The OxyContin family

[Seasick Sailor 3747]

If anyone is interested in reading more about the opioid epidemic and Purdue's role in it, check out the book Dopesick. Some truly eye-opening information about how Oxy and other opioids were marketed and the effect it has had on communities across the nation.  

[SHOOTER12 8800]

33 minutes ago, Druggist said:

And to be fair, I am sure I filled some scripts here and there that I shouldn’t have. I was just so beaten down and exhausted to deal with them at the moment. I always tried to do my part, but sometimes I failed too.  It sucks to know that, but I also know I was never a pharmacist that drug seekers wait to see because I was a pushover.

Nope, you sound like one of the good guys, which there are far too few of.  On the other side of the coin are some pharmacists who think they are the smartest people on earth.  I've had a Walmart pharmy refuse to fill my hydrocodone for me 2 DAYS AFTER BEING RELEASED FROM THE HOSPITAL FOR MY AMPUTATION?  I've also had one from there fill the wrong strength Digoxin (twice as strong as what was prescribed), and swear up and down that's what they had been giving me for years.  Then she had the audacity to tell me she was a professional who looking out for my best interest and was more aware of my situation that my cardiologist.

Thank God for guys like you, the world needs more of you.

[Underdog 28544]

Got prescribed both oxy/hydrocodone after my last knee replacement, had horrible reactions to both and my PT recommended to me that I stop taking them.  Not super macho but feel I have a high pain threshold, so rarely take anything stonger than Tylenol or Ibuprofen, most prescribed painkillers never did much for me. 

[cactusflinthead 27598]

4 minutes ago, TwiceHorn said:

I just got around to reading OPs article. Check it out, it has some new information at least to me.  Arthur Sackler not only mismarketed OxyContin, he basically created the pharmaceutical advertising industry.

 

According to the article, he was responsible for the over advertising of Valium and Librium also.

Really quite the evil figure.

It's rage porn. futureman said so.

 

[Nice Guy Eddie 13507]

41 minutes ago, futureman said:

ok.  I hope you’re as angry at ronald mcdonald and the burger king and the rest of their cronies.  per your logic, they didn’t give a shit about providing fast, cheap food options.  they consciously devised a plan to create an obesity epidemic solely to line their own pockets while maliciously destroying the foundation of public healthcare.  right?

that's exactly what I didn't say.  I didn't say they sought out to create addicts but they're purposely mislead the medical industry on the potential harm of their drugs and then failed to act when they knew it was being abused.    And when confronted they blamed the addicts as the cause of the problem.

[futureman 22440]

3 minutes ago, cactusflinthead said:

It's rage porn. futureman said so.

no I said anger porn.  but you were too angry to even read my post. 

[cactusflinthead 27598]

3 minutes ago, futureman said:

no I said anger porn.  but you were too angry to even read my post. 

Anger doesn't equate to rage? 

Ok then. 

[Al_4_ISU 12447]

And meanwhile people are jailed for marijuana.

Hell of a country we got here.

[futureman 22440]

6 minutes ago, cactusflinthead said:

Anger doesn't equate to rage? 

Ok then. 

calm down, dude.  

[cactusflinthead 27598]

Just now, futureman said:

calm down, dude.  

I'm gonna....go find a quiet place. 

[TwiceHorn 31435]

Again, have to recommend reading of the article posted by OP.   It has quite a bit more information about the Sackler family then I had previously read and about OxyContin as well.

Being a patent attorney, I have to comment on some of the patent aspects raised in the article.

• OxyContin was developed to replace another time release opioid called MS Contin, which was going off-patent;  so yes you have a Pharma "extending" patents on marginally new drugs, but I submit that this is not that big a deal because the old drug is off patent and freely available at what should be lower cost. It is a problem of the pharmaceutical and medical industries that new patented products seem to automatically replace the unpatented ones without regard to whether they represent an actual improvement:  the unpatented drug should still be available at lower cost
• PP developed a new formulation for OxyContin that could not be crushed and patented it. Another example of Pharma "extending" patent protection.
• While seeking FDA approval for the new formulation, PP argued to the FDA that generic versions of OxyContin (old formula) should not be approved because they are dangerous. The FDA agreed.

