If you've already watched Painkiller, you've likely been left wondering about the real story behind OxyContin and whether it's still prescribed.
Read on for everything you need to know about what has become of OxyContin today.
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Painkiller on Netflix: What is OxyContin?
Whether you've finished watching Painkiller or not, the chances are that you've heard of the drug at the centre of the drama. But what exactly is OxyContin?
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Well, the drug is a strong, semi-synthetic class of drugs mainly used to treat pain, hence the name of the series: Painkiller. The American opioid crisis itself, though, has been tied to the marketing and distribution of OxyContin, a particular opioid that contains oxycodone.
Oxycodone is used for treating moderate to severe pain, as well as chronic pain when other treatments are no longer sufficient.
In 1972, the controlled drug-release system, Contin, was developed by Purdue Pharma and in 1984, its extended-release formulation of morphine, MS Contin was released. MS Contin became the top-selling drug in Purdue's history but its patent was about to expire in the late '80s, which led to Purdue developing its replacement, OxyContin.
At the time of developing OxyContin, oxycodone was used in other drugs and was inexpensive to produce. Oxycodone was found in drugs such as Percodan where it was blended with aspirin, and Percocet, where it was blended with Tylenol. But Purdue developed an oxycodone-only pill, using it time-release formula that it used for MS Contin.
Purdue developed OxyContin pills as low as 10 milligrams, but also developed jumbo pills of 80 milligrams and 160 milligrams, which Pain Killer author Barry Meier writes: "In terms of narcotic firepower, OxyContin was a nuclear weapon."
Purdue Pharma released OxyContin on the US market in 1996 and lauded its major innovation, the 12-hour time release of oxycodone. But mis-users of the drug soon devised ways to bypass that time release, thereby ingesting a major dose at once.
The marketing of OxyContin at the time underlined that the drug wasn't just to be used for end-of-life palliative care or severe pain, as many people thought an opioid like oxycodone was used for, but that it could also be used for "acute, longer-lasting pain: arthritis, back pain, sports injuries, fibromyalgia", as Patrick Radden Keefe outlines in The Family That Built an Empire of Pain.
According to series executive producer Alex Gibney: "OxyContin is a drug that has some valuable medical uses. But when it was marketed too broadly, without concern for its dangers, it was inappropriately and too widely prescribed, which led to massive addiction. That spilled out over, and over, and over again in communities across North America."
Painkiller on Netflix: Is OxyContin still prescribed?
Yes, OxyContin as a brand is still in use – but with some changes. More than a decade ago, Purdue Pharma reformulated OxyContin using a polymer, Intac, to make the pills more difficult to crush or dissolve in water. In 2013, the FDA approved labelling of OxyContin as an "abuse-deterrent".
Researchers at the time stated: “The abuse-deterrent version of OxyContin uses physiochemical barriers to make the pill difficult to crush or dissolve, thus deterring the most dangerous methods of abuse of inhalation or injection."
After the 2010 reformulation of OxyContin, the abuse of the drug became widespread and while the new drug couldn't be crushed or dissolved, it was found that many misusers of OxyContin turned to heroin.
According to The New York Times, the heroin overdose rate more than tripled in several years after the start of the new version of OxyContin. The American Economic Journal: Economic Policy also found that states with the highest rates of original OxyContin misuse had the largest increase in heroin deaths after its reformulation.
The drug is still available, as well as oxycodone, on prescription in the US and here in the UK, although the use of oxycodone differs between countries on account of legislation and national laws.
In the UK, oxycodone is classified as a class A drug and the dealing of the drug is punishable by up to life imprisonment, a fine or both. But OxyContin has been continued to be used to treat patients who are suffering from moderate to severe pain arising from terminal illnesses such as cancer or recovery from surgery or trauma, according to UK Rehab.
On the usage of oxycodone, the NHS outlines that patients can either be given capsules, standard tablets, slow-release tablets or a liquid form and that patients will begin on a low dosage that can be increased gradually until the pain is under control.
It also states: "Oxycodone is an opioid painkiller. It's used to treat severe pain, for example after an operation or a serious injury, or pain from cancer. Oxycodone liquid, standard tablets, capsules and injections work quickly. They're used for pain which is expected to last for a short time and are often used when you start taking oxycodone, to help find the right dose."
It continues: "It's possible to become addicted to oxycodone, but your doctor will explain how to reduce the risks of becoming addicted."
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