Pain Killer

OxyContin, a powerful prescription painkiller derived from opium and similar to morphine, was first brought to market in 1996 to help alleviate pain for cancer patients and other chronic pain sufferers, and was heralded as a wonder drug that dramatically reduced suffering. Its time-release formula meant pain sufferers no longer needed to awaken during the night to take more pain medication. Within a few years of its release ? backed by aggressive marketing from the drug's manufacturer, Purdue Pharma, whose sales reps had access to a powerful database that helped them target doctors who were writing the most prescriptions for painkillers ? it was racking up sales of more than $1 billion per year. By 2002, the company was doing $30 million worth of OxyContin sales every week. Today it is known as 'hillbilly heroin,' a highly addictive and potent narcotic that is frequently abused by drug addicts, and the drug of choice in rocker Courtney Love's most recent drug possession charges.

The tale of the drug's slip from grace is documented in journalist Barry Meier's "Pain Killer."

As early as 1998, Canadian researchers at the University of British Columbia had sounded alarm bells when they had uncovered the abuse of time-release narcotics by drug addicts in downtown Vancouver. By 1999, medical examiners in the United States started taking notice when the drug showed up in increasing numbers of toxicology tests conducted for autopsies; people who overdose on the drug stop breathing since it depresses the respiratory system. Some of the medical examiners started asking questions, such as whether the deceased had received a prescription from a doctor for the drug and, in the majority of cases, the answer to that question was no. In fact, many of the subjects were teenagers who had bought OxyContin on the street and had used it as a recreational drug, frequently losing interest in school and other activities and experiencing painful withdrawal symptoms when they discontinued its use.

Other painkillers such as Percodan and Percocet contain about five milligrams of the narcotic oxycodone, while OxyContin contains as much as 160 milligrams. As Meier puts it, 'In terms of narcotic firepower, OxyContin was a nuclear weapon.'

In the second half of 2000, there were more overdose deaths in the United States from prescription painkillers than from heroin and cocaine. Despite convincing evidence of widespread abuse of the drug and complaints from doctors and medical examiners, Purdue took a Machiavellian approach to the problem that included manipulating politicians and drug enforcement agencies and paying others ? including former mayor of New York, Rudy Giuliani ? to support its cause, with the result being the FDA dragging its feet when it came to regulating the drug's use.

Oddly enough, it was the FDA that claimed OxyContin would be less appealing to drug abusers than other painkillers because the narcotic was released over a 12-hour period. But addicts found a way to defeat the drug's time-release feature. By 2001, OxyContin represented 90 percent of police undercover drug buys in some areas in the United States.

Meier does a thorough job of tracking OxyContin's trail of destruction and the havoc it has wreaked ? 'a medical, social, legal and societal catastrophe,' as one doctor put it ? and it is hard not to wonder what the future holds in regard to highly addictive prescription drugs after reading his book. Purdue is already selling a time-release version of Dilaudid, another powerful narcotic, in Canada.

Detailing the rise in popularity of the drug, while profiling some of those left in its wake, and including an engrossing history of the use of medication to treat pain, "Pain Killer" is a page-turner that is hard to put down.