It has been and remains my position that the FDA is a bigger market distortion in pharmaceuticals than the patent system, and is frequently primarily responsible for the price distortions that occur.

[Guest Lobo]

9 minutes ago, Al_4_ISU said:

And meanwhile people are jailed for marijuana.

Hell of a country we got here.

They had to figure out some way to keep people of color from voting since they outlawed that pesky Jim Crow shit.  

[bernorange 8359]

1 hour ago, TwiceHorn said:

... This little experiment did confirm for me, to a degree, that taking narcotic pain relievers when actually in pain does not produce an intoxicating effect.  ...

I mentioned on the old site about my ordeal with back pain.  I was doing some work in the back yard and put too much stress on my lower back and tweaked it.  I had a flash of pain that started growing in intensity and immediately called for help to get to the ER.  I was in debilitating pain for several months.  The initial pain was so severe I could not walk or even sit upright.  Over the course of those months, I ended up getting three steroid injections in my back and butt and finally got the issue under control.  I've still got lingering issues, but they aren't debilitating.

The day the injury happened, they gave me morphine in the ER.  I was laying on a table and pain started to ebb.  When I stood up (got off the table), the pain hit me so bad, I fell to the floor.  Morphine couldn't quell that pain.

The back pain doctor I saw prescribed hydrocodone for me during the initial weeks.  It was a miracle.  I definitely noticed the euphoric high that came with each dose as the pain melted away.  But I stopped taking it long before the script I had expired.  The doc was surprised (and pleased) when I told him I stopped taking them and did not want the Rx refilled.  Last thing he told me after our last meeting was that he hoped he never saw me again (that my back never hurt again).

[Smax 3800]

2 hours ago, TwiceHorn said:

I think this is how it started out:  a pleasant intersection of profit and public good.  But there are piles of evidence that PP quickly began to emphasize profit and ignore the public good.

 

when does something go from a moral ethical issue to a legal one?

[Guest Lobo]

in Torts class, 1L

[futureman 22440]

9 minutes ago, cactusflinthead said:

I'm gonna....go find a quiet place. 

we’re having fun, right?

[TwiceHorn 31435]

6 minutes ago, bernorange said:

I mentioned on the old site about my ordeal with back pain.  I was doing some work in the back yard and put too much stress on my lower back and tweaked it.  I had a flash of pain that started growing in intensity and immediately called for help to get to the ER.  I was in debilitating pain for several months.  The initial pain was so severe I could not walk or even sit upright.  Over the course of those months, I ended up getting three steroid injections in my back and butt and finally got the issue under control.  I've still got lingering issues, but they aren't debilitating.

The day the injury happened, they gave me morphine in the ER.  I was laying on a table and pain started to ebb.  When I stood up (got off the table), the pain hit me so bad, I fell to the floor.  Morphine couldn't quell that pain.

The back pain doctor I saw prescribed hydrocodone for me during the initial weeks.  It was a miracle.  I definitely noticed the euphoric high that came with each dose as the pain melted away.  But I stopped taking it long before the script I had expired.  The doc was surprised (and pleased) when I told him I stopped taking them and did not want the Rx refilled.  Last thing he told me after our last meeting was that he hoped he never saw me again (that my back never hurt again).

Yeah, one thing I have to consider in my recent experience is that Tylenol three is pretty weak (I mentioned my addiction issues to the doctor and got the impression that he may have prescribed the milder narcotic, while recommending that I not go entirely without). The only other experience I have had with painkillers was pre-addiction  with Percodan. I took it after wisdom tooth removal, when I was in real pain, but still noticed a euphoric/intoxicating effect. Suffice it to say that I am not going to play around with narcotic painkillers now or in the future.  But for me personally, I feel that if I am in real pain, narcotic painkillers may be justified and an acceptable risk.

Edited January 17, 2019 by TwiceHorn

[cactusflinthead 27598]

3 minutes ago, futureman said:

we’re having fun, right?

Yeah. Much hilarity. 

Watching someone go cold turkey?

Not fun.

[staboner 4969]

2 hours ago, alincoln said:

It's insane to me that the distributors would move literally millions of pills to small and isolated towns in Appalachia and not question what the fuck was happening.  

