News that Purdue Pharma has been fined $600 million and some of its top executives criminally charged and fined for "misbranding" the painkiller Oxycontin has been treated with great glee by the media-- who are rightfully happy to see that sometimes corporate irresponsibility has consequences.
Unfortunately, however, in their rush to condemn Purdue as a pusher, both the media and some activists like Public Citizen are missing a huge part of the story: Oxycontin has been a wonder drug for many pain patients and contrary to their drug warrior rhetoric, virtually every case of "Oxycontin-related death" has occurred amongst addicts who mix drugs, not "innocent" pain patients.
Conventional wisdom biases the media to see the Oxycontin story as one of pill-pushing doctors and hyper-marketing drug companies turning innocent pain patients into addicts. However, this is simply not what typically happens: according to the National Institute on Drug Abuse, the average Oxycontin misuser (some 90%) has also taken cocaine and psychedelics.
Unless we want to believe that grandma took Oxycontin for her hip pain and therefore became a hipster, maneuvering her walker to find dealers to supply her with the coke and acid she couldn't get from her doctor, the more plausible interpretation of this finding is that pre-existing addicts are scamming doctors to get Oxycontin, rather than doctors turning patients into dope fiends. This is why Purdue won every single lawsuit filed against it for "addicting" particular patients.
As my colleague at Stats, Trevor Butterworth notes here, it was the media-- not Purdue Pharma-- that literally instructed drug users and teenagers about how to misuse Oxycontin. According to a great deal of research on what makes some drugs more addictive than others, Purdue was actually correct to claim that long-acting opioids like Oxycontin WHEN TAKEN AS DIRECTED are less likely to lead to addiction than shorter acting medications.
But here's where I believe the company did cross the line into criminal behavior. It went on claiming that Oxycontin had lower abuse potential than other opioids after addicts had learned to defeat the time-release mechanism and make it into a more risky, shorter-acting drug. In the age of the internet, this information was bound to travel even faster than prior drug lore from user to user-- and the mainstream media ensured that even naïve users like teenagers would know how to make the drug more dangerous by literally demonstrating what to do on TV.
By focusing only only on the risk of addiction-- one that is less than 1% for the older people without a prior history of it who are most likely to need pain medication-- the media has done America's 20-30 million chronic pain patients a tremendous disservice. Without opioids, many cannot live productive and loving lives; why should their needs be neglected in favor of an attempt to protect others from themselves that cannot possibly succeed?
And Public Citizen-- which claims to represent patients-- should be ashamed of itself.
Its director, Sidney Wolfe, commented in the New York Times on the Purdue case, saying that ""The damage to the public from these white-collared drug pushers surely exceeds the collective damage done by traditional street drug pushers."
Oxycontin has only been on the market since 1995 and its active ingredient, oxycodone, isn't even the most commonly used prescription opioid by addicts. Only about 4% of people in treatment for addiction report prescription painkillers as their primary drug problem.
Purdue was wrong in its aggressive marketing-- but an even bigger harm is being perpetrated by the media and drug warriors who view opioids only as evil addiction-producers and deny their transformative mercy to people in pain.
Note: I changed some wording from the original post to clarify where I am expressing my own opinions, as opposed to what the court said.
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