Tag: opioids

  • Opioid Prescribing Varies Widely By Region, Study Shows

    Opioid Prescribing Varies Widely By Region, Study Shows

    In some states, patients were up to three times more likely to be prescribed opioids.

    Whether or not patients are prescribed opioids in the emergency room and how many of the pills they get varies widely by region, according to a new study, suggesting that despite increased awareness about the dangers of opioids there is still plenty of room to cut down on unnecessary prescribing. 

    According to Science Daily, researchers from the University of Pennsylvania School of Medicine examined insurance claims to see how patients presenting with sprained ankles were treated for pain.

    In some states, patients were up to three times more likely to be prescribed opioids. Researchers also found that people who received more opioid pills were five times more likely to fill an additional opioid prescription over the following six months. 

    “Although opioids are not—and should not—be the first-line of treatment for an ankle sprain, our study shows that opioid prescribing for these minor injuries is still common and far too variable,” said M. Kit Delgado, MD, MS, an assistant professor of Emergency Medicine and Epidemiology at Penn who led the study

    “Given that we cannot explain this variation after adjusting for differences in patient characteristics, this study highlights opportunities to reduce the number of people exposed to prescription opioids for the first time and also to reduce the exposure to riskier high-intensity prescriptions,” Delgado said. 

    The study examined more than 30,000 patient records and found that 25% were given opioids. 

    “Although prescribing is decreasing overall, in 2015 nearly [25%] of patients who presented with an ankle sprain were still given an opioid, a modest decrease from 28% in 2011,” Delgado said. “By drilling down on specific common indications as we did with ankle sprains, we can better develop indicators to monitor efforts to reduce excessive prescribing for acute pain.”

    Researchers found that there was a huge variation between states in the percentage of patients given opioids. For example, only 3% of patients received an opioid prescription in North Dakota, compared to 40% in Arkansas. If states with above-average prescribing were reduced to the average amount, 18,000 fewer opioids pills would be prescribed each year. 

    In addition, if all patients were given the smallest supply of opioids, usually 10-12 pills, there would be a significant reduction in the number of pills distributed. 

    “Simply making these amounts the default setting electronic medical record orders could go a long way in reducing excessive prescribing as our previous work has shown,” Delgado said, noting that the concept could be expanded to other areas of care.

    “It would be great to see analyses such as ours replicated in other settings, such as post-operative prescribing, where prescriptions are higher intensity. In these settings there may be greater opportunities to decrease transitions to prolonged opioid use by reducing excessive prescribing.”

    View the original article at thefix.com

  • Could Ketamine Replace Opioids In The ER?

    Could Ketamine Replace Opioids In The ER?

    A new study examined whether ketamine could work as an alternative to opioids for pain relief in an emergency room setting. 

    Ketamine could be a viable option for acute pain relief, working at least as well as morphine, according to a new medical review. 

    “Ketamine appears to be a legitimate and safe alternative to opioids for treating acute pain in the emergency department. Emergency physicians can feel comfortable using it instead of opioids,” Dr. Evan Schwarz, senior study author, said according to Medical News Today

    Schwarz led a team of researchers from the Washington University School of Medicine in St. Louis who reviewed the experience of 261 patients who were given only ketamine to treat their pain in the emergency room.

    The researchers found that ketamine was as effective as morphine for pain relief. There were no severe adverse affects reported, although ketamine did have a higher instance of minor adverse affects. Overall, however, the study authors concluded that ketamine is an effective pain relief tool. 

    “Ketamine is noninferior to morphine for the control of acute pain, indicating that ketamine can be considered as an alternative to opioids for ED short‐term pain control,” study authors wrote.

    Ketamine, which is a well-known party drug, was approved for medical use by the Food and Drug Administration (FDA) in 1970. Since then it has been used as an anesthetic. It is also sometimes used in conjunction with opioids for pain relief. However, the new study indicates that low-dose ketamine can provide pain relief even when it is used alone. 

