The wave of prescription drug abuse and addiction took a heavy toll on many Juneau families over the last four years before subsiding recently. Because of the cost of these drugs on the street, many of the families affected were middle to upper income families. Now, a new drug tragedy is set to be repeated across many affluent communities and especially in Alaska.
The prescription drugs that were so available on our streets were the highly addictive opiate pain killers.
The major drug that impacted Juneau was developed and marketed by Purdue Pharmaceuticals beginning in 1996.
This drug, OxyContin, a powerful time-released pain medication designed to deliver oxycodone, the active analgesic, into the blood stream over a 12 hour period. Since each oral capsule contains up to four times the standard dose in other prescription opioid medications, this drug was particularly attractive to street dealers.
The price for an 80 milligram pill reached as much as $240 in Alaska. This medical community initially welcomed this first-time released opioid as a pain management drug for terminally ill patients. This was the only approved use for this medication when released in the 90s.
However, Purdue Pharma, the patent holder, actively marketed this drug for broad use as a pain reliever while overproducing the drug in its New Jersey pharmacies.
Many of these drugs found their way to Mexico and Canada and eventually to our streets. At the same time the company, and their physician Dr. Russell Portenoy, minimized the addictive nature of opioids to every doctor in the nation.
When these drugs hit the illicit trade, kids discovered they could crush the capsules and smoke the contents for a heroin-like high, and a drug crisis was born. Parent groups from 27 states pushed their Attorney Generals to sue the company. The company was found to be fraudulent and paid a $635 million fine while some of the executives were fined as well. In addition, the company was forced to develop a crush proof version of OxyContin in August of 2010. Parent groups also forced the company to produce less of the drug and physicians to stop overprescribing the pain killer.
The reformulation of the pill, parent group efforts and legal action all influenced this drugs illicit availability and the crises subsided. Law enforcement efforts in Juneau also had an impact on the availability of this drug.
Now, recent developments have caused a number of federal agencies to send out an alarm notice to communities. Communities near the Canadian border have been alerted to possible new drug addiction crises.
Two of these drugs are going off patent in the near future and all efforts at containment to have failed.
This means that generic drug companies across the world will be allowed to produce as much as they can sell.
The Canadian government recently approved production of generic Oxycontin in the original crushable formulations. After the failure of both governments and parent groups to halt the generic production of Oxycontin, production is schedule in Canada early next year.
Now U.S. generic pharmacies are wanting in on the $6 to $7 billion annual sales as well and are pressing for a production license.
Endo Pharma, another drug company that makes a powerful oxymorphone drug, Opana, also lost its fight to extend the existing patent.
The Canadian generic companies immediately applied for license to start production of Opana in April. In a desperate effort to halt the new production, parent groups joined Purdue Pharma to extend the old patent of crushable Oxyontin and Opana, but they did not prevail in courts.
With 16,500 overdose fatalities in this country annually, surpassing deaths from drunken driving, physicians are having second thoughts about their promotion of this class of medications.
Dr. Russell Portenoy, the most influential physician in the revitalization of opioid medications apologized in a Wall Street Journal article recently. He states “I understated the dangers of addiction and overstated the benefits of opioids. We in the medical professions did not know then what we know now, but it is a bit late.”
Attending a major workshop on opioid risks in New York, other physicians interviewed for the Wall Street article said “Oh my god, what are we doing?”
• Felix recently retired from a 38 year career in health care administration, the last 15 years was at NCADD-Juneau. Chapman is the new executive director at NCADD-Juneau. NCADD is a national organization with an affiliate office in Juneau since 1965.