The recent Empire article on prescription drug abuse was well-written but did not tell the whole story.
Over the last 10 years, many Alaskans have suffered the consequences of prescription drug abuse. While many communities escape the effects of illicit drug abuse, few remain unaffected by prescription drug abuse. Never before has prescription drug abuse been so widespread, reaching into so many homes across socioeconomic groups. This particular problem has a number of factors unique and has frustrated those of us working in disease prevention.
Over the last 10 years we have witnessed an ever-increasing amount of prescription drugs available on the streets here in Alaska and in other American communities.
The National Council on Alcoholism and Drug Dependence, through its 130 affiliate offices, advocated for more restraint in producing and prescribing these narcotics. One drug that became increasingly available during the late 1990s and into the new century is a strong narcotic called OxyContin.
OxyContin, produced by Purdue Pharmaceuticals, is an opiate, containing the same compound as heroin, morphine, and other painkillers. OxyContin is not synthesized from the poppy like many opiate pain killers, but is made in laboratories. In addition, OxyContin delivers oxycodone through a controlled-release mechanism over 12 hours when used orally.
The drug was brought to market in 1996, targeting terminally ill patients and those with severe chronic pain. Purdue soon expanded its use and in 2003, sales numbered $1.6 billion. Today, this drug's sales are well over $2 billion. This figure does not include drug sales to other countries, which often supply the American illicit market.
National surveys of drug use among teens show a steady increase in the use of these drugs over the last 20 years. The Youth Risk Behavior Survey, which includes Alaska, first reported prescription drug abuse back in the mid-1990s. Recent surveys summarized by the office of National Drug Policy show that 4-5 percent of all 12th graders have used OxyContin for nonmedical purposes.
Along with overproduction, a great contributing factor to increasing availability was a calculated campaign by Purdue to lie to the medical community about the drug's addiction potential. Purdue sent teams of drug sales people into doctors' offices with misinformation about this drug. They made videos and sent them to virtually every medical specialty. These messages encouraged off-label use and minimized the addictive nature of this drug. As a result, many doctors freely prescribed this drug for every imaginable pain over the last 10 years.
As communities and families began to complain, the U.S. Attorney General's Office began to investigate. Last year Purdue admitted to criminal charges that it knew about the addictiveness of this compound, purposely lied, and overproduced to maximize income from this one drug. A $634.5 million settlement was reached and three executives pleaded guilty but received no jail sentence.
In addition, 27 state attorneys general filed suit and were awarded $20 million from Purdue for unlawful marketing of OxyContin. The Maine attorney general, spokesman for the entire group, stated that Purdue marketed this drug inappropriately and produced devastation to families without regard for public health. The Arizona attorney general stated that no company had produced such deceit since the tobacco companies lied about their product's safety. Participating states will receive $719,000 each. States like Alaska, that did not participate despite our strong encouragement, will receive $500,000.
Although the heart of this suit involved Purdue's misrepresenting the drug to doctors, not all of its excessive availability in Juneau comes from the medical community. At least half those seeking treatment at NCADD purchased drugs that were illegally shipped from down south. Another common report is that drugs are often found in Juneau medicine cabinets when visiting friends. At a street price of $120-$180 per tablet, OxyContin is very tempting to even those who do not use it.
Broken up and smoked in small pieces, one tablet has even greater potential for addiction. During the lawsuit, all NCADD chapters in the U.S. advocated unsuccessfully to support a clause that would force Purdue to make the drug unsmokeable, and many Juneau families were willing to give testimony about its devastating effects.
Those of us who have spent our lives trying to prevent these epidemics know all too well that drug availability is a big determining factor in the health of a community. This drug episode is especially disappointing to us at NCADD. We get the first cry for help and see the hurt families first. Alaska with its higher per-capita income has been a target of illicit sales since the pipeline construction days.
OxyContin was so overproduced and overprescribed for so many years we will see more devastation in for years to come.
Matt Felix is executive director of the National Council on Alcoholism and Drug Dependence's Juneau affiliate, incorporated in 1965, and one of 130 affiliates across America. This is his 36th year in alcohol and drug treatment and prevention.
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