Readers React: OxyContin’s grip shows drug companies prioritize their bottom lines over human lives

To the editor: With the consent of the U.S. Food and Drug Administration, Purdue Pharma was allowed to promote its drug OxyContin as providing pain relief for 12 hours. The Times noted that in many cases the drug did not work for the full 12 hours and that it had to be given at more frequent intervals to patients. (“‘You want a description of hell?’ OxyContin’s 12-hour problem,” May 5)

The drug company and the FDA were also aware that the more frequent use of the drug led to abuse and addiction. Yet this was allowed through weasel wording by the FDA that permitted physicians to prescribe drug usage as needed and allowed doses of the drug to be dispensed in greater concentrations. The larger doses often resulted in users overdosing.

It seems to me the war on drugs is being fought on the wrong front. I have to think that big drug companies feel their bottom lines are more important than human lives.

Harry Norkin, Thousand Oaks

..

To the editor: I write to express my disappointment with your article. Far from an “untold story,” the long-discredited theory rehashed by your paper substitutes anecdotes for facts and omits information refuting the article’s central claims.

Nearly a decade ago, the FDA cited a lack of evidence in rejecting the claim that patients receiving OxyContin more frequently than 12-hour dosing intervals are at increased risk of side effects and serious adverse reactions. Also, the FDA prohibits pharmaceutical companies from promoting their products for uses not approved by the agency. The FDA has not approved OxyContin for eight-hour use, so we do not recommend that dosing to prescribers.

By omitting these facts from your story, The Times didn’t just violate its own ethics guidelines; your paper also potentially worsened the opioid epidemic by encouraging patients to take their medicines more frequently than their physician prescribed.

Gail Cawkwell, MD, Stamford, Conn.

The writer is Purdue’s chief medical officer.

..

To the editor: Your article oversimplifies pain treatment and drug addiction.

Most patients can be subjected to short-term opioid use for treatment of acute pain with zero risk of addiction. There is a subset of patients who, for whatever reason, derive much more from opiate drug treatment and will opt to continue taking the drug after it is no longer needed. If these patients have chronic pain, they are at extreme risk for physical addiction.

As compassionate physicians, we minimize pain with medication. The best treatment for pain is multi-modal, including local anesthetics, anti-inflammatory medications and opiates only as needed.

For many chronic pain patients, opioid narcotics are essential for comfort. It is cruel to subject them to extremely short-term medication with peaks and valleys of relief. For this reason, longer-duration medication is helpful.

Prescribers need to be educated that opioid drugs are only one prong in pain treatment, and drug companies should not exaggerate the capabilities of their products.

Laws and regulations to restrict drug use and criminalize drug users have been useless to stop drug abuse and prevent drug deaths. We have seen that restriction of legal drugs has just pushed addicts to beg, borrow and steal to obtain readily available illegal narcotics.

More of the same approach is not the answer. Educating the public, prescribers and drug manufacturers, combined with compassionate individualized treatment of those who become addicted, will be much more effective.

Thomas Einstein, MD, Santa Monica

The writer is an anesthesiologist.

..

To the editor: Thanks for doing such a wonderful job of exposing this dreadful situation.

However, you could have included information that genetic testing is now available to identify patients who may be high metabolizers of this drug and therefore particularly at risk of addiction for the reason your article so graphically described. It would be helpful if the drug company included this advice in its marketing to physicians.

(As a disclosure, I am a laboratory director for a company that performs genetic testing of that type for many physicians who specialize in pain management.)

James Dibdin, MD, Santa Monica

..

To the editor: What an astonishing example of journalistic research it was to obtain and sift through reams of overlooked materials to provide your readers with this amazing story. As I read the article, I felt the excitement of uncovering a probable national scandal reported in my lifetime by my newspaper.

This is why print reporting will never be outdone. Bravo.

Esther Treadway, Culver City

..

To the editor: We the people complain about being left out of making our own healthcare decisions. Is the onus of four pills a day for pain control — as opposed to the two-a-day regimen marketed for OxyContin — unbearable?

Managing temporary discomfort is a temporary inconvenience and should presage the return to normal life. We need to participate in our own care, ask for choices and not surrender to “care as usual.”

No one wants to be a junkie.

David Eckhous, Long Beach

Have you or a loved one had an experience with OxyContin? We’d like to hear about it.

Follow the Opinion section on Twitter @latimesopinion and Facebook