 

why do you hate America? let the market work it out

[Druggist 303]

12 minutes ago, TwiceHorn said:

 

• PP developed a new formulation for OxyContin that could not be crushed and patented it. Another example of Pharma "extending" patent protection.
• While seeking FDA approval for the new formulation, PP argued to the FDA that generic versions of OxyContin (old formula) should not be approved because they are dangerous. The FDA agreed.

 

I remember hearing that  one of he professors in the pharmacy school, Dr. Robert Williams, that developed that formulation for them.  I am sure the university did quite well from that if true.  I can’t find anything through google to confirm it though.

[C-Man 27183]

3 hours ago, TwiceHorn said:

The other thing to consider is that it isn't just oxy, it's hydrocodone and codeine, and everything else, too.  PP really unleashed a monster here.  I'm not sure that was entirely foreseeable.

The real problem -- if I'm remembering from the 60 MINUTES report -- is that OxyContin (oxycodone) was *supposed* to give relief as a controlled-release formula for up to 12 hours but in many -- if not most -- cases, it was wearing off much sooner. Naturally, those that processed it much quicker began over-dosing themselves. Oxy is insidious and PP forged all kinds of in-house data and shipping records to cover what they absolutely knew was going on, IIRC.

[BillyGoatHill 4312]

4 hours ago, alincoln said:

From 2007-2012, 30,000 opioid pills were distributed to Kermit. WVA . . . per resident.

Americans are now more likely to die from an opoiod OD than in car crash.  

The big class actions are focused on both manufacturers and distributors.

https://www.cbsnews.com/news/opioid-crisis-attorney-mike-moore-takes-on-manufacturers-and-distributors-at-the-center-of-the-epidemic-60-minutes/

How many $1,500 dollar an hour defense attorneys can you fit in a room?

 

4 hours ago, alincoln said:

It's insane to me that the distributors would move literally millions of pills to small and isolated towns in Appalachia and not question what the fuck was happening.  

 

It's not called "Hillbilly Heroin" for nothin'......

I've been involved in pre-hospital medicine for over 30 years. Meth, crack and others get headlines but...... In eastern Kentucky from 1995 to 2001, there was a 500% increase in the number of patients entering methadone maintenance treatment programs, about 75% of whom were OxyContin dependent. 

PP and Docs peddled this full well knowing what it was capable of, but turned a blind eye because of the bulge in their wallets. It didn't take long to spread throughout the country including the West coast where I previously worked. The methadone clinics in my city were full of Oxy (and it's spinoffs) patients.

[ztejas 43411]

2 hours ago, TwiceHorn said:

Yeah, one thing I have to consider in my recent experience is that Tylenol three is pretty weak (I mentioned my addiction issues to the doctor and got the impression that he may have prescribed the milder narcotic, while recommending that I not go entirely without). The only other experience I have had with painkillers was pre-addiction  with Percodan. I took it after wisdom tooth removal, when I was in real pain, but still noticed a euphoric/intoxicating effect. Suffice it to say that I am not going to play around with narcotic painkillers now or in the future.  But for me personally, I feel that if I am in real pain, narcotic painkillers may be justified and an acceptable risk.

Glad you mentioned it - I was going to jump in. 

T3 is child's play. You'll kill yourself from liver-failure before you OD from codeine on T3 unless you're extracting the codeine.

I don't disagree that when you are in actual pain, the drug has much less potential for abuse, but T3 and OxyContin are in different ballparks. 

[TwiceHorn 31435]

42 minutes ago, C-Man said:

The real problem -- if I'm remembering from the 60 MINUTES report -- is that OxyContin (oxycodone) was *supposed* to give relief as a controlled-release formula for up to 12 hours but in many -- if not most -- cases, it was wearing off much sooner. Naturally, those that processed it much quicker began over-dosing themselves. Oxy is insidious and PP forged all kinds of in-house data and shipping records to cover what they absolutely knew was going on, IIRC.

The other insidious thing about OxyContin is that a single tablet, because of the time-release formulation, contains considerably more oxycodone than a conventional oxycodone or hydrocodone tablet. Once a crushed and snorted or injected an abuser gets an exceptionally heavy dose.

[El Diablo 4232]

5 hours ago, futureman said:

slanted anger-porn. 

This the stuff with the tentacles? Asking for a friend.