    With more healthcare providers looking for alternative pain treatments that do not involve opioids, this is a promising finding. Ketamine is not addictive and does not cause respiratory depression, two conditions that are the main risk factors when using opioids to treat pain, particularly in older patients. 

    The study looked at a relatively small number of patients. However, authors said that its findings indicate that more research is needed into using ketamine as a potentially safer pain-relief option for acute pain. 

    “Opioids are commonly prescribed in the emergency department (ED) for the treatment of acute pain,” study authors wrote. “Analgesic alternatives are being explored in response to an epidemic of opioid misuse. Low‐dose ketamine (LDK) is one opioid alternative for the treatment of acute pain in the ED.”

    Ketamine has been showing promise for treating a variety of conditions. Earlier this year, ketamine nasal spray was shown to quickly reduce suicidal ideation in patients being treated in the emergency room.   

    View the original article at thefix.com

  • Relapsing While Famous: Demi Lovato, Stigma, and Compassion

    Relapsing While Famous: Demi Lovato, Stigma, and Compassion

    “We would typically not blame a patient with a chronic medical condition for their problem; nor imbue the patient with shame over their offending organ—why do we seem to do this with addiction?”

    The news that Demi Lovato was hospitalized of a suspected drug overdose has sent her celebrity friends and fans into overdrive; they are full of praise and well wishes for the singer.

    The support offered has been a beautiful response to witness, and this outpouring of encouragement is the exact caring that Lovato needs right now.

    This overwhelmingly positive response is a very different reaction than we normally associate with people falling off the wagon. Our society has painted the ordinary (non-celebrity) person with an addiction—whether it be to drugs, alcohol, sex or some other negatively perceived behavior—who loses their sobriety as a monster, as someone who cannot fix themselves, as a loser, as an undisciplined and unhealable soul.

    How many Internet memes have been generated that show the unforgiving and unflattering face of addiction? How many ill-conceived jokes about addicts relapsing have you heard? How often do you see mockery of those who have lost their fight? Or a sense of them being not strong enough to withstand the urges we all face?

    But the reality is that relapses are oftentimes part of the process, even for those who have spoken about their recovery. Just because someone has stood up and celebrated their recovery does not mean they will never possibly have a setback.

    Demi Lovato has been open about sharing her struggles through addiction, eating disorders and bipolar disorder. In her music (her song “Sober” details her ongoing struggle with sobriety), her interviews and social media accounts, Lovato has never shied away from speaking her truth. She is proud to be a mental health advocate and has spoken about how she knows her music has helped other young women struggling with some of the same issues that she has.

    Lovato’s openness in sharing her fight and the help her art has provided for others is all the more remarkable considering she was on the Disney Channel when she first entered rehab. There were many pressures and expectations upon her young shoulders and no one would have blamed her for wanting to keep that part of her life private.

    But admitting that the struggle continues after a setback can be the hardest part. Often, as a culture, we are not gung ho on offering people second chances, and especially not third or fourth chances.

    What’s that famous saying? Hurt me once, shame on you. Hurt me twice, shame on me.

    As a society, we can be unforgiving when it comes to people relapsing, but we seem to be much more sympathetic and forgiving with celebrities who struggle with addiction than we are with our ordinary peers.

    There is an unwritten social contract that we follow with celebrities that allows them to loom larger in our minds than normal, everyday people. We see them as larger than life while at the same time feeling intimately connected to them, as though they are family. We feel we know them.

    And we do know them when they share their personal demons with us. We recognize our own struggles and feel buoyed up by their example of openness and honesty.

    Could Lovato’s suspected relapse be an opening for a new understanding of the addiction cycle and conversation about the role of relapse in recovery? Perhaps her experience can shine a light on why no one deserves to be stigmatized for their illness.

    Of course, this goes for all mental health conditions, whether the diagnosis is addiction, bipolar disorder, depression, schizophrenia or others. Historically, our culture has stigmatized people with mental illness so that they feel embarrassed or that they need to hide their condition. It is only in recent decades that more individuals have been brave enough to come forward and speak about their struggles.

