Entries in OxyContin (5)


Abuse-Proof Prescription Painkillers May Spur Heroin Habit

iStockphoto/Thinkstock(NEW YORK) -- The move by drug companies to make abuse-proof prescription painkillers may be inadvertently promoting heroin use, a new study found.

The study of more than 2,500 people with opioid dependence found a 17 percent drop in OxyContin abuse with the 2010 arrival of a formula that's harder to inhale or inject. During the same time period, heroin abuse doubled.

"I think the message we have to take away from this is that there are both anticipated consequences and unanticipated consequences to these new formulas," said Theodore Cicero, a professor of psychiatry at Washington University in St. Louis and lead author of the study published today in the New England Journal of Medicine. "Substance abuse is like a balloon: If you press in one spot, it bulges in another."

Unlike its predecessor, the abuse-deterring version of OxyContin turns to gel when crushed, making it harder for people to snort or inject for a rapid high. But nearly a quarter of study participants found a way around the formulation tweak, and 66 percent said they switched to another opioid – usually heroin.

"Most people that I know don't use OxyContin to get high anymore," one participant said, according to the study. "They have moved on to heroin [because] it is easier to use, much cheaper and easily available."

A small bag of heroin – enough for a high – can cost as little as $5, according to Cicero. An 80-milligram dose of OxyContin, on the other hand, can cost up to $80 on the street, according to the U.S. Drug Enforcement Administration.

"The rationale was if we reduced the supply, it would decrease the demand," Cicero said of national efforts to limit access to prescription painkillers and minimize the potential for abuse. "But what we're seeing is the demand is still there and it's driving the procurement of different drugs."

Different, and potentially more dangerous, that is. Whereas the dose of OxyContin is engraved in the pill, heroin powder is usually cut with other chemicals to bolster dealers' profits.

"When people switch over, they don't really know what they're getting," said Cicero. "They don't know the dose or the purity, so overdoses become quite common."

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OxyContin maker Purdue Pharma said in a statement, "It is unreasonable to expect the reformulation of one medication by one pharmaceutical company would reduce overall opioid abuse. Rather, these data suggest that reformulating all opioid medications over time to incorporate abuse-deterrent properties may help to reduce the overall abuse of this class of medications."

H. Westley Clark, director of the Center for Substance Abuse Treatment at the U.S. Substance Abuse and Mental Health Services Administration, said the shift to heroin use among people with opioid dependence reflects the challenge of obtaining prescription painkillers.

"Our belief is that those coordinated and comprehensive efforts to curtail the problem of prescription drug abuse are having an impact. Now we have to be concerned about the unintentional consequences," he said.

By ramping up public awareness and cracking down on illicit drug use, Clark hopes to see a downtick in prescription drug abuse without an uptick in heroin use.

"We should not attempt to solve one problem by creating another," he said.

Copyright 2012 ABC News Radio


OxyContin Being Tested on Young Kids

iStockphoto/Thinkstock(WASHINGTON) -- The maker of the powerful pain drug OxyContin is beginning to test the medicine in children, hoping to secure an extra six months of protection for the drug's patent, which is set to expire in 2013.

The move is controversial, in light of problems with addiction to OxyContin, which belongs to the family of drugs called opioids that also includes morphine and heroin. But several pain specialists say the move is an important step in giving a more accurate picture of the drug's effect on children, considering that many doctors already prescribe the drug off-label for children.

OxyContin's manufacturer, Purdue Pharma, emphasized that the company is not trying to make a kid's version of the drug, nor is it hoping to seek the U.S. Food and Drug Administration's approval for pediatric use of OxyContin. The goal, said company spokesman James Heins, is to give more information on how the drug acts in the bodies of children who may need it for the overwhelming pain of conditions such as cancer, sickle cell anemia, severe burns and other trauma.

"Doctors are already prescribing it in limited cases for kids, but they don't have the benefit of any clinical studies showing how these drugs work in kids. Right now, all they have to go on is data from adult patients," Heins said.

The trials are already underway across the country, and Purdue hopes to enroll 154 children from ages 6 to 16 who would take the drug for four weeks. When the trial is complete, the company will send the results to the FDA. Whatever the outcomes of the study, Purdue will get an extra six months of patent protection for their trouble. OxyContin earned Purdue $2.8 billion in 2011.

The trial may seem to be centered in financial gain, and experts said the company is likely moved in large part by financial incentives. But Dr. Joseph Tobin, professor and chair of anesthesiology at Wake Forest University School of Medicine, said if drug companies are not given financial incentives to test drugs in pediatric populations, the studies would not get done at all.

