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Dangerous High
Did OxyContin Maker Fail to Heed Signs of Drug�s Growing Abuse?
By Brian Ross and Jill Rackmill
Oct. 17 � OxyContin, a powerful painkiller introduced on the market seven years ago, has proven a wonder drug for many sufferers of persistent pain.
But now, in the wake of conservative radio show host Rush Limbaugh's announcement that he's "addicted" to prescription pain medications � among them, OxyContin, according to law enforcement officials � much of the nation is aware that the drug can take powerful hold of people who misuse it.
The front-page coverage of Limbaugh's addiction comes as questions are already being raised in Congress about the company that makes OxyContin, Purdue Pharma Co. of Stamford, Conn.
"My concerns," said Rep. Frank Wolf, R-Va., "are they have pushed the envelope to the point that a lot of innocent people have just been devastated by this drug."
New York Times reporter Barry Meier says in his upcoming book Pain Killer that Purdue Pharma failed early on to fully heed warnings its pain killer was becoming widely abused.
"This public health epidemic played itself out in that time," Meier said. "It took root. It festered. It exploded. � Many things could have been done to prevent the scope of this tragedy, had they been done in time."
An Instant Hit
OxyContin quickly became a $1 billion-a-year drug after its introduction in 1996. It was considered a godsend for millions of people suffering from persistent pain, from back problems to cancer.
OxyContin's unique feature is that it slowly releases its powerful narcotic, giving relief over a 12-hour span. Because of that, the government also allowed Purdue Pharma to claim OxyContin was less likely to be abused. In essence, it was arguing that there would be no quick hit for people looking to get high.
"It was a very nice theory," Meier said, "and, in fact, may be true. But all of this became absolutely meaningless when this drug hit the street because all you had to do was chew this drug, grind it down with your teeth, hit it with a beer bottle, crush it in any way, and it became a treasure trove."
And that's exactly what Lindsay Myers, the captain of the high school cheerleading squad in Pennington Gap, Va., says she and her friends were doing. "If I didn't have an Oxy," Myers said, "I wasn't able to cheer. I wasn't able to jump and scream."
Myers said she would take OxyContin before the game, at halftime � anytime she could get it. "At halftime, I would run to the bathroom and do an Oxy," she said. "I just didn't care. I had to get my high. � I ruined my high school years because of Oxys.
"It was just real easy to get hooked on and I just don't see how they couldn't see that early on," Myers said.
Myers, who is now clean after a painful withdrawal, says she started on pot but snorting OxyContin became her favorite four years ago � a time when Purdue Pharma maintains there was only isolated and sporadic � not widespread � abuse.
But OxyContin abuse swept through Myers' small Virginia town like no other prescription drug before it, according to drug counselors there.
"It is very clearly an epidemic � this is not some kind of bizarre, isolated Lee County problem," said Dr. Art Van Zee of the Lee County Coalition for Health.
�It's Got to Be Cool�
Yet even as word of the OxyContin high spread to the fast lane in Beverly Hills, the company continued to insist the abuse was largely limited to pockets of poor and rural America.
A lot of things have been said about Jack Osbourne and his wacky family, but never that they were poor or rural. Osbourne bought his Oxy on the streets of Los Angeles. "This drug is getting all this attention, it's got to be cool," he said.
And the high didn't come cheap. Osbourne said he'd pay $40 for an 80-milligram pill of OxyContin.
Osbourne said it was even pricier than heroin. Oxy's appeal, according to Osbourne, was that it is cleaner than heroin. "You know exactly what you're getting," he said.
The 17-year-old Osbourne says snorting OxyContin became his drug of choice, to his everlasting regret. "It's not glamorous, it's not fun and it's completely redundant," he said. "You become this lifeless human pod at the end of the day. You serve no purpose."
But when Congress began investigating, executives of Purdue Pharma testified under oath before the House Appropriations Subcommittee on Commerce, Justice, State and the Judiciary that they did not learn that OxyContin was being widely abused until four years after it was introduced.
A company official said, "In February 2000 was the first time we became aware that something different was going on."
Now that testimony is being called into questions by committee Chairman Wolf. "The company must have known," Wolf says, "I mean they know how powerful a drug this can be, both for good and for evil. And so clearly the company had to know."
Were Salespeople Pressured to Push the Drug?
For example, some of Purdue Pharma's own salespeople were sending in reports from the field in 1999, about growing OxyContin abuse. Patients, according to field rep reports, were "chewing Oxy."
But that didn't slow the big push to sell OxyContin, according to former Purdue sales representative Karen White. "The company was all about the bottom dollar. Sell OxyContin. Period," said White, who worked for four years as an OxyContin sales representative in Florida, until she was fired last year.
In a lawsuit against Purdue Pharma, White says it was impossible for her to meet company sales quotas unless she dealt with doctors she thought were running "pill mills."
"I made the ethical decision not to call on what I refer to as pill-mill doctors. And by pill-mill doctors I mean those physicians who inappropriately described high doses to anyone who walks in and says I want 80 milligrams of OxyContin," White said.
But executives at Purdue Pharma say White's claims are baseless.
And they strongly deny tolerating any illegal sales of OxyContin or doing anything improper in marketing the drug.
Pharmacist Says Company Pressured Him
That's not the way some people in Pennington Gap, Va., remember it.
"Purdue representatives, in my opinion, had an almost lackadaisical attitude," said Greg Stewart, a pharmacist in Pennington Gap.
Purdue says its policy is to encourage pharmacists to be vigilant, but Stewart says he was berated by Purdue representatives when he refused to fill OxyContin prescriptions from people he thought were abusing the drug.
"I have to get up and look at my face in the morning, which is what I told the Purdue rep when he said you can both morally and legally dispense all Oxy prescriptions," Stewart said.
The company says it is unaware of what Stewart says happened.
It was only after a growing number of complaints from federal and state law enforcement officials about widespread abuse � including fatal overdoses � that Purdue Pharma finally agreed to stop marketing the drug as less likely to be abused and to issue a nationwide alert to doctors.
"The FDA decided, 'We made a mistake. We permitted something on to the label of this drug that we do not believe should be there and so it was taken off,' " according to Meier.
The company says that once it learned about the extent of the abuse problem, it acted aggressively to combat abuse and diversion of the drug. These actions included introducing educational programs for doctors and teenagers, tamperproof prescription pads, efforts to cut off questionable doctors, and contributions and support to local anti-drug organizations.
"They're doing many, many things now that are commendable," said Meier. "The question is, why didn't they do them earlier?"
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