    Lovato’s overdose can serve as an example and a beacon to help people understand that addiction and other mental health issues are illnesses which aren’t always cured on the first, second or even third try.

    The fact that wealthy celebrities, who often have the best treatments and practitioners at their fingertips, still suffer relapses shows us how devastating mental health conditions can be. How can we expect our neighbors—who have those same diagnoses but may be struggling to make ends meet—to fare any better than our most celebrated and privileged?

    Many individuals prefer to suffer in silence rather than seek help because of this prejudice. They would rather live with often debilitating diseases rather than expose themselves to the potential stigma that comes with admitting they need help.

    What can we do to help alleviate the suffering of those around us?

    We can read and learn more about addiction and how difficult the road is to recovery and we can work to understand that the road is not always without bends and turns and sometimes brief exits.

    “Research has consistently shown addiction to be a chronic/relapsing disease, where multiple treatment episodes are often necessary, and that recovery may be a cumulative and progressive (non-linear) process,” says Dr. David Greenfield, Assistant Clinical Professor of Psychiatry at University of Connecticut Medical School and a specialist in addiction medicine. “We would typically not blame a patient with a chronic medical condition for their problem; nor imbue the patient with shame over their offending organ—why do we seem to do this with addiction?”

    We can have compassion for those who struggle and sometimes fall in their recovery, which will help alleviate their feelings of shame. For those closest to us, we can be supportive without enabling them or being codependent. The celebrity outpouring of love and caring through social media is an example of how compassion can be expressed through this modern tool.

    But Lovato’s friends are not the only ones sharing the love; her fans are sending messages of support, too.

    How Demi Lovato speaks to the public about her reported relapse can have real consequences for the greater conversation society needs to have. Hopefully, she will use her celebrity status to continue the dialogue with her fans about addiction; at the same time, she may express a need for privacy and time for reflection.

    The real opportunity for change will occur around the water coolers at work or on our social media feeds. When we can openly discuss mental health conditions—not as signs of weak moral character or evidence of being less than or incapable—but as true illnesses which require assistance from all corners—financial, family and friends, and sociocultural—we will then be truly supporting not only the celebrities amongst us, but our neighbors and ourselves as well.

    View the original article at thefix.com

  • DEA Agents Who Helped Bring Down Escobar To Tackle Opioids In New Series

    DEA Agents Who Helped Bring Down Escobar To Tackle Opioids In New Series

    The docu-series will reportedly give viewers unprecedented access to how the DEA plans and executes drug busts.

    Steve Murphy and Javier Peña are the former DEA agents who brought down cocaine kingpin Pablo Escobar. The Netflix show Narcos is based on their true experiences fighting the drug trade.

    Now Murphy and Peña are behind a new show about the opioid crisis and the DEA’s efforts to fight it.

    As The Wrap reports, this new docu-series will cover several different angles of the current drug war including what happened to the international drug cartels after the fall of Escobar.

    The show hopes to capture “controlled busts,” where smaller dealers can still continue their deliveries in exchange for giving up bigger dealers.

    The show will also feature doctors getting arrested for overprescribing opioids and pharmacists who are making fentanyl with their own pill presses.

    Murphy and Peña plan to film in China, where you can buy opioids off the web and get them delivered through U.S. mail. Murphy and Peña also plan to travel with DEA agents through Europe on drug busts.

    “What we want to do is show people what’s being done and what could be done,” Murphy says. “[The opioid epidemic] is now the leading cause of overdose deaths in the country.”

    Murphy says the DEA is “onboard” with this series, and it promises to give viewers unprecedented access to how the DEA plans and executes drug busts.

    “The DEA sees the seriousness of this epidemic,” says Murphy. “One of the things they agreed to do is take us to their Chinese counterparts and show us where fentanyl comes from, how it’s produced and how the pill press works.”

    The timing couldn’t be better for a series that will tackle the opioid crisis head on.

