Pubdate: Sun, 16 Jan 2005
Source: Eagle-Tribune, The (MA)
Copyright: 2005 The Eagle-Tribune
Author: Claude R. Marx

Index -- Special On Opiate Use (Eagle-Tribune) --
Bookmark: (Oxycontin/Oxycodone)


BOSTON -- When children died after misusing their product and a  prominent 
talk show host entered treatment because of his addiction to it and  other 
painkillers, the manufacturers of OxyContin fell back on an 
age-old  strategy: The best defense is a good offense.

Connecticut-based Purdue Pharma has been doing an extensive advertising 
campaign, funding drug-awareness programs and sending people to speak at 
public events, all reinforcing the message that the product is generally 
safe and effective if used properly.

Marketing and health-care policy experts say it is a risky, though 
necessary, approach for preserving the viability of a product that had $1.6 
billion in worldwide sales last year.

"They are very aggressive in protecting their right to market their 
product, and early on they felt it wasn't their responsibility to combat 
illegal uses of  their product. They have focused on promoting the product 
as filling an important need, pain control. Their attitude has been, 'We 
are only doing this as a public service. We don't have to,'" said Steven 
Henson, a marketing professor at Western Carolina University in North 
Carolina. Just this week, company officials were in the Merrimack Valley 
speaking at a townwide meeting Thursday in North Andover, sponsored by 
Essex County District  Attorney Jonathan Blodgett, and meeting with 
newspaper editorial boards. The  meeting and a recent series of articles by 
the Eagle-Tribune Publishing Co. have  focused on the increased use of 
OxyContin and heroin in Essex County in recent  years. Last year, there 
were at least 39 fatal drug overdoses in Essex County.

Executives came from corporate headquarters in Stamford, Conn. They also 
hired a Boston-based public relations firm to establish better local 
contacts and have done similar things elsewhere.

"We are trying a lot of ways to address the problem," said company 
spokesman C.R. Hogen. "We have had an approach of full engagement with all 
sectors of society, including community and law enforcement officials and 
health-care professionals."

OxyContin is a synthetic opiate. The prescription pill, which was approved 
by the Food and Drug Administration in 1995, has been popular with those 
suffering  from cancer and other illnesses that cause severe pain. Some 
people, primarily teenagers, have abused the drug by removing its 
time-release coating to get an immediate "rush" or "high." Adults, 
including conservative talk show host Rush Limbaugh, have become hooked on 
it and other painkillers when they have been trying to find ways to deal 
with pain. The need sometimes gets so severe that patients resort to 
"doctor shopping" and try to get prescriptions from several physicians.

To combat this abuse, Purdue Pharma's outreach efforts have included a 
$35,000 grant to Massachusetts Department of Public Safety in 2002 to set 
up a tips line for people to call in information about pharmacy robberies. 
Also, the company provides $500,000 to help fund "Communities That Care" 
programs in 20 cities throughout the country, including Lynn. These are 
programs designed to help community leaders identify the risk factors that 
lead to substance abuse  and other problem behaviors. They expect to award 
another 10 grants this year, including one in Massachusetts, Hogen said.

The company ran about $2 million worth of public service advertisements on 
local television stations and newspapers in 15 media markets. It ran a 
$150,000 radio campaign, which often took a humorous approach. One such ad 
said: "It's hard to make new friends, especially if you are someone 
who  frequently vomits." The company also has set up a Web site to educate 
people  about the dangers of abusing prescription drugs: Jane Williamson, the program director of CAB 
Health and Recovery Services in Danvers, said advertising won't necessarily 
make an impact on teenagers' drug-abuse habits.

"The kids are getting it out of their parents' medicine cabinets; they are 
not buying it because they see ads. They do it because it feels good to 
them. They don' realize how addicting it is until they are addicted," she 
said. The company's advertising and marketing response is appropriate, but 
they also need to improve the product, said Leonard Glantz, a professor of 
health law at Boston University's School of Public Health.

"Manufacturers are required to foresee the wrongful use of a product. Once 
they know a product is being abused, they have an obligation to do 
something about it without changing the essence of a product. All opiates 
are addictive. What makes OxyContin effective is that is time-released. The 
problems come when  the pill is crushed, and that's what the company needs 
to deal with," he said. Hogen said that they are working on a "smart pill" 
that when swallowed acts like a pain reliever, but when crushed its 
pain-relieving properties are disabled. He said he could not predict when 
Purdue Pharma would be ready to submit the drug to the Food and Drug 
Administration for approval. Purdue Pharma's public relations challenge is 
not unique these days. Last week, the drug manufacturer Eli Lilly & Co. 
launched an extensive newspaper advertising campaign throughout the country 
to counter a report in a British health journal linking the company's 
anti-depressant drug Prozac and increased risk of suicide attempts.

Some industry critics, such as health-care policy scholar Myron Fottler, 
said the advertising campaigns are an insufficient response to a serious 
public-safety problem.

"I'd be impressed if they'd withdraw the controversial product from the 
market and do more evaluation on their effects. But they are not there 
to  impress me; they are there to sell their products," said Fottler, a 
professor of health services administration at the University of Central 
Florida in  Tampa.
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