OxyContin, prescription opioid abuse and economic medicalization

Poitras, Geoffrey

doi:10.2147/mb.s32040

Cited by 10 publications

(13 citation statements)

References 41 publications

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“…Their accounts, which involved crossing thresholds of stigmatized behavior at each stage, attributed this progression to their growing dependence and tolerance, the rising cost of their pill habit coupled with their need to avoid withdrawal symptoms and heroin’s easy availability and comparatively lower cost. Depending on local markets, interviewees and published sources have reported pill prices varying considerably across the country (eg Poitras, 2012). …”

Section: Resultsmentioning

confidence: 99%

“Every ‘Never’ I Ever Said Came True”: Transitions from opioid pills to heroin injecting

Mars

Bourgois

Karandinos

et al. 2014

International Journal of Drug Policy

405

278

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Section: Resultsmentioning

confidence: 99%

“Every ‘Never’ I Ever Said Came True”: Transitions from opioid pills to heroin injecting

Mars

Bourgois

Karandinos

et al. 2014

International Journal of Drug Policy

405

278

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“…25 In tandem with this growing movement, drug manufacturers began the aggressive promotion of new opioid formulations for the treatment of chronic pain. 6,26 Legal proceedings have allowed key insights into one major instance of this promotion, namely, the development and marketing of sustained-release oxycodone by Purdue in the US. In 2007, Purdue pleaded guilty to the felony misbranding of OxyContin TM .…”

Section: 15mentioning

confidence: 99%

“…In 2007, Purdue pleaded guilty to the felony misbranding of OxyContin TM . 26 They acknowledged capitalizing on the notion that oxycodone was less potent than morphine and suggesting that long-acting oxycodone might be used to ''weed out'' addicts and drug seekers. 27 The company's sales representatives were incentivized to increase sales.…”

Section: 15mentioning

confidence: 99%

“…26,28 They issued free samples to pharmacies and targeted high-frequency physician prescribers while reporting a falsely low addiction risk among oxycodone users. 26 Other opioid manufacturers have also been cited for inappropriate marketing, including Janssen Pharmaceuticals and King Pharmaceuticals. 6 Less is known about the marketing of opioids in Canada.…”

Section: 15mentioning

confidence: 99%

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The prescription opioid epidemic: an overview for anesthesiologists

Alam

Juurlink

2015

Can J Anesth/J Can Anesth

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Purpose The objectives for preparing this article were to review the historical context and epidemiology surrounding the North American prescription opioid crisis, to summarize the evidence regarding the benefits and harms of long-term opioid therapy for non-cancer pain, and to outline ways in which anesthesiologists may help ameliorate the problem. Source We searched PubMed, Google Scholar, and EMBASE TM for relevant articles using various search terms, including pain, opioid epidemic, history of opioid use, perioperative care, and addiction. Related citations were further explored and searched depending on the specific subtopic of interest. Principal findings In the 1980s and early 1990s, opioids were infrequently used for the treatment of chronic pain. Thereafter, however, physicians were gradually inculcated with the message that long-term opioid therapy was a safe and effective treatment option for patients with chronic non-cancer pain. Pharmaceutical companies supported this growing movement and employed aggressive and sometimes misleading marketing strategies for new opioid formulations. As a result, the practice of prescribing opioids flourished in the late 1990s. The surge in prescribing opioids was accompanied by a marked increase in opioid-related morbidity and mortality. This change in practice transpired despite the absence of randomized trials showing clinically significant benefit from the long-term use of opioids. Subsequently, however, a large and growing body of evidence has emerged quantifying the harms associated with long-term opioid therapy. Anesthesiologists widely prescribe opioids for acute and chronic pain; yet, as a group, they may be largely unaware of the current state of this growing epidemic and what role they can play to rectify this problem.Conclusion Anesthesiologists are well positioned to take a leadership role in the management of postoperative discharge opioid therapy in an effort to curb the overutilization of opioids. Furthermore, anesthesiologists who regularly prescribe opioids for chronic pain patients should appreciate the limited evidence base for this practice and communicate the risks of opioid therapy to their patients.

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“…Since a previous contribution to this journal in 2012, 2 the epidemic of opioid abuse has become increasingly frightening and tragic. That contribution focused on the relevance of OxyContin to prescription opioid diversion and abuse, the marketing tactics employed by pharmaceutical companies to promote products, and the associated economic medicalization of substance abuse and addiction.…”

Section: Introductionmentioning

confidence: 99%

The prescription opioid epidemic: an update

Poitras¹

2018

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Background: Since a previous contribution to this journal in 2012, the epidemic of opioid abuse has become increasingly frightening and tragic. Of an estimated 62,632 drug overdose deaths in the US in 2016 about 2/3 were from opioids, more than deaths from traffic fatalities. Preliminary data for 2017 indicates an even higher opioid overdose death count. Methods: This paper reviews available data from public health agencies and other sources detailing the significant changes in both the regulatory response and characteristics of the opioid overdose epidemic. While discussion provided is primarily for the US, where the epidemic is centered, results from other countries, such as Canada, are also examined. Results: The available data indicates a dramatic evolution in both the characteristics of the epidemic and the legal fallout for companies involved in providing prescription opioids. Regulatory efforts to control the supply of prescription opioids, such as revised guidelines for physicians employing opioids in pain management, combined with an avalanche of lawsuits against companies involved in the prescription opioid supply chain, has resulted in a frightening shift in to fentanyl-contaminated black market opioids by addicted populations. Conclusion: The shift to black market opioids has created an even more complicated regulatory problem, exposing the deep societal problems that underpin the epidemic. While attempts to address this new stage of the epidemic, including the widespread use and availability of naloxone, creating of drug injection sites, passage of 'Good Samaritan' laws and the like, have not been accompanied by a commensurate reduction in the overdose death rate.

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OxyContin, prescription opioid abuse and economic medicalization

Cited by 10 publications

References 41 publications

“Every ‘Never’ I Ever Said Came True”: Transitions from opioid pills to heroin injecting

“Every ‘Never’ I Ever Said Came True”: Transitions from opioid pills to heroin injecting

The prescription opioid epidemic: an overview for anesthesiologists

The prescription opioid epidemic: an update

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