HJAR Jul/Aug 2022

HEALTHCARE JOURNAL OF ARKANSAS I  JUL / AUG 2022 13 making and marketing OxyContin. Combin- ing oxycodone with a time-release ingredi- ent, OxyContin promised 12 hours of pain relief. The U.S. Food and Drug Administra- tion approved this mixture in 1995. If we want to determine the moment the “Pan- dora box” was opened, I would say it was when the use of this drug was approved for prescription and marketed to treat pain. TheAmerican Pain Society came up with a very catchy phrase: “pain as the fifth vital sign.” There were posters spread all over family medicine clinics, surgical specialties, oncology and subspecialty clinics, ambula- tory surgery centers, hospitals, etc. On Nov. 11, 1996, during his presidential address to theAmerican Pain Society, James Campbell, MD, introduced the mentioned phrase, “pain as the fifth vital sign.” 6 Purdue Pharma pushed their new drug through an overly aggressive marketing campaign that included an army of med reps, free trips, cruises, costly gifts to the doctors prescribing OxyContin (the more they prescribed the drug, the more expen- sive the present was). During the promotion of OxyContin, some of the med reps showing good con- science reported to their supervisors the increase of overdose events in the territories they had been assigned. Soon, they realized that the long-lasting effect that was claimed the drug had (12 hours) was not the case. It barely lasted eight hours, tops. They were ordered to continue to lie to the doctors about the half-life of OxyContin and suggested the doctors increase the dose to “prolong”the effect. Due to the very high amounts of money they got through the promotion and sales of the drug, several of them kept quiet. The ones who were not in agreement and decided to leave the Purdue Pharma organization, in order to get their severances, were required to sign a non- disclosure agreement to protect the darkest secrets of how this drug was being marketed and were threatened with very costly conse- quences to prevent the spread of the details of their training to increment the sales of OxyContin to monumental amounts! It took a decade to realize how deadly and tremendously addictive this drug was. Even some of the prescribing doctors, with all their medical and pharmacological knowledge, could not help themselves from becoming addicted to OxyContin. An article published in the Journal of Public Health summarizes the tremendous consequences of the aggressive and danger- ous marketing campaign. The title says it all: “The Promotion of Oxycontin: Commercial Triumph, Public Health Tragedy.” 7 “AMONG THE GLOBAL PRODUCTION OF OPIATES ALL OVER THE PLANET, AND KNOWING THAT 7.6 BILLION PEOPLE LIVE ON OUR EARTH, ONLY 20% OF THE OPIOID PRODUCTION IS USED TO MANAGE THE PAIN OF THE REST OF THE WORLD; THE OTHER 80% IS CONSUMED HERE, IN THE U.S., WITH ONLY APPROXIMATELY 314 MILLION POPULATION.”