    Murphy told Fox Business, “The one thing that we’re finding out is that these new traffickers, like the ones we chased in the 1980s 1990s, are getting smarter at hiding their drugs. Now, most of them are coming through as counterfeit medications, and they are getting people sick, and they are dying.”

    Peña added, “Today’s [drug crisis] is worse than it was in the 1980s because of how smart these drug dealers are getting in smuggling these drugs into the country in the most modern and efficient ways possible.”

    The new Murphy and Peña show is currently being shopped around by powerhouse talent agency UTA. 

    View the original article at thefix.com

  • Recovery Advocates Respond To Trump's Opioid PSAs With New Video

    Recovery Advocates Respond To Trump's Opioid PSAs With New Video

    Two recovery advocates made a personal video about their addiction struggles in hopes of getting a meeting with the president to discuss opioid policies. 

    The Trump Administration’s quartet of “Know the Truth” public service announcements about the dangers of opioid use and abuse have garnered mixed reviews from the recovery community for their shocking tone.

    They have also spurred a response from an Ohio-based recovery advocate, who has created his own video that details a more personal take on dependency and recovery.

    Richie Webber, who recovered from heroin dependency to found Fight for Recovery, and his friend Chanda Lynn, of Jamestown, New York, talk openly about their struggles with dependency in the video in hopes of not only encouraging viewers to do the same, but also garnering a meeting with President Trump to discuss more compassionate opioid policies. The video has been submitted to a White House site for review.

    Webber has been sober for four years from a dependency on heroin that he developed in high school after suffering a sports injury. He currently operates Fight for Recovery, which offers support for those with dependency issues and their families and friends. He said that he was encouraged by Trump’s initial statements about dependency, which hinged on his brother, Fred, who struggled with alcoholism before his death in 1981. 

    But when he saw the “Know the Truth” videos, Webber said, “Wow, this isn’t going to work.” The strident tone reminded him of previous efforts, which he viewed as failed attempts. “We did the DARE commercials in the ’80s, and that clearly didn’t work,” he said.

    So with Lynn, whose previous videos about recovery have generated more than 8 million views, and Zach Yoney of Sandusky, Ohio, he created a message that talked directly to viewers—and Trump—about their paths to recovery.

    In the video, Webber discusses his “all-American” teen years, when he was a track star at Clyde High School, as well as the multiple overdoses, jail time and friends he lost to dependency. The piece concludes with a direct address to Trump: “Let us help you help America.”

    Since its release on Facebook in early July 2018, the video has been viewed more than 163,000 times. Webber and Lynn have plans to release additional videos, and hope to start filming a new effort in September 2018.

    He also remains active with Ohio-area events to raise awareness about dependency and recovery. “We’re just trying to cover as many bases as possible,” said Webber.

    View the original article at thefix.com

  • Man Sets Out On Legal Mission After Seeing Opioids Destroy His Hometown

    Man Sets Out On Legal Mission After Seeing Opioids Destroy His Hometown

    A West Virginia lawyer is working to hold major opioid manufacturers legally responsible for their role in the epidemic that has ravaged his home state.

    With record-high rates of overdose deaths and babies born with opioid dependence, Huntington, West Virginia is at the heart of the nation’s overdose crisis.

    It’s also home to Paul Farrell, a lawyer working to sue major opioid manufacturers, who doesn’t want his town to be grouped into the usual picture of downtrodden rural America. 

    “People have been underestimating me for a very long time,” Farrell told MSN. “I’m accustomed to being stereotyped as the Appalachia, redneck hillbilly.”  

    Farrell is leading the lawsuits for many West Virginia towns, who are suing big names like Purdue Pharma, Johnson & Johnson, Endo Pharmaceuticals, Teva, and drug distributors.

    He says that he has personally seen the toll that opioids have taken on the region. “I have people my age that I know that are addicted to opioids,” Farrell said. “I know people that have children in their early 20s that they have lost.”

    And yet Farrell isn’t overly sentimental about the crisis—he’s out for revenge. “We eat what we kill,” Farrell said. “I’m stalking. I’m stalking the herd.”

