Monday, March 12, 2018

Opioids are Legal Heroin. They Are Killing Our Kids.

Did you know that legally prescribed opioid narcotics like OxyContin, Vicodin and Percocet are actually pharmaceutical-grade heroin produced in a laboratory? Many patients taking prescription opioids know them as “pain killers” and are not aware of their similarity to heroin.
Approximately 100 years ago, "Heroin" was first marketed as “safe” by Bayer and it was widely prescribed to everyone including children. Around the 1920’s Heroin was pulled from the market because of its highly addictive nature. Today, OxyContin and Percocet are two of the frequently prescribed opioids used to treat pain. They were both originally developed to treat cancer pain ONLY. Both are narcotics containing the active ingredient oxycodone.
The molecular structures of heroin and oxycodone are almost identical. Prescription opioid narcotics come from the same place heroin does – the opium poppy. Oxycodone and other legally prescribed opioids mimic the effects of heroin on the body and mind and in fact are used interchangeably by many who are addicted. This is the primary reason we are seeing an epidemic of death and addiction caused by prescription opioids, far surpassing those of illicit drugs.
To understand the appeal of opioids it is necessary to understand the effects. At low to moderate doses the “High” from opioids is not intoxication or impairing (as with alcohol). It does not feel like alcohol or marijuana, or hallucinogens. It instead provides feelings of intense joy and comfort, much more so than can be obtained naturally. It is similar to feelings of joy from achieving a lifetime goal, rather than an impairment.
At higher doses, breathing is slowed, eventually to the point of death. This respiratory depression is the cause of overdose deaths. With opioids there is a small window between euphoria and death.
How did this start? How did they hook so many people on prescription heroin? Marketing and scientific fraud. Greed. Control. Purdue developed OxyContin as a cure for pain — and to solve a financial problem from lost revenue on a drug called MS Contin used to treat cancer pain ONLY. The company’s owners were the Sacklers, a New York family of physicians and philanthropists, who bought Purdue in 1952. By the late 1980s, the patent on its main source of revenue, a morphine pill for cancer patients called MS Contin, was running out. Executives anticipated a massive loss of revenue as generic versions drove down the price of MS Contin. The company was focused on finding a new moneymaker. In a 1990 memo, Robert F. Kaiko, vice president for clinical research, laid out why it was important to develop a second painkiller:
“MS Contin may eventually face such serious generic competition that other controlled­-release opioids must be considered,” Kaiko wrote. Purdue already had developed a technique to stretch a drug’s release over time. In MS Contin, the technique made morphine last eight to 12 hours. Kaiko and his colleagues decided to use it on an old, cheap narcotic, oxycodone. Sold under several names and formulations, including Percocet and Roxicodone, Oxycodone controls pain for up to six hours.
With the delayed-release technique, executives theorized, the drug would last 12 hours — at least twice as long as generics and the high end of MS Contin’s range. Over the next decade, Purdue sunk more than $40 million into development of OxyContin.
The first patients to use OxyContin were women recuperating from abdominal and gynecological surgery at two hospitals in Puerto Rico in 1989. In the clinical study, designed and overseen by Purdue scientists and paid for by the company, 90 women were given a single dose of the drug while other patients were given short-acting painkillers or placebos. None of the women were regular users of painkillers, so they were more susceptible to the effects of narcotics. Even so, more than a third of the women given OxyContin started complaining about pain in the first eight hours and about half required more medication before the 12-hour mark. Regardless, Purdue moved ahead on two paths: seeking patents for its new drug and running additional clinical trials to secure FDA approval.
In a 1992 submission to the Patent Office, the company portrayed OxyContin as a medical breakthrough that controlled pain for 12 hours “in approximately 90% of patients.” Applying for a separate patent a few years later, Purdue said that once a person was a regular user of OxyContin, it “provides pain relief in said patient for at least 12 hours after administration.”
Purdue’s researchers, meanwhile, were conducting at least a half dozen clinical trials, according to the company’s FDA application. In study after study, many patients given OxyContin every 12 hours would ask for MORE medication before their next scheduled dose.
