Home Publisher's Note Prescribing Opiates
Publisher's Note
Prescribing Opiates
June 2007

Last month, federal prosecutors accepted the criminal guilty pleas of top Purdue Pharma executives, including its medical director, as well as that of the company itself, in what has finally been exposed as among the most egregious cases of drug company narcotics sales malfeasance in U.S. history.

Using outright lies and deceptions in its marketing efforts to doctors regarding the addictive risks of OxyContin, Purdue Pharma drove sales of the now infamous pain killer to enormous levels. In a five year period beginning in 1996, sales of OxyContin soared more than 30 fold, reaching major blockbuster levels of over $1.5 billion.

The fines imposed - although critics say they are not nearly enough, and they are indeed just a fraction of OxyContin’s enormous profits - define the seriousness of the problem. More than $600 million in levies were imposed, mostly on the company, but also on the executives.

And while the malfeasance of Purdue and its sales agents was certainly colossal - they were claiming, basically, that because OxyContin was time released it was less addictive - equally colossal was the credulity of doctors who actually believed such claims when there was clearly no strong evidence that they were true. After all, it is the prescribers who bear much responsibility for narcotic epidemics like that of OxyContin, because it is they who write the prescriptions and it is they who should know better than to believe the suspect claims of drug company sales agents.

And for those who bemoan the fact that the crackdown on Purdue could set back the cause of pain management, because doctors may now be less liberal with their prescription pads, let them know that this may not be such a bad thing.

The fact is we know little about the iatrogenic rate of addiction, which is the rate of addiction that occurs when narcotics are used for medical purposes like treating pain. And until we know more, some caution on the part of prescribers may be just what the doctor ordered.

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