    Many of Farrell’s lawsuits hang on public nuisance laws, with his argument essentially being that drug manufacturers and distributors created a massive and costly public nuisance throughout the state. 

    “If you drop a nuclear bomb right there—boom!—this is the fallout,” Farrell said of the region. 

    Paul Hanly, a lawyer who has sued Big Tobacco and is working with Farrell on his suits, said that Farrell is tenacious in defending his region. 

    “He’s a gladiator,” Hanly said. “He feels he’s on a mission to correct some wrongs that have adversely affected his state worse than any other state in the nation.”

    Farrell is also unapologetic about the potential money that he could make from the lawsuits. The firms filing the suits stand to make up to 25% of their client’s portions of any settlement. With settlements that could reach $50 billion, the payout for lawyers could be significant. 

    “Sometimes it’s a feast. Sometimes it’s a famine,” Farrell said.

    Farrell started his career in family law, before moving on to the more lucrative role of a plaintiff’s attorney, representing people who had been harmed. “I was writing very large checks to dumbass lawyers, and I thought to myself, ‘I’d like to be one of those dumbasses that gets one of these checks,’” Farrell said.

    This time, he’s aiming for a significant payout for the communities that have been impacted. Farrell believes that past settlements between West Virginia and opioid manufacturers have been too small.

    “It pissed me off that we got handled like that,” he said.

    View the original article at thefix.com

  • Elizabeth Warren Questions Trump's Response To Opioid Crisis

    Elizabeth Warren Questions Trump's Response To Opioid Crisis

    “You pledged that ‘we will be spending the most money ever on the opioid crisis.’ Yet your claim appears to have no basis in reality.” 

    Senator Elizabeth Warren is not impressed with President Donald Trump’s lack of action when it comes to the opioid crisis—and she is making that known.

    According to Vox, the senator (D-MA) wrote a letter to Trump recently, expressing her concern.

    “Experts and observers have concluded that your efforts to address the opioid crisis are ‘pathetic’ and ‘ambiguous promises’ that are ‘falling far short of what is needed’ and are ‘not… addressing the epidemic with the urgency it demands,’” she wrote. “I agree, and I urge you to move quickly to address these problems.”

    In her letter, Warren highlights the fact that while campaigning and while in office, Trump has made promises to take action. In October, he declared the opioid epidemic a national public health emergency—a declaration that has been renewed twice since, according to Vox.

    Next week, it’s due to be renewed for a third time. 

    “Six months after you first declared the opioid crisis a public health emergency, you pledged that ‘we will be spending the most money ever on the opioid crisis,’” Warren wrote. “Yet your claim appears to have no basis in reality. While the U.S. Senate reached a budget agreement earlier this year to spend an additional $6 billion over two years to address the opioid crisis, your Administration’s own proposals to address the opioid crisis, including your most recent opioid initiative policies released on March 19th, lack commitments of federal funds.”

    Warren goes on to ask Trump to expand on how his administration is taking action and whether the public health emergency declaration will be extended.

    “Despite multiple calls to action from public health advocates and families whose loved ones have been devastated by the ongoing opioid crisis, your Administration is failing to implement aggressive and necessary measures to combat this epidemic,” she wrote. “Efforts by state and local governments and communities to address this crisis require support, meaningful action, and resources from the federal government.”

    Warren concluded by asking Trump to respond to her letter, as well as a number of questions, by  July 23, 2018.

    Warren isn’t the only one taking action and voicing concern, Vox notes. In fact, Warren teamed up with Rep. Elijah Cummings (D-MD) to introduce a bill that would allocate $100 billion to the opioid epidemic over the next decade.

    Other senators are also questioning the president’s lack of action. In January,  Sen. Patty Murray (D-WA) and other democrats in the senate requested a Government Accountability Office investigation into Trump’s actions when it comes to the crisis.

    In April, they sent an additional letter.

    According to Vox, Warren says her letter and questions have not yet been addressed.

    View the original article at thefix.com

  • Could A Scientific Study Have Slowed The Opioid Crisis?

