Oxycontin has been a wonder drug for many pain patients. Contrary to what the media’s drug- warrior rhetoric would have us believe, virtually every case of "Oxycontin-related death" has occurred amongst addicts who mix drugs, not "innocent" pain patients. Conventional wisdom biases the media to portray the Oxycontin story as one of pill-pushing doctors and hyper-marketing drug companies turning innocent pain patients into addicts.

However, this is simply not what typically happens: according to the National Institute on Drug Abuse, the average Oxycontin misuser (90% of them) has also taken cocaine and psychedelics. Purdue was actually correct to claim that long-acting opioids like Oxycontin WHEN TAKEN AS DIRECTED are less likely to lead to addiction than shorter acting medications.

But here's where the company went criminally wrong. It went on to claim that Oxycontin had lower abuse potential than other opioids after addicts had learned to defeat the time-release mechanism and make it into a more risky, shorter-acting drug. In the age of the internet, this information was bound to travel even faster than prior drug lore did, from user to user-- and the mainstream media ensured that even naïve users like teenagers would know how to make the drug more dangerous by literally demonstrating how to do it on TV.

By focusing only on the risk of addiction—which is less than 1% for the older people without a prior history of it who are most likely to need pain medication-- the media has done America's 20-30 million chronic pain patients a tremendous disservice. Only 4% of people in treatment for addiction — is in 25-- report prescription painkillers as their primary drug problem.

Misrepresentation of facts in stories like this is a large part of why chronic pain is undertreated in this country. Many physicians fear being labeled "drug pushers" when they prescribe oxycodone, hydrocodone, fentanyl, or other potent narcotics to anyone who is not literally at death's door.

The fact Is that people who have bonafide chronic pain syndromes associated with underlying disease do not become addicted in the traditional sense; i.e. is, they don't take the drugs to get "high." Some do, however, develop tolerance, which requires higher doses of medication to achieve the same relief. The MSM, in its effort to stay relevant and sell media, does no one any favors when it sensationalizes topics like this without first doing the research.

The Drug Enforcement Administration traced 142 deaths to OxyContin overdose and said the drug contributed to another 318 fatalities. The DEA said the number of deaths related to the substance rose 400 percent from 1996 to 2001.” This is the same report that the DEA was forced to publicly admit was so methodologically flawed as to be “worthless” – after the Government Accounting Office analyzed it; the same report that was rejected by the Food and Drug Administration’s Dr. Cynthia McCormick because the fatality reports it cited were too ambiguous to arrive at any conclusions about the safety of OxyContin; the same report whose expose, the New York Times Barry Meier reported in his book “Painkiller,” was a “crushing” blow to Laura Nagel, the DEA’s head of Diversion Control. It is also the report whose conclusions about the safety of OxyContin were demolished by a peer-reviewed study in the Journal of Analytical Toxicology a year later, which analyzed autopsy reports from 23 states and found that 96.7 percent of deaths (a total of 919 fatalities), in which OxyContin’s active ingredient – Oxycodone – was present, occurred in people who also had other illegal drugs in their system.

The real data on OxyContin makes a strong argument for holding the media responsible for the rise in OxyContin abuse. According to the Drug Abuse Warning Network, the number of times OxyContin was recorded in an emergency department visit due to drug abuse or a suicide attempt went from zero in 1996 to four in 1997 to 527 in 1998 to 1,178 in 1999. The most dramatic increase occurred between 2000 and 2002, when the number of mentions went from 2,772 to 9,998 in 2001 and then to 14, 087 in 2002. This shows a correlation between the media’s frenetic coverage of OxyContin, which began during the February 2001 sweeps, and the sharp increase in emergency room mentions of abuse during and after this time period.

Normally, one should be grateful when news organizations are forthright in admitting mistakes. Yet, in this case, the applause is muted, if not grudging. By portraying OxyContin as a home-grown weapon of mass destruction, the media has significantly hampered the medical community’s attempts to treat chronic pain in millions of Americans.

One other statistic was clarified in September 2003. The increase in numbers of emergency room visits involving oxycodone cited by the Times back in February 2001 was finally disaggregated by the Drug Abuse Warning Network. The Times originally pointed out that “such visits doubled from 3,190 in 1996 to 6,429 in 1999, the period that corresponds with OxyContin’s introduction and marketing. The data indicated that deaths attributed to oxycodone products also grew in that period.” Yet in fact, the disaggregated DAWN data show that the number of actual OxyContin “mentions” (that is, the number of times OxyContin was recorded in an emergency department visit due to drug abuse or a suicide attempt). (This makes sense, as many of the news reports explained how to defeat OxyContin’s time-release feature).

The problem is whether tens of millions of Americans (which even the DEA admits are being under-treated for pain) are suffering unnecessarily because there is an intractable base rate of addiction in America. As Doctor Passik put it in his letter, "With 6 to 15% of the U.S. population having a drug problem, any highly available opioid will be sought by this proportionately small fraction of the population, which actually represents millions of substance abusers... Because 6 to 15% of the U.S. population abuses drugs, the history of pain management is marked by the undertreatment of the other 84 to 94% of the population, and we do not want to go back to the bad old days."

Jerry Rand, MD