TO MILLIONS OF AMERICANS living daily with chronic pain, it was a godsend. Approved by the Food and Drug Administration (FDA) without controversy in 1995, OxyContin, a narcotic painkiller twice as potent as morphine, was the first drug to provide cancer patients and victims of severe arthritis with continuous relief from debilitating pain over a 12-hour period. By 2001 sales for the drug had reached $1 billion.
"When [OxyContin] falls into the wrong hands, that's when the danger starts," says Dr. Sudhir Diwan, director of the Division of Pain Medicine at Cornell's Weill Medical College. Indeed, the drug's extreme potency has been both its boon and its bane. Crushing the pill into a powder, then snorting or injecting it, produces a heroinlike rush--the result of ingesting 12 hours' worth of narcotics in seconds. As OxyContin (a trade name for oxycodone hydrochloride) found its way onto the street, stories of abuse and addiction surfaced across the country. In southern and eastern Kentucky, Operation OxyFest 2001 was the largest drug raid in state history and resulted in 207 arrests. Last month 18 people in Massachusetts, New Jersey and Arizona were arrested in connection with a multistate OxyContin ring that allegedly involved mobsters, gang members, pharmacists and college students. According to a nationwide Drug Abuse Warning Network survey in 2002, 1.9 million people said they had used OxyContin for nonmedical reasons; by 2003 that number had jumped to 2.8 million.
The most recent research by the Drug Enforcement Agency (DEA), from 2002, indicated that OxyContin abuse was most prevalent in the Southeast and Northeast, as well as parts of Kentucky, Pennsylvania and Virginia. Experts cite a history of prescription drug abuse in many of these areas, but otherwise they can offer little explanation as to why OxyContin abuse takes hold in certain pockets of the country. According to the National Drug Intelligence Center, OxyContin is abused "by individuals in all age groups and social strata." There is no evidence that OxyContin abuse is particularly widespread among athletes, but doctors say that the drug could be beneficial to those competing through intense pain.
OxyContin's medicinal success only paves the way for stronger painkillers to hit the market. This spring the FDA approved a generic form of OxyContin, which brings other pharmaceutical companies into the manufacturing and distribution process; Teva Pharmaceutical Industries Ltd. has already rolled out its generic product and two other companies have received FDA approval to do so. More widespread availability, of course, raises concerns about abuse. Also, next year Purdue Pharma, the Stamford, Conn.--based pharmaceutical company that developed the drug, plans to introduce Palladone, a narcotic similar to OxyContin but even more potent. Says Kentucky's U.S. representative Hal Rogers, "Today the problem is OxyContin. Tomorrow it could be something else." --Albert Chen