[elfenix 34221]

couple of podcasts on the subject:

https://www.marketplace.org/2017/12/13/health-care/uncertain-hour/s02-4-sentence-helped-set-opioid-crisis

https://www.vox.com/2017/11/7/16387318/doctors-helped-create-opioid-epidemic

 

[futureman 22440]

16 minutes ago, TwiceHorn said:

The other insidious thing about OxyContin is that a single tablet, because of the time-release formulation, contains considerably more oxycodone than a conventional oxycodone or hydrocodone tablet. Once a crushed and snorted or injected an abuser gets an exceptionally heavy dose.

that’s what makes it awesome. 

[TwiceHorn 31435]

2 hours ago, Smax said:

 

when does something go from a moral ethical issue to a legal one?

Particularly when considering civil causes of action, as opposed to criminal charges, there is a great deal of overlap between "moral" and "ethical" issues and legal ones.  Do something unreasonable that causes people harm and you should expect to answer in damages.

[RockyMountainHighHorn 890]

I will never forget the first time I took an 80, the best feeling ever. Years later - jail for the Tcu thing, missed funerals of two of people I loved most, ruined career, relationships, family dread, etc....... worst feeling ever.

Well that family in the story helped destroy my life(not blaming them solely, I know I’m the driver of the car) so each one of them can eat a dick or, even better, they can all enjoy oxy withdrawals and see how great it is. Anyway, lucky to be alive. Glad to be alive. Thankful to have endured one of the toughest things to do on this planet. Lastly, grateful for this board by making me laugh or be intrigued through my struggles. Hook em

[futureman 22440]

2 minutes ago, RockyMountainHighHorn said:

I will never forget the first time I took an 80, the best feeling ever. Years later - jail for the Tcu thing, missed funerals of two of people I loved most, ruined career, relationships, family dread, etc....... worst feeling ever.

Well that family in the story helped destroy my life(not blaming them solely, I know I’m the driver of the car) so each one of them can eat a dick or, even better, they can all enjoy oxy withdrawals and see how great it is. Anyway, lucky to be alive. Glad to be alive. Thankful to have endured one of the toughest things to do on this planet. Lastly, grateful for this board by making me laugh or be intrigued through my struggles. Hook em

how’d you get that first 80?  chemo?

[Deej 76750]

3 hours ago, BillyGoatHill said:

 

It's not called "Hillbilly Heroin" for nothin'......

 

 

[Al_4_ISU 12447]

Just now, Deej said:

 

My dog has to take heart medication, and we feed it to him in these little "pill pocket" treats.  He fucking loves the pill treats, and has thus learned to associate the noise of the rattling pill bottle with treats.

Once I realized this, I went out to the kitchen, turned the phone camera on and started doing the "Boone County matin' call!" as he came running in from the living room.  To this day, my proudest Snapchat.

[JimmyHoffa 1188]

7 hours ago, Dewey said:

I'll back away, being someone who went to treatment twice for alcoholism, thus spending plenty of time with heroin and opioid addicts, it's really sad to see. The entire chain of pharma, doctors, rx, patients, insurance, treatment is fucked up. If you do not have good money and a good insurer, you are not getting the proper help needed for such an addiction. And it doesnt take much to get addicted. People all the way up and down the chain were/are pretty lazy about it , "back pain? Here, take these, call if you need more". That's what was said to. Guy I knew in treatment, he worked as a mechanic in the military and they needed him back at work asap, he came home with a terrible addiction. I took a girl to detox where she brought a small bag full of scripts that "she needed". That was a holy shit moment for me, doctors told er she needed none of them, after a short time sober, she was back visiting doctors and getting her scripts filled. Pharma lies, doctors lie, rx, patients lie, it's all fucked up. Theres not an ounce of honesty in the whole process, all the characters are pointing the finger at the others.

 

There are assholes and shitty people in every profession. But let's not lump everyone together. There are a shit ton of amazing doctors, nurses, and health care professionals that actually care about their patients well being, look out for them and want whats best for them. There are also doctors that are lazy and think their scrip pad is some magical easy peasy formula to fix everyone's problems. 

