In 1996, a company called Purdue Pharmaceutical launched a new opiate painkiller called OxyContin. At a party celebrating its release to the public, Richard Sackler, a scion of the family that owns the company and its senior vice president of sales, made exuberant predictions about its success. ‘The launch of OxyContin tablets will be followed by a blizzard of prescriptions that will bury the competition,' he said, according to a lawsuit recently filed against Purdue. ‘The prescription blizzard will be so deep, dense, and white …'
The active ingredient of OxyContin is oxycodone, a semi-synthetic opiate (an ‘opioid') first synthesised in Germany in 1916. Prior to OxyContin's launch, oxycodone had been marketed as a painkiller in various pill forms for years, including Percocet (where it is mixed with paracetamol), Percodan (where it is mixed with aspirin) and Roxycodone (where it is dispensed pure in small doses of 15 to 30 milligrams). Other kinds of opiate painkillers, like the hydrocodone-based Vicodin, were also mixed with aspirin and came in small doses. While people did become addicted to these pills, the low doses of opiates they contained made it hard to overdose on them, and the paracetamol and aspirin would cause liver damage if the drugs were taken for a long time.
OxyContin distinguished itself from these medications, and received a patent, on the basis of an extended-release technology, the ‘contin' of the drug's suffix. Purdue developed OxyContin not to serve an urgent public health need but because the patent was expiring on its most profitable drug, a time-release morphine pill called MS Contin. Pharmaceutical patents, which last twenty years, allow pharmaceutical companies to maintain a monopoly on a drug and avoid competition from generic manufacturers. When a patent on a popular drug expires, its price can drop by as much as 90 per cent. To maintain monopolies, the industry often makes small adjustments to existing medications in order to patent and market them as new. OxyContin was one such drug.
OxyContin dissolves slowly in the digestive system, titrating the oxycodone into the body. Instead of taking a conventional painkiller like Vicodin or Percocet every few hours, the manufacturers claimed a patient could take OxyContin once in the morning and once at night and experience long-lasting pain relief. The slower-acting nature of OxyContin justified the manufacture of pills that contained much higher quantities of oxycodone than had ever been available in a single dose: up to 80 milligrams at first; 160 milligrams a few years later.
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