For example, in one study of 164 cancer patients, one third of those given OxyContin dropped out because they found the treatment “ineffective,” according to an FDA analysis of the study. Researchers then changed the rules of the study to allow patients to take supplemental painkillers, known as “rescue medication,” in between 12-hour doses of OxyContin. In another study of 87 cancer patients, “rescue was used frequently in most of the patients,” and 95% resorted to it at some point in the study, according to a journal article detailing the clinical trial.
A Tennessee pain specialist whom Purdue selected to field-test the drug in 1995 as part of the FDA approval process eventually moved 8 of 15 chronic pain patients to 8-hour dosing because they were not getting adequate relief taking the drug twice a day.
Narcotic painkillers work differently in different people. Some drug companies discuss that variability on their product labels and recommend that doctors adjust the frequency with which patients take the drugs, depending on their individual response.
The label for Purdue’s MS Contin, for instance, recommends that doctors prescribe the drug every eight or 12 hours to suit the patient. The morphine tablet, Kadian, manufactured by Actavis, is designed to be taken once a day, but the label states that some patients may need a dose every 12 hours. Despite the results of the clinical trials, Purdue continued developing OxyContin as a 12­-hour drug. It did not test OxyContin at more frequent intervals.
To obtain FDA approval, Purdue had to demonstrate that OxyContin was safe and as effective as other pain drugs on the market. Under agency guidelines for establishing duration, the company had to show that OxyContin lasted 12 hours for at least half of patients. The FDA approved the application in 1995.
Dr. Curtis Wright, who led the agency’s medical review of the drug, left the FDA and, within two years, was working for Purdue in new product development.
After OxyContin hit the market in 1996, ads in medical journals left no ambiguity about how long it lasted. A spotlight illuminated two dosage cups, one marked 8 AM and the other 8 PM.
A 1997 OxyContin advertisement in the American Family Physician shows marketing promoting the benefits of 12-hour dosing. he year OxyContin was introduced, Elizabeth Kipp, a 42-year-old stay-at-home mom, went to her doctor in Kansas City, Kan. She had struggled with back pain since age 14, when she was thrown from a horse while practicing for an equestrian competition.
In the intervening decades, she’d taken short-acting generic painkillers. On that day in 1996, her physician said he had something new for her to try. He told her to take OxyContin every 12 hours. Kipp, who had a bachelor’s degree in plant science from the University of Delaware, said she followed his instructions precisely.
“I’m a scientist, very regimented,” she said.
For the first two or three hours, she experienced a “modicum of relief.” Then her pain roared back, accompanied by nausea, she said in an interview. Only the next pill would relieve her suffering. She spent hours lying rigidly on her bed, waiting.
“I was watching the clock. ‘What time is it? Oh, God, I have to medicate. My whole nervous system is on red alert. You want a description of hell. I can give it to you.”
She eventually checked herself into rehab and said she no longer takes painkillers.
Before OxyContin, doctors had viewed narcotic painkillers as dangerously addictive and primarily reserved their long-term use for cancer patients and the terminally ill. Purdue envisioned a bigger market.
“We do not want to niche OxyContin just for cancer pain. We need to use it on healthy people, too."
The company spent $207 million on the launch, doubling its sales force to 600. Sales reps pitched the drug to family doctors and general practitioners to treat common conditions such as back aches and knee pain. Their hook was the convenience of twice-a­-day dosing. With Percocet and other short-acting drugs, patients have to remember to take a pill up to six times a day. Purdue told doctors that OxyContin spares patients from anxious clock­watching. Sales reps showered prescribers with clocks and fishing hats embossed with “Q12h.” The company invited doctors to dinner seminars and flew them to weekend junkets at resort hotels, where they were encouraged to prescribe OxyContin and promote it to colleagues back home. The marketing succeeded in ways that astonished even Purdue executives. OxyContin didn’t just replace MS Contin revenues. It dwarfed them.
By the third year, sales were more than double MS Contin’s peak, according to sworn testimony by a Purdue executive. By the fifth, OxyContin was generating annual revenue of more than $1 billion. Sales would continue to climb until 2010, when they leveled off at $3 billion.
