OxyContin maker's culture change starts today: No more promoting opioids

John Bacon | USA TODAY

Show Caption Hide Caption CDC: Opioid overdose deaths tip of the Iceberg The opioid epidemic is being called the worst public health crisis in American history, with its lethal consequences exacting a toll on users and families nationwide. Eric Hargan, acting secretary of HHS spoke about the crisis at the CDC. (Dec 4)

The decision by OxyContin maker Purdue Pharma to stop encouraging physicians to write the painkiller's scripts is drawing positive reviews from opioid experts who caution that far more work must be done to crush the killer epidemic.

Purdue said it is slashing its sales staff and will halt, effective Monday, promoting the drug to health care professionals. The decision comes as the industry battles an avalanche of lawsuits across the nation related to an epidemic of opioid abuse.

Indra Cidambi, medical director at the Center for Network Therapy detox program in New Jersey and a nationally recognized authority on opioid abuse, said she was encouraged by Purdue's announcement. But she warned that tightening the prescription supply already has illegal drug dealers turning out more pills that look like branded prescription meds but can be even more dangerous.

"The decision by a manufacturer to stop pushing opioid pain medications is late, but better late than never," Cidambi told USA TODAY. "Even if we save one life due to this decision, it is worth it."

Kevin O'Grady, clinical director for Kansas City-based Midwest Recovery Centers, echoed Cidambi's reaction. He said prescription manufacturers, medical professionals and society need more resources on how to treat those afflicted by "this national health crisis."

"This recognition by Purdue is a step in the right direction, however, it only represents a small fraction of the problem," O'Grady said. "The focus still seems to be trying to stop this epidemic by increasing legal consequences, rather than treating it as an illness."

More: Opioid makers face hundreds of lawsuits

OxyContin is a time-release version of oxycodone, a semi-synthetic opioid, and has been a major force in the treatment of chronic pain for more than two decades. Purdue said in a statement that it is reducing its sales force by more than 50%, with its remaining 200 sales reps focusing on non-opioid drugs.

Purdue, a privately held company based in Stamford, Conn., is no stranger to the controversy. The company and three former executives pleaded guilty in federal court a decade ago to criminal charges of misleading the public about the addictive nature of OxyContin, paying more than $630 million in fines and penalties.

More recently Purdue has again been slammed with lawsuits claiming the company has downplayed OxyContin's addiction risk. Opioid litigation increased sharply in 2017 when hundreds of cities, counties and states sued opioid makers, wholesalers, distributors and marketers.

The lawsuits accuse the companies of, among other things, misleading prescribers and the public by marketing opioids as a safe substitute for non-addictive pain medications such as ibuprofen. Opioids also have been blamed for a resurgence in heroin use.

The government claims the results have been tragic — and left government agencies with millions in social and health care costs.

Purdue said in the statement that it "vigorously denies" allegations of misconduct, adding that its products account for only "approximately 2%" of all opioid prescriptions. The company said it has consistently followed opioid guidelines from the Centers for Disease Control, which include a recommendation that opioids not be the first option for chronic pain.

Purdue's head of medical affairs, Monica Kwarcinski, sent a letter to prescribers updating what she described as the company's efforts to support responsible opioid use.

"Effective Monday, February 12, 2018, our field sales organization will no longer be visiting your offices to engage you in discussions about our opioid products," Kwarcinski said in the letter, which was released to media outlets. "Requests for information about our opioid products will be handled through direct communication with the highly experienced health care professionals that comprise our Medical Affairs department."

Opioids are substances that work on the nervous system in the body or specific receptors in the brain to reduce the intensity of pain. The CDC says more than three out of five drug overdose deaths involve opioids — and that annual deaths from heroin and prescription opioids have increased more than five-fold since 1999, including 42,000 deaths in 2016.

"We are deeply troubled by the opioid crisis, and we are dedicated to being part of the solution," the company said in its statement.

Kevin Tuohy, associate professor of pharmacy practice at Butler University, said he was not surprised by Purdue's concession given the current political climate. He also said he doubts the decision will have much impact.

"They (opioids) are exceptional painkillers used to treat severe chronic pain associated with cancer and other chronic pain conditions," he said. "Discontinuing the sales information pipeline to prescribers will most likely not affect the prescribing of these drugs."