Abuse of Purdue Pharma's chronic pain treatment OxyContin (oxycodone), a class II narcotic analgesic, began to receive intense media scrutiny in early 2001. Teenagers and young adults had begun abusing the medication, and the consumer media jumped in to cover this new "drug de jour," calling it the next crack cocaine because of its potential for addiction.
But patients, many of them suffering from cancer, say it's heaven-sent and the only medication that provides them with continual pain relief. Here, Michael Friedman, Purdue's executive vice-president and COO, describes the balancing act his company must maintain to combat OxyContin abuse without restricting patient access.
PE: What is the biggest challenge facing the industry in combating prescription drug abuse?
Friedman: There is a lack of information about the nature and extent of that kind of abuse. Based on government data, four million people in America misuse or abuse prescription drugs each month. But there's no good government data that explains which drugs are abused and how people are abusing them. And the limited data that does exist is not available in a manner that would allow any meaningful action.
There's a system called DAWN, the government's Drug Awareness Warning Network, which reports emergency room admissions of people suffering from adverse events related to drug abuse. But we first heard about Oxycontin abuse from the media in Maine because DAWN only samples emergency rooms in metropolitan area hospitals, whereas most OxyContin abuse takes place in rural parts of the country. In fact, we now know there is a very significant prescription drug abuse problem in rural American schools.
PE: How did you react to those media reports?
Friedman: My immediate reaction was to meet with officials in Maine to find out more and to see if there was something we could do to help deal with the problem. Accompanied by Dr. David Haddox, a Purdue physician and an expert in pain management, I met with Jay McCloskey, US Attorney for the state of Maine, who explained that people were fooling doctors into writing prescriptions by either faking symptoms or asking for more pills than they needed. Others were "doctor shopping"-going to different physicians, in many cases with false medical records, to obtain drugs that they couldn't otherwise get legitimately.
McCloskey believed that training physicians and increasing awareness of prescription drug diversion could be effective in dealing with the problem. So we approached Oxycontin abuse as a shared problem.
Purdue, working with McCloskey's staff, developed a pamphlet for physicians outlining what they could do to prevent diversion of prescription products. We also developed a companion piece for pharmacists. Because the pamphlets were so well received in Maine, we mailed about 700,000 of them to physicians and pharmacists across the country.
But we knew we needed to do more, so we ran special training programs in which we invited police officers and members of McCloskey's staff to speak with physicians.
PE: When did Purdue start its teen drug abuse awareness program?
Friedman: In response to McCloskey's concerns about prescription drug abuse among teens, our investigation found that no national anti-drug program addressed the problem of prescription drug abuse. The programs focused on illicit drugs, such as cocaine, heroin, and marijuana, but didn't mention opioids such as hydrocodone and oxycodone, or other categories such as benzodiazepines.
We hired advertising agency North Castle Partners, which conducted focus groups with kids. With the insights gained from that research, Purdue developed a national program called "Painfully Obvious," which uses words and images that play off of teen psychology to teach students that abusing prescription drugs is not cool. The program also includes materials that teach parents how to talk to teenagers about the risk of prescription drug abuse.
This year, Purdue spent about $4 million on educational materials targeted to teens-more than any other entity, government or private. Our emphasis is on education and awareness rather than prevention, which we felt was a necessary first step.