"Children have become therapeutic orphans in the development or testing of new drugs. The expense and the risk are high, but the profit margin to be obtained is small compared with other diseases," Tobin said. "I think it's essential that this type of process goes forward so we can get better information on the safest uses of drugs in children."

In 2002, the government attempted to give drug companies incentives to test their medicines in kids with the Better Pharmaceuticals for Children Act, a law that allows an additional six months of patent protection for on-patent drugs. The patent that would be extended for Purdue would be the one covering OxyContin's formulation, which was modified in 2010 to make it harder for people to misuse and abuse the drug.

One of the drug's patents that will expire in 2013 is the one covering OxyContin's controlled release mechanism, which allows one pill to steadily dole out the medication over an extended period of time.

That mechanism is also what makes OxyContin different from other pain drugs, such as morphine and meperidine, or Demerol. It makes the drug more effective at treating pain, but it also makes it a highly attractive target for people addicted to opioids.

"The reason OxyContin has been such a social problem is that it locks up a large amount of drug in a small pill," said Dr. Elliot Krane, director of the pediatric pain management program at Lucile Packard Children's Hospital at Stanford University.

Health officials have become increasingly concerned about rapidly rising rates of painkiller addiction in the U.S. In 2010, a study funded by the National Institute of Drug Abuse found that 2.1 percent of 8th graders, 4.6 percent of 10th graders, and 5.1 percent of 12th graders had abused OxyContin for nonmedical purposes. The U.S. Centers for Disease Control and Prevention reported in 2011 that 40 people die per day from overdoses of painkiller medications like OxyContin.

Krane, who is participating in Purdue's OxyContin trial and was a paid consultant for the company until last year, said the potential for children to become addicted to the drug is no greater or less than it is with other opioids that doctors give to children, such as morphine.

"Mere exposure will not turn them into an addict," Krane said.

Dr. Daniel Frattarelli, chair of the American Academy of Pediatrics' Committee on Drugs, said doctors face the challenge of balancing concerns about addiction with the need to treat pain in children. But he said if OxyContin is going to be used in children, it must be studied in children.

"Pain is a real thing, and it needs to be treated," Frattarelli said. "I would be much more comfortable prescribing it [OxyContin] if I knew that well-done studies had been conducted and also that there was a way of minimizing addiction."

Copyright 2012 ABC News Radio


Pharmacies Targeted by Dealers, Addicts Desperate for Painkillers

iStockphoto/Thinkstock(NEW YORK) -- In Phoenix, two men tied up pharmacy employees while another stole painkillers.

On New Year's Eve in 2011, an armed robber demanding Oxycontin and money at a Long Island, N.Y., pharmacy encountered an off-duty Bureau of Alcohol, Tobacco, Firearms and Explosives agent and two police officers as he was leaving. He and the ATF agent were killed.

Law enforcement say that armed robbers looking for prescription drugs are turning some neighborhood pharmacies into danger zones.

At another Long Island pharmacy, an addict in search of drugs for his wife fatally shot four people, including a 17-year-old clerk days from her high school graduation, in June 2011. He then left with a backpack full of prescription painkillers. He was sentenced to life in prison.

Since 2006, there has been an 82-percent rise in pharmacy robberies -- from 385 in 2006 to 701 in 2011 -- and 3,535 pharmacies have been hit.

Police say the surge is being fueled by the nation's prescription drug abuse epidemic. According to the Centers for Disease Control and Prevention, there were 14,800 prescription painkiller deaths.

Law enforcement says the robbers are typically drug dealers who know they can make huge profits -- up to $80 a pill -- on the street. But some of the thieves are simply desperate addicts.

In the summer of 2011, the bass player for the rock group Coheed and Cambria was accused of robbing a Massachusetts Walgreens pharmacy of Oxycontin. He allegedly threatened to detonate a bomb. He reportedly headed back to the band's concert venue with bottles of pills.

Bruce Goodarzi, a Rockville, Md., pharmacist, said the robbers who'd broken into his store twice in one month were after painkillers like Oxycontin or Vicodin.

"We're talking about thousands of the pills," he told ABC News. "They are going right to the drug cabinet."

Pharmacies are beefing up their security systems -- adding watchdogs and guards -- and also storing drugs in safes. Goodarzi said he built a steel cage to protect the painkillers.

Others are refusing to stock the medications or are getting guns to protect themselves in the hopes that potential criminals pass them by.

