Zero to 8 million

Painkiller has well-documented history of abuse

By Ty Bowers - Staff Writer
citizenet.com

The company sold its first cure-all elixir in 1892 for
those suffering through America's Gilded Age.

Doctors touted Gray's Glycerine Tonic Compound as a
"sherry-based tonic for numerous ills," according to the
Purdue Pharma LP corporate Web site.

In the decades since, the drug maker has sold laxatives,
antibiotics and an ear wax remover ? none of them as
successful as OxyContin.

Hailed as the latest, perhaps greatest remedy for pain in
medical history, the powerful opiate hit the market in
1995.

The drug also has been linked to more than 400 overdose
deaths nationwide, according to law enforcement
officials.

The widespread abuse of OxyContin has put Purdue Pharma
at odds with regulators and forced the company to fight
dozens of legal battles.

Blockbuster sales of the drug have fueled the firestorm.

Purdue Pharma's sales of OxyContin topped $1 billion in
2001, according to company officials. U.S. pharmacists
filled more than 8 million prescriptions for the drug.

For decades, the Connecticut-based company has sought to
end what its leaders term the "under-treatment of pain,"
spokeswoman Merle Spiegel said last week.

It has developed drugs to manage pain, be it the constant
throb of arthritis or the terminal aches of end-stage
cancer.

Company researchers estimate that more than 50 million
Americans suffer from some sort of chronic pain, Ms.
Spiegel explained. "And that's probably a conservative
estimate."

She disputed claims that Purdue Pharma has marketed
OxyContin too aggressively for patients in little need of
it.

The company patented its first strong painkiller in 1984.
MS-Contin, an oral form of morphine, used a "controlled-
release" formula to dispense the drug throughout the body
over a 12-hour period.

By 1987, the company's drug sales exceeded $100 million.

But in OxyContin, Purdue Pharma struck gold.

A nearly pure form of the opiate oxycodone, the drug
delivers one of the strongest forms of pain relief on the
market.

The Food and Drug Administration approved OxyContin in
1995 for moderate to severe chronic pain lasting for
three days or more.

Doctors prescribed the drug for nearly 500,000 people in
1996, according to the company. Its use has risen 1,500
percent in the years since.

"It's a good drug for chronic pain," said Dr. Chris
Holstege, a toxicologist and director of the Blue Ridge
Poison Control Center at the University of Virginia.

"Unfortunately, it's a preferred drug for opioid
abusers," Dr. Holstege said.

OxyContin attaches itself to the body's opioid receptors
along the spinal cord and in the brain. As a result, the
drug blocks pain signals sent to the brain.

But drug addicts have found a way around OxyContin's
"controlled-release" mechanism.

By crushing a tablet, then snorting or injecting it,
users get an "instant shot" of the drug's full dose ?
anywhere from 10 to 80 milligrams of pure oxycodone.

The high mimics the euphoric effects of heroin, Dr.
Holstege explained.

The first reports of OxyContin's abuse surfaced in 2000
in rural Maine, according to Purdue spokeswoman Spiegel.

Cases of abuse, theft and crime involving the drug
quickly became common in "Appalachia" ? eastern Kentucky,
eastern Tennessee, West Virginia and Southwest Virginia.

Since 2000, OxyContin abuse has spread, reaching Florida
to the south, Arizona to the west and Nova Scotia,
Canada, to the north.

"It's certainly an issue we see in our practice," Dr.
Holstege said.

The Blue Ridge Poison Control Center's coverage area
extends from Southwest Virginia to Winchester, including
Fauquier. . . .
?[...]
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