It's disgusting. And the worst part I have talked to doctors that have told me to my face "if they don't prescribe a medicine, the patient will find a doctor that will." I fucking lost my shit and said you sure learned NOTHING in all that schooling you paid for. Sometimes tough love (or a softer form of it) is needed to tell all the idiots that there isn't a magic pill to fix all of their problems and that there are plenty of other solutions that can help that start with a little personal responsibility and not assuming you can take the so called easy way out to fix every problem. 

But we live in the US so it's instant gratification/short cut culture to get better in the easiest and quickest way possible that fucks everyone over. 

[Updawg 2266]

I bet the patients had to wait at least 20 minutes before the Dr would write a script

[Lhorn 4908]

8 hours ago, TwiceHorn said:

It is somewhat naive to believe that patients will use a feel-good drug as prescribed.  Ordinary people will smash that morphine pump in the hospital.  I do believe that narcotic pain relievers, used while actually in pain, probably do not cause high levels of intoxication that the same dose would produce in a patient not in physical pain.  Also, non-narcotic pain relievers are quite effective.  It isn't a completely binary choice between ignoring pain and ignoring addictive potential.

Never heard of a non substance abuser smashing a morphine or dilaudid pump. I’m sure it’s happened but isnt common  

In the elderly and chronically ill many of the non narcotic pain medications are off the table.  Kidney disease, concurrent use of blood thinners, age, history of having stomach ulcers, history of having seizures can eliminate most all of the non narcotic pain options.  Tylenol, lidocaine patches, gabapentin and narcotic might be your only options.  Non narcotics also have their concerns - ever hear of Vioxx?  Probably not lately.  Celebrex is still used but carries a black box warning.

Not defending the prescribing of narcotics as a whole but in dealing with the elderly and chronically ill (which comprises a massive percentage of health care users) the idea that effective, much safer options are being routinely ignored to prescribe potentially addictive narcotics is laughable. 

Healthy people with acute pain which is expected to be of limited duration, recovering from surgery etc, non narcotics are a great effective option.  These dont tend to be the people who get addicted however.  

As someone above said, the best option is sometimes to tell the patient “for your safety this is what I can offer you but you might not be as comfortable as you want to be.”

Edited January 17, 2019 by Lhorn

[TwiceHorn 31435]

9 minutes ago, Lhorn said:

Never heard of a non substance abuser smashing a morphine or dialaudid pain pump. I’m sure it’s happened but isnt common  

In the elderly and chronically ill many of the non narcotic pain medications are off the table.  Kidney disease, concurrent use of blood thinners, age, history of having stomach ulcers, history of having seizures can eliminate most all of the non narcotic pain options.  Tylenol, lidocaine patches, gabapentin and narcotic might be your only options. 

 

Not defending the prescribing of narcotics as a whole but in dealing with the elderly and chronically ill (which comprises a massive percentage of health care users) the idea that effective, much safer options are being routinely ignored to prescribe potentially addictive narcotics is laughable. 

Healthy people with acute pain which is expected to be of limited duration, recovering from surgery etc, non narcotics are a great effective option.  These dont tend to be the people who get addicted however.

As someone above said, the best option is sometimes to tell the patient “for your safety this is what I can offer you but you might not be as comfortable as you want to be.”

Well, I was recently bedside with a young relative post-emergency open appendectomy and he smashed the pump til it wouldn't smash no mo.  Same with another relative that had gall bladder removed.  But with her keterolac was really the only helpful med.  Neither have substance abuse problems afaik and I think I would.

All I meant to imply was that I think it is normal for non-addicts to seek pain relief and possibly even overdo it a little.  It's when the pain transitions from physical to psychological that the problem arises.

Edited January 17, 2019 by TwiceHorn

[Lhorn 4908]

That unusual. Only time I’ve ever heard of it was known drug abusers. Most don’t dare touch the pump because the nurses can usually tell if it’s been tampered with, then pain meds go bye bye. 

Edited January 17, 2019 by Lhorn

[TwiceHorn 31435]

I dont mean tampering, I just mean hitting the button for more until it would no longer dispense, as intended.  The nurses were aware, and apologized that there was nothing more they could do.

And it is possible that both parties are nascent addicts that have not come into full flower, so to speak.

Edited January 17, 2019 by TwiceHorn

[Lhorn 4908]

Ah. Makes sense 

[Underdog 28544]

1 hour ago, Deej said:

 

GDit! 

