What is interesting is that the same family owned company that created oxycontin also created valium originally. Amazing to think of how much damage one family owned business has done (Purdue Pharma) to an entire nation.
Folks blame the drug company, but honestly there are a variety of factors at play here.
Some folks genuinely need the pain relief. My mother gets migraines (or a variant). They last literally weeks and months. Sometimes these drugs work. Other migraine drugs have similar issues (addiction and tolerance), but this is villified. The doctors simply talk to her about these things.
But just as importantly, folks aren't really able to take time off to heal properly nor can a group of folks afford medical care. If you can't take time off of work and rest, you wind up needing to take more pills. For example, I had gall bladder surgery some years back. Doctors said 7-10 days completely off work. I didn't have a choice but to go back before the 10 days (and 2 days before I went back to the surgeon for aftercare checkup). I hadn't used the prescription pain meds for a few days before I went back to work, but needed them that day. And if you can't afford to e fixed, you get bandaged over - drugs.
Just as bad is that we aren't simply making sure doctors know how to talk to patients about addiction with these. Signs, symptoms, and that there is care for it if they notice the early signs.
Now, the main thing with the drug company was that they weren't upfront about risks, and that is horrible and meant that we couldn't do the things we needed to do. Not that it matters anyway: Folks often can't take off work for drug treatment nor can they afford the care in so many cases.
Purdue pharma knew that their drug was more addictive that what was reported by the FDA, and chose to keep distributing it and pushing doctors to recommend it to people who didn't need it instead of re-doing the evaluation.
I did mention that they were not upfront about the risks. This is definitely not OK, but it is still only one of the factors.
Now, as far as pushing it to doctors: That's not an issue that is unique to this drug or this drug company. It is generally more referred to as an off-label use, which has its good and bad uses. And with things like pain medicines, it gets complicated because there are so many compounding factors. (Yes, they are prescribed too much, but we need more than tight controls on one drug class).
As someone who has had to deal with restrictions on other drugs I need to function, I’m always a bit reticent to go full in on “this drug is evil” narratives.
Is Oxycotin particularly addictive in itself in ways it could otherwise not be? Or is this about general painkiller addiction plus the pharmaceutical company taking advantage of this to push it out too much?
In other words, is there a way to tackle this problem that doesn’t cut access for people who actually need this stuff?
the problems with Purdue/oxycontin was their false and extreme marketing that falsely claim lower/tiny addiction rates, bribing doctors to prescribe, claiming 12 hour relief when many users got 8 hours, and the list goes on. perhaps a misleading shorter half-life could be 'more addictive' in that users took more than prescribed to keep effect going.
In general there seems to be a rule of thumb that shorter half-life drugs are more addictive - they hit you fast and wear off fast.
Within the same category of drugs, e.g. Benzodiazepines, it's pretty well established that the first step towards getting clean is to get the dose of low half-life drug swapped out for an equivalent dose of a long-acting drug, then taper down from there.
I believe this is also the theory behind the use of Subutex/Buprenorphine and Methadone as ways to get people off heroin and oxycontin.
So conversely, if Oxycontin had a shorter half-life than was advertised then one would expect it also to have a worse addiction profile.
I'm not sure about Oxycotin specifically, but people in severe pain generally should receive medication to alleviate it. I've had severe burning. Pain medication greatly reduced the amount of suffering that occurred.
The newer formulations - especially those that are slow release and combined with naloxone, are fine and have their use. The problem is the 20+ years of overprescribing straight up plain and crushable oxycontin that for a time was better than heroin
