It was touted as a miracle pill: a narcotic pain reliever that could change the lives of people suffering from chronic pain, but with little -- so its maker claimed, and thousands of doctors believed -- risk of addiction.
Since OxyContin was introduced in 1996, Canada has recorded the second-highest number of prescription opioid painkiller addictions -- and the world's second-highest death rate from overdoses.
"It's helping your pain, but then you get immune to it, so then you go to the family doctor and he says 'Well, you're gonna need more,'" a woman who became addicted to OxyContin tells the fifth estate's Linden MacIntyre. "So he puts you on the 40 milligram (dose) and you're on that for a month, and then you get used to that dose and he puts you on the 80s."
But how did a little pill that only appeared in 1996 become so big, so fast? In 1998, Canadian sales were just a few million dollars. Twelve years later they had soared to $243 million. In the U.S., sales were $3.5 billion in 2010. Though there were differences in corporate style and legal structure between Purdue in the U.S and in Canada, a similar marketing approach proved wildly successful. the fifth estate examines why medical schools, GPs and specialists in pain clinics readily embraced the drug at first, and why some have now changed their minds.
OxyContin was dropped from provincial health plans in Ontario, Saskatchewan and Atlantic Canada. The manufacturer has now stopped making it altogether, replacing it with a new formulation known as OxyNeo. But is it too little, too late? Did the drug's maker low-ball the risks? Did they know their time-release miracle pill was really a time bomb of addiction, waiting to go off?
In August 2010, Purdue Pharma reformulated their long-acting oxycodone line, marketed as OxyContin, to use a misuse-resistant polymer designed to decrease abuse potential by defeating the release mechanism. The FDA approved relabeling the reformulated version as abuse-resistant in April 2013.
Pfizer manufactures a preparation of short-acting oxycodone, marketed as Oxecta, which contains inactive ingredients designed to induce nasal irritation if the tablet is crushed and snorted.
The non-medical use of OxyContin began in Australia in the early 2000s. By 2015, 91% of a national sample of injection drug users in Australia had reported using oxycodone, and 27% had injected it in the last six months.
Oxycodone is a semisynthetic opioid synthesized from thebaine, an opioid alkaloid found in the Persian poppy and one of the many opioid alkaloids found in the opium poppy. It is an analgesic generally indicated for relief of moderate to severe pain. It was developed in 1917 in Germany as one of several new semi-synthetic opioids in an attempt to improve on the existing opioids.
Oxycodone is available as single-ingredient medication in immediate release and controlled release. Parenteral formulations of 10 mg/mL and 50mg/mL are available in the U.K. for IV/IM administration. Combination products formulated with non-narcotic ingredients such as nonsteroidal anti-inflammatory drugs (NSAID) and paracetamol (acetaminophen) are also available as immediate release formulations; a combination with naloxone is available in managed-release tablets, the naloxone precipitates opioid withdrawal symptoms & blocks the faster onset were the tablet to be crushed and filtered for injection or otherwise tampered with in a manner not indicated.