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Drug Company Profiteering, Pill Mills and Thousands of Addicts: How Oxycontin Has Spread Through America

Corruption down the line, from Big Pharma to doctors and the war on drugs, builds a growing epidemic and an addiction-fueled empire.

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In a study on OxyContin patients, researchers at the Albert Einstein College of Medicine and the Montefiore Medical Center revealed that part of the problem with OxyContin is lack of regulation by prescribers. Researchers determined that 8 percent of patients were urine tested (to see if they were drug addicts looking for a fix or non-users looking for cash), and less than half of the patients had regular meetings with their doctors to check on signs and symptoms of addiction. Shockingly, more than one quarter of patients were receiving multiple early refills, suggesting that tolerance (and addiction) had them using at a higher rate, or selling them quicker than they could re-stock.  

Pill mills, some of which call themselves "pain management centers," are doctors’ offices that hand out powerful narcotics at a much higher rate than for strictly medical reasons. Like drug dealers, they require “patients” to pay in cash and usually do not perform physical exams or require evidence of injury. They treat pain with pills only, and they often give patients the option to choose their own medicines before directing them to “their” (conspiring) pharmacy. In some cases, doctors operating pill mills have been imprisoned for trafficking narcotics.

“If you live or work close to an OxyContin mill…99 percent of everybody that you see going in there is either an addict or a criminal,” said Assistant Scioto County, Ohio Prosecutor Joe Hale in a suit against OxyContin’s manufacturers. “If they are not an addict — if they don’t need that prescription just to get by every day — then they are going in there out of greed, because they know that they can pay some doctor $400 to write a prescription. They can take it up to Columbus, walk out with a bottle of pills, and in a matter of days they can turn it into $3,000, $4,000, $5000 — and who couldn’t use that?”

While doctors, dealers and addicts are locked-up for OxyContin, Purdue Pharma, the manufacturer, evades responsibility for the collateral damage caused by its product.

Devastation in Appalachia is so costly that several Appalachian and Southern states, including Kentucky, Mississippi, Louisiana, Virginia, and West Virginia have sued Purdue Pharma. Purdue has knocked down nearly every one of the more than 1,000 suits that have been filed against it.

With Rudy Giuliani on its side (
Giuliani Partners was an external adviser to the company since 2002), clearly Purdue has enough money and legal clout to avoid legal responsibility for its money-making, addiction-fueling product.

Alongside legal tools, Purdue Pharma, the only manufacturers of slow-release Oxycodone (which includes higher doses than fast-acting), used marketing to maintain its stronghold on Oxys and Oxy addicts. By advertising OxyContin in mainstream media, Purdue increased demand for its product, leading to large amounts of OxyContin in circulation.

“There’s just so much of it available,” said Twillman, “because they did a really good job of marketing it.”

In fact, they did too good a job.

In May 2007, Purdue Pharma and company chief executive officer Michael Friedman, general counsel Howard Udell and former chief medical officer Paul Goldenheim each pleaded guilty to a misdemeanor count of misbranding the drug, thereby misleading doctors and patients by claiming OxyContin is less likely to be abused (and addicting) than traditional narcotics. Effectively, Purdue Pharma synthesized legal heroin and advertised it to the masses as safer than other painkillers.

These “misbranding” misdemeanor offenses occurred between 1995, when the FDA approved OxyContin for sale, and 2001, when Purdue faced regular, public criticism and cut the “reduced-risk” marketing. During those years, OxyContin made Purdue Pharma $2.8 billion in profits. As Purdue championed the safety of its drug and watched the money pile up, the DEA said the number of deaths related to OxyContin rose 400 percent, and the annual number of OxyContin prescriptions increased nearly 20-fold.