    Could A Scientific Study Have Slowed The Opioid Crisis?

    Researchers suggest that a recent pragmatic trial could have played a key role in curbing the crisis. 

    While opioids are effective for acute pain relief, the widespread addiction and dependence that have swept up the country have showed that the powerful pills have unintended consequences, even as studies suggest that opioids are less effective for long-term pain than over-the-counter options. 

    Most medications are approved after undergoing a randomized controlled trial, but a different type of scientific study could have showed the real-world problems with using opioids for chronic pain relief, according to Aaron E. Carroll, a professor of pediatrics at Indiana University School of Medicine who blogs on health research and policy at The Incidental Economist.

    “These different kinds of studies actually exist. They are called pragmatic trials, and a recent one might have helped serve as a brake as the opioid epidemic accelerated,” Carroll writes in an essay for The New York Times

    Whereas randomized controlled studies evaluate whether a drug is effective in ideal circumstances, pragmatic studies measure a drug’s effectiveness in the real world. 

    “A pragmatic trial seeks to determine if, and how, an intervention might work in practice, where decisions are more complicated than in a strictly controlled clinical trial,” Carroll writes. 

    A randomized controlled study of opioids, for example, would compare whether people taking opioids get more pain relief than those taking a placebo. This is challenging, however, because people who are being treated for pain are desperate for relief, and often change treatments hoping to find one that will work. 

    “Under these conditions, it’s hard to get patients to participate, and the same with doctors,” Carroll writes. 

    The Strategies for Prescribing Analgesics Comparative Effectiveness study took a more pragmatic approach to analyzing the effectiveness of pain relief medications, comparing opioids to non-opioid treatment.

    Whether a patient was receiving opioid or non-opioid treatment there were options to progress to stronger pain relief options, which helped people stick with the study long-term, rather than dropping out to try other pain relief. Doctors could also change doses and medications within the same class, tailoring treatment to the individual patients. 

    “That’s how actual care occurs,” Carroll writes. “This way, you can measure how treating someone with opioids might compare with treating someone without opioids for a sustained period.”

    The study eventually showed that adverse symptoms were lower for patients treated without opioids, and those patients were also less likely to become dependent. 

    Although studies like this are important, Carroll writes that they’re unlikely to become mainstream because of their intricacies and expense. 

    “Although drug companies are willing and ready to pay for randomized controlled trials to prove efficacy, it’s not clear who is going to finance studies like these,” Carroll writes. “They use lots of different drugs—which is what happens in the real world—and no company wants to foot the bill for other companies’ products to be evaluated. Certainly no opioid-related companies would want to pay for this trial.”

    View the original article at thefix.com

  • Demi Lovato Hospitalized For Apparent Overdose

    Demi Lovato Hospitalized For Apparent Overdose

    Paramedics reportedly revived Lovato with Narcan before transporting the singer to the hospital for further treatment. 

    Demi Lovato has been hospitalized after an alleged heroin overdose, according to numerous reports Tuesday afternoon.

    According to TMZ, which broke the news, the singer and actress, 25, was rushed to a Los Angeles hospital shortly before noon on Tuesday, July 24.

    Paramedics were called to the singer’s Hollywood Hills home where she was found unconscious. The first responders reportedly revived the singer with Narcan before transporting her to the hospital, according to TMZ.

    Law enforcement tells TMZ that the hospitalization was due to a heroin overdose and Lovato is being treated. Currently, her condition is not known. 

    Lovato has a history of substance use disorder, bipolar disorder and has also battled bulimia. On March 15, 2018, she celebrated six years of sobriety. However, in June, Lovato released a new song called “Sober,” which led listeners to believe she was no longer abstaining from substance use.

    The chorus of the song is as follows: 

    “Momma, I’m so sorry, I’m not sober anymore/And daddy, please forgive me for the drinks spilled on the floor/To the ones who never left me/We’ve been down this road before/I’m so sorry, I’m not sober anymore.”

    In October 2017, Lovato released a YouTube documentary called Demi Lovato: Simply Complicated, in which she discussed her alcohol and cocaine use. 

