OxyContin: A Public Health Threat or Remarkable Painkiller

By Ronald T. Libby
Professor of Political Science
University of North Florida
[email protected] and [email protected]
(904) 808-4612 or (904) 806-4404

Florida Pain Task Force
AAPS The American Pain Institute,
The Pain Relief Network
National Pain Patients Coalition
Comfort Inn Suites Downtown
Orlando, Florida
January 16, 2004

Another round of congressional hearings on the "national epidemic of OxyContin addiction" is scheduled for February 2004. Representative John Mica, R-Winter Park who requested the hearings has cited a five- part series in the Orlando Sentinel on OxyContin's threat to public health as the rationale for the hearings.

The series was written by Doris Bloodsworth and was entitled "OxyContin Under Fire" (www.orlandosentinel.com/extras/dynamic/news/oxycontin/).

  • Shortly after the Drug Enforcement Agency announced an OxyContin Action Plan in May 2001, Florida Attorney General Bob Butterworth started a statewide investigation into OxyContin. He claimed that the painkiller was "a major threat to public health". He even told a group of doctors that he wanted to ban the drug. One year later, the investigation was quietly closed and Butterworth praised the drug describing it as "one of the most remarkable and most prescribed painkillers in the nation today."

    Unpersuaded by the Attorney General's investigation, the editors and staff of the Sun-Sentinal questioned the AG's "paper-gathering" exercise in the midst of "mounting overdoses and deaths linked to OxyContin".

    The series claimed that the drug's manufacturer, Purdue Pharma minimized the danger of the drug while aggressively marketing it to doctors. Indeed, Representative Frank Wolf, R-Va and chairman of the appropriations subcommittee has asked for congressional authorization to investigate Purdue's marketing practices.

    The Sun-Sentinal insists that OxyContin constitutes a threat to public health. However, they present no documented evidence for their claim. In October of 2003, the paper reported that in 2001 and 2002, the Florida medical examiners recorded 573 deaths in the state caused by oxycodone--the active narcotic agent in OxyContin. They added total deaths with oxycodone plus other drugs in the decedents for the years 2001 and 2002 (Doris Bloodsworth, "Congress Tackles OxyContin", Orlando Sentinel, December 5, 2003). That means the autopsy reports indicated the presence of multiple drugs including alcohol which makes it impossible to identify which drug was responsible for the overdose.

    There are two additional problems with this claim. The first is that there is no test for OxyContin. The only chemical test is for oxycodone. And there are 59 drug products containing oxycodone in differing doses and with and without other non-narcotic pain medication such as aspirin and Tylenol. That means it is not possible to identify OxyContin as a cause of death.

  • The Second problem is that the medical examiners' report shows a total of 71 oxycodone only related deaths for 2001 and 2002. There were 35 deaths in 2001 and 36 in 2002 in which only oxycodone was found in their system. Furthermore, even this relatively small number of overdoses is questionable. That is due to the fact that the medical examiners only reported 14 drug groups in the autopsy reports. (wwww.fdle.state.fl.us/publications/examiner_drug_report.pdf).

    This means that there may well have been other non-reported drugs and other medical causes of death in the overdoses. For example, the deceased may also have been taking other prescription drugs such as anti-depressants, heart medication, and diabetic medications that could have contributed the cause of death. This is particularly the case with the large number of deaths of those 50 and older.

  • The Series describes the heart-wrenching experience of deaths due to OxyContin overdose. However, tragic, a handful of cases do not add up to a drug addiction epidemic. Physicians and the public should be warned about the dangers of misusing the drug. Doctors should not be intimated from administering pain relieving medication to millions of legitimate, untreated chronic pain suffers, however.





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