Copyright 2012 ABC News Radio


Doctors Fail to Monitor Potential Opioid Abuse Appropriately

Brand X Pictures/Thinkstock(NEW YORK) -- Statistics show the abuse of prescription painkillers has been on the rise for nearly two decades, but a new study found that primary care physicians may not be diligently monitoring patients who are taking opioid painkillers such as OxyContin, even those who are at risk for becoming dependent on them. Experts say dependence on opioids accounts for much of the rampant prescription drug abuse.

"We studied a cohort of more than 1,600 primary care patients prescribed long-term opioids and looked at how frequently they received three strategies for reducing the risk of misuse," said lead researcher Dr. Joanna Starrels, assistant professor of medicine at the Albert Einstein College of Medicine and Montefiore Medical Center in the Bronx, N.Y. The three risk-reduction strategies are urine tests, face-to-face office visits at least every six months and within a month of changing an opioid prescription, and limiting the number of early refills.

Data showed that only eight percent of the patients in the study had any urine drug testing, less than half had regular office visits and nearly 25 percent received multiple early refills.

"This suggests that primary care physicians are not using these risk reduction strategies very frequently," said Starrels.

Whitney O'Neill knows just how powerful prescription pain medication can be, and also how easy it could be for doctors to miss the signs of addiction.

For almost eight years, she was physically dependent on them. She started taking the drugs when she was around 12, after a fall caused her to suffer from crushing migraines. She was 17 when she said the drugs became a problem.

"After years of repeated use, I developed a dependency on them," said O'Neill, now 31. "I started to get sick if I didn't take them."

While she doesn't blame her doctor for feeding her habit with a constant supply of painkillers, she doesn't think her doctor realized she had a problem. And at that time, she couldn't admit she was an addict.

"I think it was a missed opportunity to have recognized I had addictive disease," said O'Neill, who is now outreach coordinator for Faces and Voices of Recovery, an advocacy group.

Addiction specialists say a lot of burden falls on primary care physicians, usually on the front lines of pain management. Some believe primary care physicians just don't know enough about addiction, while others say factors beyond their control are contributing to the increased use of opioids.

"Most primary care physicians are not trained in addictions," said Dr. Stephen Ross, clinical director of the NYU Langone Center of Excellence on Addiction. "It's not that physicians are not well-meaning, it's just a lack of education and not knowing how to treat addictions."

"It's not a lack of awareness or caring, but they don't have the tools to help manage the risk," said Starrels. "They may not know what risk the factors are or how to monitor their patients for evidence of misuse."

As for the finding that many doctors provide more early refills to patients at higher risk for misuse, even those who have a drug use disorder, Starrels stressed it's important to figure out why. She says it may be because patients are abusing the medications or because doctors are cautious and prescribing a lower dose than patients need for pain.

"This finding is very concerning, and we need to understand the reasons." 

Copyright 2011 ABC News Radio


Some Painkillers Safer Than Others, Study Finds

Photo Courtesy - Getty Images(BOSTON) -- For the first time, research has compared the safety of some of the most commonly used painkillers.  And the drugs that raised the biggest questions?  Opioids -- the regularly prescribed class of painkillers that include Vicodin and OxyContin.

In two new reports published in the Archives of Internal Medicine, researchers from Brigham and Women's Hospital in Boston found that opioid users experienced higher rates of serious problems than patients taking other types of painkillers, such as coxibs or nonsteroidal anti-inflammatory drugs, or NSAIDs.

The use of hydrocodone, brand name Vicodin, and oxycodone, brand name OxyContin, nearly doubled between 2001 and 2006.  Doctors said a major reason for the spike came from noncancer patients taking the painkiller.

And last year, the Centers for Disease Control and Prevention reported that the number of fatal opioid poisonings more than tripled from 4,000 to 13,800 deaths between 1999 and 2006.

In the first report, researchers collected Medicare data between the years 1996 and 2005, including information from more than 31,000 older Americans who had been prescribed an NSAID, coxib or opioid.  The report found that opioid users experienced higher rates of cardiovascular problems and fractures than patients taking other types of painkillers.

In the second report, the authors compared the rates of serious problems occurring after 30 and 180 days among patients taking one of five opioids: codeine, hydrocodone, oxycodone, propoxyphene and tramadol.  They found that patients taking codeine or oxycodone were about twice as likely to die from any cause compared with patients taking hydrocodone, an opioid similar to oxycodone and stronger than codeine.

Copyright 2010 ABC News Radio

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