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One of the most prescribed painkillers in the US has failed to fulfill its promises and created a pathway to addiction, a new investigation has claimed.

Purdue Pharma, a Stamford, Connecticut-based pharmaceutical company, launched OxyContin 20 years ago, claiming it would provide '12 hours of smooth and sustained pain control'.

But the opioid actually wears off earlier than that in many cases, creating a cycle of withdrawal symptoms and cravings for the drug, the Los Angeles Times reported this week.

Instead of telling physicians to prescribe OxyContin at shorter intervals, Purdue Pharma, which has denied the report, told them to increase their patients' doses, the newspaper wrote.

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OxyContin (file picture) came out 20 years ago and was meant to provide '12 hours of smooth and sustained pain control', but the drug actually wears off earlier for many users, the Los Angeles Times found

Patients for whom OxyContin wears off before 12 hours can experience withdrawal symptoms such as body aches, anxiety and nausea, experts said.

Their original pain, the reason why they took the drug in the first place, can also return. 

Taking the next dose can relieve both the withdrawal symptoms and the underlying pain, leaving patients feeling euphoric and trapping them into a cycle of suffering followed by intense relief.

In that scenario, OxyContin is 'the perfect recipe for addiction', neuropharmacologist Theodore J. Cicero told the Los Angeles Times.

Going through withdrawal episodes can lead some patients to abuse the drug, neuroscientist and painkiller addiction specialist Peter Przekop added. 

'You are messing with those areas of the brain that are involved in addiction, and you are going to get the person dependent on it,' he told the newspaper.

Elizabeth Kipp, 42, a stay-at-home mother in Kansas City, began taking OxyContin the year of its launch every 12 hours.

She said it relieved her pain for two to three hours before it came back. Kipp also had nausea and spent hours waiting for the next pill.  

'I was watching the clock. "What time is it? Oh, God, I have to medicate,"' she told the Los Angeles Times. 'My whole nervous system is on red alert.'

She experienced this cycle for a year and a half and checked herself into rehab after having suicidal thoughts. 

Many doctors began prescribing more frequent doses of OxyContin to remedy the problem, sometimes writing to insurance companies who would not cover more than two pills a day.

But Pursue Pharma ordered hundreds of sales rep to visit physicians and get them back on the 12-hour dosing in a bid to make more money, the Los Angeles Times wrote.

Instead of taking OxyContin more frequently, they advocated higher doses of the drug, saying there was no upper limit to how much OxyContin could be prescribed at once.

Pursue Pharma sold bottles of 10-milligram pills, the smallest dosage, for $97, while the highest dosage, 80 milligrams, came at more than $630 per bottle, according to 2001 sales data reviewed by the Los Angeles Times.

According to the newspaper, a West Virginia supervisor told a sale rep in a 1999 letter that she could earn a trip to Hawaii if she persuaded more doctors to prescribe larger doses.

 

 

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Pursue Pharma (pictured), the Stamford, Connecticut-based pharmaceutical company that launched OxyContin, has denied the report and says the 12-hour dosing has been approved by the FDA

An August 1996 memo published by the Los Angeles Times bears the headline '$$$$$$$ It's Bonus Time in the Neighborhood!'

In it, a manager reminded Tennessee reps that advocating higher dosage was essential, writing: 'Talk titration, titration, titration... He who sells 40mg will win the battle...'

The Los Angeles Times, whose investigation is based on 'thousands of pages of confidential Purdue documents and other records', says the company knew OxyContin wasn't effective for 12 hours before it even came out.

Pursue Pharma denied this in a one-page statement issued in response to the investigation, saying the FDA has approved the 12-hour dosing and that 'scientific evidence amassed over more than 20 years, including more than a dozen controlled clinical studies, supports the FDA’s approval'.

But doctors are supposed to adapt the doses' frequency to their patients' individual needs, an FDA spokeswoman told the Los Angeles Times.

'It should be well understood by physicians that there will be some individual variability in the length of time that patients respond to this drug,' Sarah Peddicord said.

'While the labeled dosing regimen is a reasonable starting point, physicians should carefully individualize their approach to patients based on how quickly they metabolize the drug.'

Pursue Pharma has opposed the Los Angeles Times's report, saying in its statement: 'This story not only fails to provide the public with the facts about a complex topic, it risks creating more confusion around our national opioid epidemic.

'For more than a decade, Purdue Pharma has sought to play a constructive role in the fight against opioid abuse, including by reformulating OxyContin with abuse-deterrent properties and leading our industry in this area of innovation. That may be an inconvenient fact for the Los Angeles Times, but it’s a fact nonetheless.'

Pharmacies in the US dispensed 53 million prescriptions for oxycodone, the opioid contained in OxyContin, in 2013 according to the National Institute On Drug Abuse.

The number of opioid prescriptions, including oxycodone, almost tripled between 1991 and 2013, with the US accounting for 81 per cent of oxycodone consumption around the world.