Index -- Special On Opiate Use (Eagle-Tribune) --

http://www.mapinc.org/drugnews/v05/n042/a06.html
Bookmark: http://www.mapinc.org/oxycontin.htm (Oxycontin/Oxycodone)

POLICING PRESCRIPTIONS

BOSTON -- When children died after misusing their product and a prominent
talk show host entered treatment because of his addiction to it and other
painkillers, the manufacturers of OxyContin fell back on an
age-old strategy: The best defense is a good offense.

Connecticut-based Purdue Pharma has been doing an extensive advertising
campaign, funding drug-awareness programs and sending people to speak at
public events, all reinforcing the message that the product is generally
safe and effective if used properly.

Marketing and health-care policy experts say it is a risky, though
necessary, approach for preserving the viability of a product that had $1.6
billion in worldwide sales last year.

"They are very aggressive in protecting their right to market their
product, and early on they felt it wasn't their responsibility to combat
illegal uses of their product. They have focused on promoting the product
as filling an important need, pain control. Their attitude has been, 'We
are only doing this as a public service. We don't have to,'" said Steven
Henson, a marketing professor at Western Carolina University in North
Carolina. Just this week, company officials were in the Merrimack Valley
speaking at a townwide meeting Thursday in North Andover, sponsored by
Essex County District Attorney Jonathan Blodgett, and meeting with
newspaper editorial boards. The meeting and a recent series of articles by
the Eagle-Tribune Publishing Co. have focused on the increased use of
OxyContin and heroin in Essex County in recent years. Last year, there
were at least 39 fatal drug overdoses in Essex County.

Executives came from corporate headquarters in Stamford, Conn. They also
hired a Boston-based public relations firm to establish better local
contacts and have done similar things elsewhere.

"We are trying a lot of ways to address the problem," said company
spokesman C.R. Hogen. "We have had an approach of full engagement with all
sectors of society, including community and law enforcement officials and
health-care professionals."

OxyContin is a synthetic opiate. The prescription pill, which was approved
by the Food and Drug Administration in 1995, has been popular with those
suffering from cancer and other illnesses that cause severe pain. Some
people, primarily teenagers, have abused the drug by removing its
time-release coating to get an immediate "rush" or "high." Adults,
including conservative talk show host Rush Limbaugh, have become hooked on
it and other painkillers when they have been trying to find ways to deal
with pain. The need sometimes gets so severe that patients resort to
"doctor shopping" and try to get prescriptions from several physicians.

To combat this abuse, Purdue Pharma's outreach efforts have included a
$35,000 grant to Massachusetts Department of Public Safety in 2002 to set
up a tips line for people to call in information about pharmacy robberies.
Also, the company provides $500,000 to help fund "Communities That Care"
programs in 20 cities throughout the country, including Lynn. These are
programs designed to help community leaders identify the risk factors that
lead to substance abuse and other problem behaviors. They expect to award
another 10 grants this year, including one in Massachusetts, Hogen said.

The company ran about $2 million worth of public service advertisements on
local television stations and newspapers in 15 media markets. It ran a
$150,000 radio campaign, which often took a humorous approach. One such ad
said: "It's hard to make new friends, especially if you are someone
who frequently vomits." The company also has set up a Web site to educate
people about the dangers of abusing prescription drugs:
www.painfullyobvious.com. Jane Williamson, the program director of CAB
Health and Recovery Services in Danvers, said advertising won't necessarily
make an impact on teenagers' drug-abuse habits.

"The kids are getting it out of their parents' medicine cabinets; they are
not buying it because they see ads. They do it because it feels good to
them. They don' realize how addicting it is until they are addicted," she
said. The company's advertising and marketing response is appropriate, but
they also need to improve the product, said Leonard Glantz, a professor of
health law at Boston University's School of Public Health.

"Manufacturers are required to foresee the wrongful use of a product. Once
they know a product is being abused, they have an obligation to do
something about it without changing the essence of a product. All opiates
are addictive. What makes OxyContin effective is that is time-released. The
problems come when the pill is crushed, and that's what the company needs
to deal with," he said. Hogen said that they are working on a "smart pill"
that when swallowed acts like a pain reliever, but when crushed its
pain-relieving properties are disabled. He said he could not predict when
Purdue Pharma would be ready to submit the drug to the Food and Drug
Administration for approval. Purdue Pharma's public relations challenge is
not unique these days. Last week, the drug manufacturer Eli Lilly & Co.
launched an extensive newspaper advertising campaign throughout the country
to counter a report in a British health journal linking the company's
anti-depressant drug Prozac and increased risk of suicide attempts.

Some industry critics, such as health-care policy scholar Myron Fottler,
said the advertising campaigns are an insufficient response to a serious
public-safety problem.

"I'd be impressed if they'd withdraw the controversial product from the
market and do more evaluation on their effects. But they are not there
to impress me; they are there to sell their products," said Fottler, a
professor of health services administration at the University of Central
Florida in Tampa.