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Aerosmith Don't Miss A Thing
Adolph K. Reekie
Purdue Pharma, makers of the now infamous OxyContin, told the public in 2001 and for several subsequent years, that OxyContin had a lower risk of abuse and addiction than other prescription painkillers. The drug took the country by storm and, unfortunately, the users of the drug did the same with hospital ERs, drug detox and rehab centers, and morgues. Purdue lied, some people died, and many had their lives ruined. OxyContin addiction and abuse became almost epidemic and Purdue was fined $634.5 million earlier this year for their misdeeds. Now Alpharma is developing a synthetic morphine capsule they hope will fulfill the OxyContin promise. But how much of the abuse and addiction problem will it really resolve?
The story behind Purdue's claim that OxyContin addiction and abuse was less likely than with other opiate painkillers was based on the drug's time-release formulation. In fact, the FDA did allow Purdue Pharma to state that the time release of a narcotic like OxyContin "is believed to reduce" its potential to be abused. But Purdue sales reps, with the permission of Purdue, took it several steps further - they told doctors that "believed to reduce" is more than just theory and, according to federal officials, even drew their own fake scientific charts and distributed them to doctors to support the claim.
There were two basic problems with their claim: first, OxyContin addiction or, at the very least, dependency, is going to occur if you take it for even a relatively short period of time and even when taken as directed. The time release functionality has absolutely nothing to do with it.
Second, if you crush, dissolve or chew the pill, the time release functionality goes out the window and you get the full 12 hour dose in one hit. This point was considered to be the major departure from the truth in the Purdue hearings, and is the problem Alpharma is hoping to resolve with their new morphine pill. Here's how it works - theoretically.
The new morphine pill is a capsule containing 100 to 200 tiny pellets. Each pellet contains a core of naltrexone - a drug that inhibits morphine-induced euphoria. If the capsule is taken intact, the naltrexone core remains inactive, but when crushed, chewed or dissolved the naltrexone integrates with the morphine.
The rationale behind this is that someone who is 'using' the drug as directed would take the capsule intact and get the pain relief they're looking for, and someone wishing to 'abuse' the drug would crush, chew or dissolve it to get the morphine euphoria. However, if the naltrexone nullifies the euphoria, 'abusers' will not be interested in the drug.
And this, apparently, will reduce abuse and addiction.
How solid is this argument? Let me count the holes.
First, each individual metabolizes morphine and naltrexone differently, as directed by their DNA and a number of other complex factors. The amount of naltrexone in each pill may prove to be too little, or too much. Too little wouldn't nullify the morphine euphoria, and too much could induce withdrawal. And you never really know how each person will respond.
Second, I can pretty much guarantee that anyone who's at the point of chewing, crushing and dissolving any pill is already an addict. So, even though the person may be discouraged from using this particular morphine formulation, it's not going to stop or prevent addiction or abuse.
Third, you don't need to chew, crush or dissolve opiate painkillers to get addicted to them. And you don't need to chew, crush or dissolve them to abuse them.
I don't know how many of the 30,000 people who went to ERs, drug detox and rehab centers and morgues over the first few years after OxyContin's release had chewed, crushed or dissolved the pills before taking them, but I do know there are plenty of people out there who wouldn't even think of doing that who still developed an OxyContin addiction or dependency. I also know that taken as directed or not, time release or not, naltrexone core or not, people are going to get addicted to and dependent on this new drug.
Really, changing the way a pill is made will not change morphine addiction, Percocet addiction, OxyContin addiction or addiction to any other heavy opiate painkiller. They are highly addictive and they create physical dependency. Period.
What you can do is use these drugs only when absolutely necessary, take them only as directed, keep them out of everyone else's reach even if you have to keep the bottle on your person at all times, and get off them as soon as possible. If you have trouble getting off them, find a good medical drug detox program that can help make it safe and as comfortable as possible. Whatever you do, don't buy the hype.
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