OxyCon Game: Anatomy of a Media-made Drug Scare

By Sandeep Kaushik, AlterNet. Posted June 4, 2001.

In early January, Time Magazine became the first major media outlet in America to report on the growing abuse of a synthetic opioid prescription painkiller named OxyContin. According to the story, the drug was "so popular and addictive" that it was generating "a blizzard of a crime wave" in several "pockets of the nation." While the article admitted that it "has been hailed as a miracle" by legitimate users, it added that OxyContin pills were nicknamed "killers" in some areas due to the rapidly escalating toll of overdose deaths allegedly associated with its illicit use.

These two themes, that OxyContin is an ultra-powerful narcotic coveted by junkies for its uniquely intense high, and that it is responsible for scores if not hundreds of fatalities -- the specific numbers would vary widely -- were to be repeated ad nauseam in a spate of succeeding media accounts. Indeed, readers didn't know it at the time, but the Time piece was only the opening salvo in a sustained journalistic campaign -- conducted over the angry protests of pain specialists and their patients -- which has, in a space of a few short months, irredeemably stained the public image of a medication previously acknowledged as a major breakthrough in the treatment of debilitating, chronic pain.

In fact, in the last four months, reporting on OxyContin abuse has become a national media craze, with often sensational, fear-mongering stories appearing in hundreds of publications from Newsweek to small town newspapers in rural Midwestern hinterlands.

"Pain Pills Blamed for Rash of Deaths" the Associated Press proclaimed. "The 'poor man's heroin,'" U.S. News described the drug. "Prescription Painkiller Gains Status as Thrill Pill," claimed the Indianapolis Star, while the Cincinnati Enquirer called it the "'Heroin of the Midwest;' Traffickers' and Abusers' First Choice." But none could match the Port St. Lucie News, which called it the "New Crack" and touted its "Herion-Like High" in the same headline.

Taken together, all of these stories (and countless others) have misleadingly and preemptively proclaimed a major epidemic of OxyContin abuse. Yet experts say no evidence exists that increases in the abuse of the drug are outpacing increases in prescriptions for the drug. In fact, several incidents seem to suggest that the media's sensational coverage -- which advertises to the addicted the existence of the new drug and explains how to get it and use it -- may be contributing to the increase in OxyContin abuse.

Meanwhile, doctors and legitimate users have become needlessly afraid of utilizing an important advance in the treatment of pain.

The Dukes of Hazard

OxyContin was an instant hit with doctors when first introduced in December 1995. Hailed by pain management specialists as a wonder drug, the oxycodone-based formulation was considered a major advance in the medical profession's expanding effort to battle the debilitating effects of chronic pain. As the good news spread sales of the drug mushroomed, rising from $40 million in 1996 to more than $1 billion last year, outstripping even Viagra.

And the drug was a godsend for a bevy of patients who were not finding relief for their pain from other medications. "Without OxyContin I wouldn't be able to get out of bed in the morning, much less hold down a fill-time job," says Tracey Jordan of Houston, Texas, who suffers from three degenerative disks in her back. Prior to going on it in August 2000 she took a host of other medications, but they "were just too harsh, and didn't really take care of my pain," she said.

Media accounts of OxyContin's effectiveness were also glowing, though relatively few in number. For instance, in a September 1996 article Oxy was said to be enjoying "a groundswell of international support" at the annual meeting of the International Association of the Study of Pain (IASP), as members touted it as "an excellent opiod for moderate to severe pain."

But about 18 months ago -- roughly three-and-a-half years after OyxContin's auspicious debut -- some cases involving the illegal use of the drug surfaced in rural Maine. Soon after, the drug's popularity began to rise in rural Appalachia, especially parts of western Virginia, eastern Kentucky, West Virginia and southern Ohio (in and around Cincinnati). If claims of epidemic levels of abuse are true anywhere, it's here, says Ashland, KY pain specialist, Dr. Shelley Freimark. "In this area right now it is a severe problem," she states.

This can largely be chalked up to the fact that the usual street drugs are simply not as readily available in these rural outposts, says Dr. Phil Fisher, head of the Appalachian Pain Foundation (APF), a group formed last year by pain doctors devoted to educating the medical community and public about the uses and benefits of OxyContin: "This is an isolated area where it's hard for people to get real street drugs. By and large, OxyContin is not a street drug in most places."

Also, demographic and economic conditions in Appalachia have contributed to an established, long-term problem with prescription drug abuse in the region. In general, the population is older, Fisher says, and many suffer from chronic illnesses and debilitating diseases born of years working in the mines, increasing both the number of addicts and the availability of such drugs.

Still, outside of the region this development initially went largely ignored by the press. The media lacked a "hook," some spectacular news event around which to build their coverage of OxyContin. But that all changed on February 6 with "Operation Oxyfest 2001:" more than 100 Kentucky cops fanned out in "the largest drug raids in state history." Sweeping a five county area, they netted 207 dealers and users.

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