Purdue’s owners, the Sackler family, were already rich — the family name adorns a wing of the Metropolitan Museum of Art and several galleries in the British Museum. The success of OxyContin brought a whole new level of wealth. Forbes magazine last year estimated the Sacklers’ worth at $14 billion, which, the magazine noted, put the family ahead of American dynasties such as the Mellons and Rockefellers.
OxyContin’s impact on the practice of medicine was similarly transformative. Other drug companies began marketing their own narcotic painkillers for routine injuries. By 2010, one out of every five doctor’s visits in the U.S. for pain resulted in a prescription for narcotic painkillers, according to a Johns Hopkins University study. OxyContin accounted for a third of all sales revenue from painkillers that year, according to industry data.
Rates of addiction and overdose have soared alongside the rise in prescriptions. News coverage of these problems in Appalachia and New England in the late 1990s made OxyContin notorious. Purdue dispatched representatives to Virginia, Maine and elsewhere to defend its drug and quiet the media. They blamed misuse of OxyContin and insisted their pill was a godsend for pain sufferers when taken as directed.
The U.S. Justice Dept. launched a criminal investigation, and in 2007 the company and three top executives pleaded guilty to fraud for downplaying OxyContin’s risk of addiction. Purdue and the executives were ordered to pay $635 million. The case centered on elements of Purdue’s marketing campaign that suggested to doctors that OxyContin was less addictive than other painkillers.
In the years after the settlement, Purdue funded programs to prevent pharmacy robberies and keep teenagers from stealing relatives’ pills. The company eventually rolled out a tamper-resistant version of the painkiller that was harder to crush and snort. But in all the scrutiny of Purdue and OxyContin, the problem of the drug wearing off early was not addressed.
Purdue sales reps who spent their days visiting doctors to talk up OxyContin heard repeatedly that the drug didn’t last. In reports to headquarters, they wrote that many physicians were prescribing it for three or even four doses a day. Company officials worried that if OxyContin wasn’t seen as a 12-hour drug, insurance companies and hospitals would balk at paying hundreds of dollars a bottle. Some already were.
Dr. Lawrence Robbins started prescribing OxyContin at his Chicago migraine clinic shortly after it hit the market. The neurologist recalled in an interview that “70 to 80%” of his patients reported that the drug “just lasts four, five, six, seven hours.” Robbins started telling people to take it more frequently. But insurance carriers often refused to cover the pharmacy bill for more than two pills a day, he said.
Over the years, he wrote insurance companies more than 25 times on behalf of patients who he believed needed OxyContin more frequently than every 12 hours, he said. In some cases, the insurers relented. When others did not, Robbins switched the patients to another drug.
Over 100 people die from heroin or prescription heroin overdoses everyday. Those are just the ones reported. In some small towns, devastated by job loss and poverty, the entire population is addicted to Oxy. What did the last administration do about opioid addiction? Averted their eyes and pushed for legalized recreational marijuana, another gateway drug, to create a whole new generation of addicts. A medicated society is a compliant society. Easier to control them and take their guns that way. Many universities take lots of money from Purdue. Like Yale, which has a professorship funded by the Sacklers at its Cancer Center and which is also home to the Raymond and Beverly Sackler Institute for Biological, Physical and Engineering Sciences.
This map shows the number of LEGAL opioid pain pills prescribed by DOCTORS by county in the United States. Opioids like OxyContin, Norco, Percocet and Vicodin are legal prescription heroin and morphine. Over-prescribing can create a lifelong addict within a few weeks of use. Kicking heroin is one of the most difficult addictions to overcome.
75% of heroin users started after an addiction to prescription pain medication. Heroin, and other street drugs, are now being laced with Fentanyl. Fentanyl is 50-100 times the strength of morphine or heroin. 3 grains of Fentanyl can kill a person. 100 pounds of Fentanyl can kill 1/3 of the United States. The DEA just seized two 100 pound shipments of Fentanyl in New Jersey and at the Mexican border.
Fentanyl, pumped through a ventilation system, can kill everyone in an instant. The Mexican cartels source Fentanyl from Communist China. Over 200 people die from Fentanyl every day in the United States.
Connect the dots. See the problem? People who do not are simply not paying attention or too addicted to marijuana or pain meds to care.

No comments:

Post a Comment