[TwiceHorn 31435]

12 minutes ago, Lhorn said:

Ah. Makes sense 

My bad for using "smash" in the sort of recent colloquial sense.  I didn't mean to suggest they were "smashing/destroying the pump," just hitting the button with some frequency in response to pain.

[SizzleChest 8283]

10 hours ago, Nice Guy Eddie said:

FYI, apparently given the troubles in the US market, Purdue Pharm is now concentrating on medicating China, India and Mexico.

And, the Chinese at least, are giving it right back to us with the bullshit Fentanyl.  That crap makes Oxy look like baby aspirin.

[futureman 22440]

36 minutes ago, TwiceHorn said:

I dont mean tampering, I just mean hitting the button for more until it would no longer dispense, as intended.  The nurses were aware, and apologized that there was nothing more they could do.

And it is possible that both parties are nascent addicts that have not come into full flower, so to speak.

PCA pumps won’t dispense enough morphine or dilaudid or anything else to get you that fucked up.  it’s very limited and only gives enough to alleviate pain, not enough for an addict to get any real buzz.  I know because I’m an addict, and I spent a week jamming that goddamn button a few months ago. 

[futureman 22440]

6 minutes ago, SizzleChest said:

And, the Chinese at least, are giving it right back to us with the bullshit Fentanyl.  That crap makes Oxy look like baby aspirin.

fentanyl is one of the worst things ever created. 

[Dolemite 143]

11 hours ago, Nice Guy Eddie said:

https://www.newyorker.com/magazine/2017/10/30/the-family-that-built-an-empire-of-pain

over a year old but a good article regarding Purdue Pharma and the Sackler family who have made billions with OxyContin.  Critics state that the company and family knew people were becoming addicted but the money was too good.  Main culprit lives in Austin.    

Rudy Giuliani makes an appearance to represent the poor people that were unknowingly addicted and only want some assistance.   Nah, I’m screwing with you.  Rudy was Rudy.  He represented the family to hide their names, quietly settle lawsuits and lobby the govt to keep the money following even at the costs of many lives.  

I get it but please, how dumb do you have to you have to be to think that something that feels so good is not addictive?

[Dolemite 143]

4 hours ago, futureman said:

how’d you get that first 80?  chemo?

My first 80 made my face feel like it was melting off. And that was before I found out it was even better when crushed and snorted.

I love learning new things.

[Dolemite 143]

29 minutes ago, futureman said:

PCA pumps won’t dispense enough morphine or dilaudid or anything else to get you that fucked up.  it’s very limited and only gives enough to alleviate pain, not enough for an addict to get any real buzz.  I know because I’m an addict, and I spent a week jamming that goddamn button a few months ago. 

Hopefully, you got some kind of refund. 

[futureman 22440]

7 minutes ago, Dolemite said:

Hopefully, you got some kind of refund. 

being in the hospital is hell for an addict craving a buzz.  goddamn nurses rationing out one 10mg norco every 8 hours... “oh are you still in pain?  I can’t give you another norco until tomorrow morning.  would you like a tramadol?”  no I’m not in pain but I’m telling you I am because I want a fucking buzz you cunt bitch.  your PCA pump is shit.  give me a handful of percocet and get lost, you goddamn whore. 

don’t worry, I was only ornery in my head, was always polite to the nurses...

[Surly Bevo 24908]

Mortgage banking crisis, opiod crisis, rinse repeat, rinse repeat.....all of the really big crisis pretty much take everybody on the chain from the end user all the way up to the top of the corporations and those who regulate them to engage in the dance to get to these melting points.  

[Dolemite 143]

Tramadol is awful. It gives a funky low grade high and makes you feel like shit after a few days of taking it.

I went to the orthopedic guy whose associate did my disc surgery with the only purpose in mind was to get pain pills because it hurt like hell.

When he came in, I told him, listen my back is killing me and I don't any physical therapy because it doesn't work. I just want some pain pills and that is the only a reason I am here.

He gave me a prescription for 60 10mg Vicodin, with two fucking refills. 

Had a friend who was a pharmaceutical sales rep tell me that if your doctor won't give you what you want, you have the wrong doctor. This was a long time ago through 10-15 years or so. I know its changed now.