A General Accounting Office report today said the basis of abuse of the opiate pain reliever OxyContin was rooted in the drug's potency as a pain reliever, its increased availability due to successful marketing, its widespread embrace by physicians who may have been inadequately trained in pain management, and, ironically, the drug's own label that proved to be, in effect, a how-to manual for abusers.
The GAO was asked by Congress to report on the causes of increased diversion and abuse of OxyContin after it became by 2001, just six years after receiving FDA approval, the most widely prescribed narcotic medication for treating moderate to severe pain.
Twice as potent as morphine, the active ingredient, oxycodone, made it an attractive target for abusers, the GAO said. Its rapid growth in market share made it readily available. The GAO also cited Drug Enforcement Agency concerns about the aggressive marketing of OxyContin "to treat a wide range of conditions to physicians who may not have been adequately trained in pain management."
Finally, the original safety label warned patients against crushing the tablets to avoid a potentially toxic release of oxycodone and in so doing "may have inadvertently alerted abusers to methods for abuse."
The report says the FDA and OxyContin manufacturer Purdue Pharma have since developed a risk management plan to help detect and prevent abuse and diversion, including education programs, disciplinary action against some drug representatives and the referral to authorities of physicians suspected of improper prescribing.
The GAO recommended future applications for control substances like OxyContin should include a risk management plan that identifies potential problems with abuse and diversion.