    Last October, Lovato also spoke out about her recovery when receiving the Spirit of Sobriety award at a Brent Shapiro Foundation fundraising event.

    Every day is a battle,” she said. “You just have to take it one day at a time, some days are easier than others and some days you forget about drinking and using, but for me, I work on my physical health, which is important, but my mental health as well.”

    She added that when it comes to her recovery, she puts in the work like anyone else. “I see a therapist twice a week,” she said. “I make sure I stay on my medications. I go to AA meetings. I do what I can physically in the gym. I make it a priority.”

    In the aftermath of her apparent overdose, other celebrities reached out, offering their prayers.

    “My friend @ddlovato is one of the kindest, most talented people I’ve ever met,” tweeted country singer Brad Paisley. “Praying for her right now, addiction is a terrifying disease. There is no one more honest or brave than this woman.”

    Ellen DeGeneres also offered her support.

    “I love @DDLovato so much,” she wrote on Twitter. “It breaks my heart that she is going through this. She is a light in this world, and I am sending my love to her and her family.”

    View the original article at thefix.com

  • Purdue Pharma Knew About Oxy Misuse Early On, Report Finds

    Purdue Pharma Knew About Oxy Misuse Early On, Report Finds

    The report also alleges that in 1999 company officials learned of a call to a pharmacy describing “OxyContin as the hottest thing on the street—forget Vicodin.”

    Purdue Pharma reportedly knew that the opioid pill OxyContin was being snorted and sold on the street as early as 1999, just three years after the medication’s release.

    However, the company reportedly kept quiet about this knowledge and continued marketing the drug as a safer pain-relief pill.

    The New York Times obtained a confidential Justice Department report that was compiled in the early 2000s, leading up to Purdue’s settlement with the federal government in 2007.

    Purdue executives have testified in Congress that they did now know that the product was being abused until the United States attorney in Maine issued a warning in 2000. 

    “Everyone was taken by surprise by what happened,” Purdue’s top medical officer, Dr. Paul D. Goldenheim, testified in 2001. “We launched OxyContin in 1996, and for the first four years on the market, we did not hear of any particular problem.” 

    However, the Justice Department report shows that this is not true.  

    “We have in fact picked up references to abuse of our opioid products on the internet,” Purdue Pharma’s general counsel, Howard R. Udell, wrote in early 1999 to another company official.

    The report also alleges that in 1999 company officials learned of a call to a pharmacy describing “OxyContin as the hottest thing on the street—forget Vicodin.”

    Federal prosecutors also found the words “street value,” “crush,” or “snort” in 117 internal notes that recorded meetings between Purdue representatives and doctors before 2000.

    The report’s findings were so alarming that prosecutors recommended that felony charges be brought against three of Purdue’s executives. However, Justice Department officials under George W. Bush did not support that and ended up brokering a settlement in 2007 that avoided felony criminal charges and allowed Purdue to continue selling OxyContin

    Now, some people see this as a missed opportunity. 

    “It would have been a turning point,” said Terrance Woodworth, a former Drug Enforcement Administration official who investigated Purdue Pharma in the early 2000s. “It would have sent a message to the entire drug industry.”

    However, another former DEA official told The New York Times that U.S. Attorney John Brownlee ultimately felt that accepting a deal would be best because Purdue had so many resources available to aid in its defense, including the expertise of Rudy Giuliani, who helped craft the deal for Purdue. 

    “He told me he was outgunned,” Joseph Rannazzisi said. 

    Brownlee has said that he felt the deal reached in 2007 was appropriate, but that he thought it would trigger tighter oversight of Purdue, something that did not happen. 

    “I didn’t feel as a lawyer I could be in a position to bar anyone from getting OxyContin. Faced with that decision, I was just simply not prepared to take it off the market. I didn’t feel like that was my role,” he said. “My role was to address prior criminal conduct. Hold them accountable. Fine them. Make sure the public knew what they did.”

    View the original article at thefix.com