The patent on OxyContin has run out, the expected profit gone. Is it a coincidence that Purdue has stopped making it and replaced it with the new and improved OxyNEO? If Purdue can get Canadian doctors to prescribe it, their profits will continue.
In a recent edition of the Medical Post, an industry-funded newspaper which goes to all Canadian physicians, there is a 2 page advertisment for Purdue’s new formulation of oxycodone, OxyNEO.
It features a patient profile describing the story of (fictitious) Christine, a 38-year-old married accountant diagnosed three years previously with moderate to severe low back pain. For the last 3 years, her pain been “successfully managed” with a twice-daily dose of OxyContin.
I find this appalling. To try and normalize the narcotization and resultant prolongation of back pain is a cynical attempt to profit from a common, self-limiting condition best managed with simple analgesics and activity. “Yes, Christine, it hurts, but the best thing for you is to realize that the pain will pass and that narcotics will not only prolong it, they are associated with significant risks. Here are some suggestions for anti-inflammatories, ergonomic changes, exercises and perhaps a referral to physiotherapy.”
Narcotics are powerful drugs. Morphine and its derivatives are an essential part of caring for people with serious malignant pain and acute injury. They can have a role in intractable non-malignant pain when other avenues have proven inadequate. But everyone taking narcotics develops tolerance and some become addicted. As a result, it is often very hard to stop if they’ve been taken for more than a short period. Part of the withdrawal can be an increase in pain sensitivity and a vicious, sometimes escalating, cycle can ensue, good for no one but pharmaceutical companies.
A recent editorial in the British Medical Journal by Irfan Dhalla should remind us, physicians and public both, that narcotics are dangerous and should be avoided for the inevitable aches and pains of everyday life.