FROM 2005 to 2006 there was a 28.9% increase in  OXYCODONE-related deaths in Florida alone. From 716 deaths in 2005 to 923 deaths in 2006.
 

Click here to view the full Florida report

Facts about the Opioid Epidemic and New Data [from a concerned provider]:

In my opinion, two major reasons why the opioid problem got so out of hand relates to the corporate influence of both unethical over-promotion for sales and profit on one end, and the lack of regulatory over-sight to protect the public on the other.

Purdue Pharma continues to distribute material to doctors promoting OxyContin and other opioids NON-SELECTIVELY [well beyond cancer and other types of severe intractable tissue pain] for a broad range of chronic non-cancer pain disorders regardless of diagnosis. This sends a dangerous message which encourages clinical inertia and results in poor outcomes, such as when opioids are given inappropriately for chronic pain generated by psychological disorders [especially if masquerading with inaccurate musculoskeletal or other somatic diagnoses]. Furthermore, the efficacy and safety of long-term opioid therapy has NEVER been documented by a multitude of current research studies, which often indicate the opposite findings.

Regardless of the above, in a marketing booklet for providers from Purdue's "Partners Against Pain" series entitled "Clinical Issues in Opioid Prescribing: Considerations for the Practitioner in the Use of Opioids in Managing Moderate to Severe Pain" [2005], it states that the "use of controlled-release opioids is often NOT DEPENDENT ON A SPECIFIC DISEASE STATE, but is based on the severity and chronicity of pain". This contradicts the impression of experienced clinicians, as well as statements from the Federation of State Medical Boards of the United States [2004] which notes that the prescribing of a controlled substance for pain "should be based on a DIAGNOSIS---and whether the drug used is APPROPRIATE for the diagnosis, as well as improvement in functioning and/or quality of life." This cavalier attitude of the drug company regarding the non-selective use of opioids, especially when adopted by primary care providers with insufficient time to adequately evaluate difficult patients, underlies opioid overuse and the excessive availability of opioids which has contributed to many of the adverse and tragic events that have occurred over the last few years.

The same brochure states that "with pure opioid analgesics, there is NO DEFINED MAXIMUM DOSE; the CEILING to analgesic effectiveness is imposed ONLY BY SIDE EFFECTS, the most serious of which is RESPIRATORY DEPRESSION" and that therapy should be adjusted based upon "the PATIENT�S OWN REPORTS OF PAIN and side effects".These statements, when appplied to chronic non-cancer patients, facilitate the possibilities of both overdose and the act of prescribing opiate drugs to addicts and abusers.

 Furthermore, they contradict the conclusion of a major review article on opioid therapy for chronic pain which stated the following: "whereas it was previously thought that unlimited dose escalation was at least safe, evidence now suggests that prolonged, high-dose opioid therapy may be neither safe or effective." [Ballantyne JC, Mao J: Opioid therapy for chronic pain. The New England Journal of Medicine 2003;349:1943-53.].

It seems that the advice that Purdue is giving to doctors are 'prescriptions' not only for a great deal more opioids for patients, but also 'prescriptions' which may predispose to addiction, abuse, overdose and death, and which unfortunately have already occurred on a large scale.

The failure of post-marketing over-sight of safety issues by the FDA, which has been contaminated by corporate influence, has greatly amplified the problem, in spite of criticism from many parties. In a recent report by the Institute of Medicine on drug safety in the New England Journal of Medicine, some of the conclusions in regard to drug-safety included: "the negotiations between industry and the FDA about performance goals have contributed to the perception that the FDA's client is industry rather than the public." Furthermore, the article goes on to state that "in 2006, the Government Accountability Office found that the "FDA lacks clear and effective processes for making decisions about, and providing management oversight of, postmarket safety issues." [Psaty BM et. al. Institute of Medicine on Drug Safety. The New England Journal of Medicine 2006;355;17:1753-55].

The most comprehensive review of the problem appeared in the journal Pain Physician (2006;9,287-321):�Prescription Drug Abuse: What is being done to address this New Drug Epidemic?� by Laxmaiah Manchikanti, MD. CDC and DEA data taken from this review include the following:

From 1997 to 2004, there were marked increases in sales, therapeutic use,

and non-medical use of oxycodone/OxyContin, as well as in overall

opioid-related deaths. During these years there was:

[1] a 556% increase in the sales of oxycodone,

[2] a 500% increase in therapeutic grams of oxycodone used,

[3] a 568% increase in the non-medical use of OxyContin [comment- this most likely relates not only to widespread availability and increased recreational use,

especially among young people, but to the behavioral characteristics of a

growing population of newly-created addicts, as well as to diversion and sale of the drugs by those motivated for economic gain, and a rising volume of drug-related crime].

[4] a 129% increase in opioid-related deaths [without heroin or cocaine]:

from 1942 deaths in 1999, to 4451 deaths in 2002 [the last year this was

calculated].

http://www.painphysicianjournal.com/2006/october/2006;9;287-321.pdf

If one then extrapolates the 4451 figure in 2002 over the next four

years to the end of 2006 [which is probably an underestimate], the total

number of deaths from opioids over the five year period of 2002-2006 may be at

least a staggering 22,255 [4451 x 5], a number that far exceeds the combined

American fatalities of 9/11 and the Iraq War!

In addition to the CDC data documented in the above review, other reports from this institution indicate how extensive a problem this has become in both rural and metropolitan areas of the U.S:

 [1] A study from Utah reveals the tremendous percent increase in opioid-related deaths from various opioids between the period 1991-98 compared to 1999-2003. These increases include: hydrocodone +328%, oxycodone +1676%, fentanyl +2060%, and methadone +1358% [MMWR Jan. 21, 2005/54;33-36].

 [2] A just-released article from the CDC reports on the increase in opioid analgesic drug-abuse deaths in 28 metropolitan areas in the U.S. from 1997-2002. The total for all prescription opioid reports increased by +96.6%, with methadone, oxycodone and unspecified opioids accounting for 74.3% of the increase. Reports  of oxycodone deaths increased +727.8% over these years [from 72 to 596 reports]. The article states that "dramatic increases in the availability of such opioids have made their abuse a major, growing problem."

[Paulozzi LJ. Opioid analgesic involvement in drug abuse deaths in American metropolitan areas. Am J Public Health. 2006 Oct;96:1755-57.]

The handwriting is already on the wall as confirmed by many sources. These latest reports make it clear that if powerful brain-active opioids with high street value like Oxycontin (oxycodone) are given to the wrong people, bad things will inevitably happen. The public has a right to be well-informed and know all the facts, because tragically it is they who have paid the highest price.