The abuse and diversion of OxyContin has not been a secret to the public, law enforcement, pharmaceutical companies, or even patients. The drug has been made out to be a villain by the media, who often refer to the brand-name drug when other forms of oxycodone were actually the drug involved.
Nonetheless, the drug has definitely been a major source of abuse, fetching street prices of $1 per milligram and, in some areas and cases, even higher. Since OxyContin is an extended-release product, it is packed with the pain reliever oxycodone, and designed to be released over the course of approximately 12 hours. Since it is a pure drug, with no acetaminophen or other substances, there is no ceiling dosage.
When OxyContin is taken intact, it releases the powerful CII drug over the course of many hours, providing patients in pain with the promise of continuous relief, hopefully eliminating the peaks and valleys of short-acting pain relievers, and the necessity of taking many more pills over the course of a day. After conversing over the years with thousands of physicians, I am convinced that OxyContin is a superb analgesic—maybe the best for patients with chronic pain ever made. I have never heard any of those physicians complain that the drug did not work effectively, or that their patients were experiencing significant side effects.
An Explosion of Abuse
It sounded like the perfect pain reliever, until 1 or 2 years after the launch, when innovative drug abusers found that if OxyContin is broken down and chewed, injected, snorted, and even smoked, it can create a terrific “high.” This created an explosion of abuse and diversion of Will It Prevent Illicit Use?
This drug, first discovered in the state of Maine, of all places. The rest is history, as they say, and Purdue Pharma has struggled with a huge volume of bad press coverage, sometimes accurate, sometimes incredibly inept.
Something that needs to be mentioned is that over the course of these years, Purdue Pharma has taken unprecedented steps to educate the public, prescribers, and law enforcement about the abuse and diversion of pain relievers, as well as appropriate pain management. They have hired a small elite group of former law enforcement officers who had deep roots in the area of drug diversion to travel the country—educating law enforcement on prescription drug abuse, including their own product.
In the interest of disclosure, Purdue Pharma also provides the National Association of Drug Diversion Investigators (NADDI), of which I am the national president, with unrestricted grant money that we provide in the form of awards to law enforcement. In addition, they have funded our very popular Abused Pharmaceutical Substances brochure that is sent free to law enforcement across the United States.
In mid-August 2010, after approval by the FDA, Purdue Pharma began distributing a reformulation of OxyContin. The active ingredient inside did not change, but the outside of each pill was produced with the goal of making it much more difficult to compromise, something that if successful, would cause the ire of drug-seekers.
The other change was that the indicia of each strength of OxyContin changed from the letters “OC” on one side, to the letters “OP,” for those dispensed in the United States. The milligram strength of each pill still remains on the other side. The 80-mg pills are slightly larger, although this is difficult to distinguish with the naked eye.
As I write this article, the new formulation has been out at retail pharmacies for 6 weeks. By the time you read this, there will likely be none of the “OC” OxyContin on the shelves. My drug unit immediately began to see the “OP” version on the street for sale, with the chatter going back and forth among abusers as to their displeasure of this new product hitting the scene.
I also monitor law enforcement across the United States, and most have reported a drop in price, with the new formulation at about half of the old OxyContin’s street value. If the difficulty to break this drug down continues, I would expect the illegal street price of OxyContin to continue to drop accordingly. Besides, immediaterelease oxycodone products can contain up to 30 mg of the drug without the hassle of trying to make it suitable for injection, snorting, chewing, or smoking, and it seems to be readily available right now.
I have sincere hope that the new formulation of OxyContin will remain difficult, if not impossible, to break down for illicit use, and yet still remain effective for legitimate patients. Time will tell, as this is truly a unique opportunity to compare “apples to apples” over the next several months and years.