http://bmj.com/cgi/content/full/322/7295/1143/a

BMJ 2001;322:1143 ( 12 May )

News roundup

Time release analgesic causes fatal overdoses in United States

Fred Charatan Florida

Oxycodone hydrochloride (OxyContin) is believed to be responsible for more than 120 fatal overdoses among drug misusers in recent years in several states, including Maine, Kentucky, Virginia, and Florida.

The drug, manufactured by Purdue Pharma of Stamford, Connecticut, contains a synthetic form of morphine in a sustained release tablet and is prescribed for chronic pain. It was approved by the Food and Drug Administration in 1995 and is the leading narcotic analgesic sold in tablet form in the United States. Last year, sales exceeded $1bn (£714m).

Its time release formulation enables the active ingredient to work over many hours. Drug misusers discovered, however, that they could defeat the time release design by crushing or dissolving the tablet, enabling them to snort or inject the narcotic. The government has said that no prescription drug in the past 20 years has been so widely misused so soon after its release as this one.

In recent years, up until last December, Purdue Pharma marketed the drug aggressively by paying the hotel and travel expenses of hundreds of doctors who attended weekend "pain management" seminars in holiday places such as Florida. The company has also held about 7000 seminars around the country for doctors, including many general practitioners, which advocated the use of powerful, long acting narcotics such as oxycodone hydrochloride in pain treatment.

Alarmed by the growing number of reports of deaths from the drug, the Drug Enforcement Administration (DEA) made an unprecedented move by asking Purdue Pharma to limit the drug’s distribution to only those specialists who regularly treat patients for chronic or severe pain.

Purdue Pharma officials said, "We expect to have ongoing, constructive dialogue with the DEA on this subject. We do not think it would be appropriate to go into any specifics at this time."
 

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