 👍

      • (Score: 3, Interesting) by kaszz on Monday May 22 2017, @02:22PM (2 children)

        by kaszz (4211) on Monday May 22 2017, @02:22PM (#513495) Journal

        Some countries, sane countries actually have a ban on pharmaceutical advertising.

        • (Score: 1, Interesting) by Anonymous Coward on Monday May 22 2017, @07:06PM

          by Anonymous Coward on Monday May 22 2017, @07:06PM (#513676)

          Yes a lot of people are in search of a problem that can explain X. Really a result of people having too much fucking time on their hands, and not enough productive work to do.

          Blocking advertising may keep these people from going: "Oh yes! I must have OCBPSTFF as this add suggests, and this magical pill can cure it!". But stopping these types of advertisments might not work as well in the US because of corruption at every level.

          The doctors are pushing this shit. So I guess people would have to avoid going to the doctor all together!

          "Oh you indicated on the questionnaire you are experiencing low-to-moderate, intermittent, back-ache. Have you heard of Heroin-Lite (TM)?"

        • (Score: 0) by Anonymous Coward on Tuesday May 23 2017, @01:14AM

          by Anonymous Coward on Tuesday May 23 2017, @01:14AM (#513882)

          Runaway1956 does not live in a sane country, for he is not sane himself.

    • (Score: 3, Informative) by Anonymous Coward on Monday May 22 2017, @10:04AM (1 child)

      by Anonymous Coward on Monday May 22 2017, @10:04AM (#513422)

      Did you misread Oliver's statement, or are you just being an asshole?

      He's saying that banning painkillers is problematic since some people need them.

      He's not saying that people who need painkillers are problematic.

      • (Score: 0) by Anonymous Coward on Monday May 22 2017, @10:35AM

        by Anonymous Coward on Monday May 22 2017, @10:35AM (#513431)

        I think the snarky trigger word was "expect", which makes it sound like a frivolous choice rather than a medical need.

    • (Score: 2) by DeathMonkey on Monday May 22 2017, @05:28PM (4 children)

      by DeathMonkey (1380) on Monday May 22 2017, @05:28PM (#513612) Journal

      "In particular, he finishes by noting that people with chronic or terminal illness expect continued prescriptions of opioid painkillers and therefore an outright ban is problematic."

      What John Doucheiver doesn't seem to get is that late-stage cancer treatment is almost exclusively palliative. i.e.pain management. That means pain killers. Strong ones.

      That's literally what the quote above says. Learn to read first before resorting to the name-calling.

      • (Score: 0) by Anonymous Coward on Monday May 22 2017, @06:43PM

        by Anonymous Coward on Monday May 22 2017, @06:43PM (#513657)

        Substitute "need" for "expect" and you might have a point. Learn the subtle nuances of language before you snidely suggest reading lessons.

      • (Score: 0) by Anonymous Coward on Monday May 22 2017, @07:08PM (2 children)

        by Anonymous Coward on Monday May 22 2017, @07:08PM (#513679)

        Anyone using the word "problematic" gives themselves away as a clueless fuck-wit on the given subject. It basically means he will virtue-grand-stand about current policy but has no better solutions. A total fucking tool, and a waste of time to listen to.

        • (Score: 0) by Anonymous Coward on Monday May 22 2017, @09:27PM

          by Anonymous Coward on Monday May 22 2017, @09:27PM (#513775)

          A total fucking tool, and a waste of time to listen to.

          Thoth! And Forsooth! Truly this is a problematic post. I don't know what to do about it. Perhaps take its own advice?

        • (Score: 3, Informative) by DannyB on Monday May 22 2017, @09:47PM

          by DannyB (5839) Subscriber Badge on Monday May 22 2017, @09:47PM (#513787) Journal

          Utilizing the word "problematic" is not nearly as bad as an idiot who would utilize the word "utilize" and its variants. Whenever one would write "utilize", one should write "use" instead because the word "utilize" is problematic.

          --
          With modern TVs you don't have to worry about braking the yolk on the back of the picture tube.
    • (Score: 2) by DannyB on Monday May 22 2017, @10:01PM

      by DannyB (5839) Subscriber Badge on Monday May 22 2017, @10:01PM (#513798) Journal

      My arthritis specialist had me try Tramadol in 2010. And he said to take it every day. I quickly realized it didn't like it. I quit taking it because:
      * I didn't like the side effects (jittery, causes restless leg, and even one time an auditory hallucination)
      * I couldn't easily stop and start taking it at will -- because it has withdrawal symptoms that I liked even less
      * I found it to be way too addictive for me

      So I quit taking it completely. I hated it. I had already been taking hydrocodone, occasionally, as needed, for years, and still do to this day. I could sometimes even take quite a bit if needed. But I never had any bad side effects. No withdrawal -- that I am aware of. As far as I know, I don't have a tolerance, because I just don't take it very often. I like to start with 1/2 tablet and work up from there. I can stop it, and start it as I please, unlike Tramadol.

      When my primary care doctor asked what the auditory hallucination was like, I told her that in the middle of the night I could hear what sounded like voices outside my house talking. She asked what did they say? They didn't say anything intelligible. When I would listen to hear, there was nothing. When I would stop listening for it, and think about something else, I could hear a low background sound of voices again, but nothing intelligible. And again, when I would listen more closely -- nothing. That was definitely when I quit taking Tramadol after about four months in 2010.

      --
      With modern TVs you don't have to worry about braking the yolk on the back of the picture tube.
    • (Score: 2) by cafebabe on Tuesday May 23 2017, @08:14AM

      by cafebabe (894) on Tuesday May 23 2017, @08:14AM (#514077) Journal

      John Oliver may be a smug douchebag in the general case but my paraphrasing of his summary may also be at fault. I found his explanation to be concise and his summary to be nuanced and even. He has some cheap, tasteless jokes but you'll find that common to every topic he covers.

      Regarding protate cancer spreading to bones, an ex-housemate died of a similiar condition in 2015. Yes, it hurts. It hurts in every bone. Facing that without painkillers would be horrendous and I fully understand why people consider suicide in such circumstances.

      What undermines the case for very strong painkillers is people, like me, who get prescribed morphine variants for wrist injuries and suchlike. The medication doesn't work selectively and therefore all niggling sources of pain are blocked. You feel young and fitting fit. Unfortunately, this starts a cycle of addiction which has little difference to cocaine addiction or heroin addiction - with the exception that a medically qualified doctor is the drug pusher.

      --
      1702845791×2
    • (Score: 0) by Anonymous Coward on Tuesday May 23 2017, @09:14PM

      by Anonymous Coward on Tuesday May 23 2017, @09:14PM (#514525)

      Someone very close to me lost a similar battle last September. She was taking only Tramadol and nortriptyline until the last week of her life, at which point she was in hospital and had a syringe driver administering morphine. In the UK, when a patient has that kind of diagnosis then medical professionals pretty much stop worrying about addiction - it's a nonsensical concern given the prognosis - but they do have to keep the issue of acclimatisation in mind to a certain degree for the reasons you mention. The last two days of her life are my recurring nightmare such that not dreaming is a blessing. To see someone who was so independent, so clever and so witty have all that stripped from them by both disease and treatment has ensured that if I'm ever given a similar diagnosis, I'm heading straight to the nearest drug dealer to buy enough heroin to kill me in one hit.

      FWIW, Oliver's comment looked like old-fashioned sarcasm of the 'modest proposal' type.

      Posted AC because I really don't need sympathy.