The study found that OxyContin was safe, relieved pain and lasted longer than the short-acting painkillers.
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Purdue moved ahead on two paths: seeking patents for its new drug and running additional clinical trials to secure FDA approval. In study after study, many patients given OxyContin every 12 hours would ask for more medication before their next scheduled dose. A Tennessee pain specialist whom Purdue selected to field-test the drug in as part of the FDA approval process eventually moved 8 of 15 chronic pain patients to 8-hour dosing because they were not getting adequate relief taking the drug twice a day. Robert Reder wrote to the Memphis physician, using medical shorthand for hour dosing.
Narcotic painkillers work differently in different people. Some drug companies discuss that variability on their product labels and recommend that doctors adjust the frequency with which patients take the drugs, depending on their individual response.
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The morphine tablet, Kadian, manufactured by Actavis, is designed to be taken once a day, but the label states that some patients may need a dose every 12 hours. It did not test OxyContin at more frequent intervals.
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To obtain FDA approval, Purdue had to demonstrate that OxyContin was safe and as effective as other pain drugs on the market. Under agency guidelines for establishing duration, the company had to show that OxyContin lasted 12 hours for at least half of patients. Purdue submitted the Puerto Rico study, which showed that. Officials at the agency declined to be interviewed. After OxyContin hit the market in , ads in medical journals left no ambiguity about how long it lasted. A spotlight illuminated two dosage cups, one marked 8 AM and the other 8 PM. She had struggled with back pain since age 14, when she was thrown from a horse while practicing for an equestrian competition.
On that day in , her physician said he had something new for her to try. He told her to take OxyContin every 12 hours. Only the next pill would relieve her suffering. The change had little effect. For a year and a half, she spent each day cycling through misery and relief. Sometimes, she said, she contemplated suicide. Before OxyContin, doctors had viewed narcotic painkillers as dangerously addictive and primarily reserved their long-term use for cancer patients and the terminally ill. Purdue envisioned a bigger market. Sales reps pitched the drug to family doctors and general practitioners to treat common conditions such as back aches and knee pain.
With Percocet and other short-acting drugs, patients have to remember to take a pill up to six times a day, Purdue told doctors. The marketing succeeded in ways that astonished even Purdue executives. It dwarfed them.
The success of OxyContin brought a whole new level of wealth. Other drug companies began marketing their own narcotic painkillers for routine injuries. OxyContin accounted for a third of all sales revenue from painkillers that year, according to industry data.
Rates of addiction and overdose have soared alongside the rise in prescriptions. News coverage of these problems in Appalachia and New England in the late s made OxyContin notorious. Purdue dispatched representatives to Virginia, Maine and elsewhere to defend its drug. They blamed misuse of OxyContin and insisted their pill was a godsend for pain sufferers when taken as directed. David Haddox, told a reporter in The U. Justice Dept. The company eventually rolled out a tamper-resistant version of the painkiller that was harder to crush and snort.
Subscribe today for unlimited access to exclusive investigations, breaking news, features and more. But in all the scrutiny of Purdue and OxyContin, the problem of the drug wearing off early was not addressed. In reports to headquarters, they wrote that many physicians were prescribing it for three or even four doses a day. Lawrence Robbins started prescribing OxyContin at his Chicago migraine clinic shortly after it hit the market. But insurance carriers often refused to cover the pharmacy bill for more than two pills a day, he said.
Over the years, he wrote insurance companies more than 25 times on behalf of patients who he believed needed OxyContin more frequently than every 12 hours, he said.
In some cases, the insurers relented. When others did not, Robbins switched the patients to another drug. In this letter, a Purdue regional manager writes that he is concerned about doctors prescribing OxyContin at 8-hour intervals. Sales reps should visit those physicians and convince them to go back to hour dosing, he writes. Data analyzed by company employees showed that one in five OxyContin prescriptions was for use every eight hours, or even more frequently.
Purdue held closed-door meetings to retrain its sales force on the importance of hour dosing, according to training documents, some included in sealed court files and others described in FDA files. In a petition to the FDA, attorneys for the state of Connecticut described the alarm inside Purdue when some doctors began prescribing OxyContin at more frequent intervals.
There is no ceiling on the amount of OxyContin a patient can be prescribed, sales reps were to remind doctors, according to the presentation and other training materials. After some physicians began prescribing OxyContin more frequently than every 12 hours, Purdue summoned its sales force to special seminars. As this presentation shows, company officials were concerned more frequent dosing would hurt business. Higher doses did mean more money for Purdue and its sales reps.
Commissions and performance evaluations for the sales force were based in part on the proportion of sales from high-dose pills. In this memo entitled "It's Bonus Time in the Neighborhood," a Purdue sales manager told her staff to talk up stronger doses of OxyContin in conversations with doctors. In the training materials reviewed by The Times, little was said about the effect of higher doses on patient health. We get to follow Sharp as she tries to escape poverty and join the ranks of English High Society, and revel in the many, many ups and downs she experiences along the way. Watch Vanity Fair on iTunes.
Abi Morgan once again wielded her mighty pen for The Split , a new series for the Beeb which is due to return for series two in Emmy winner Morgan, who previously brought us The Hour, River and Suffragette , delivered an exploration of modern marriage and the legacy of divorce seen through the lens of the Defoes - a family of female lawyers at the heart of London's emotionally-charged divorce circuit. Watch The Split on Amazon.
Ben Hardy stars as Walter Hartright, a drawing master who runs into a ghostly woman dressed in white on auld Hampstead Heath. It turns out she's not a ghost, though, but an escaped psychiatric patient.
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They're all set to become part of the bigger mystery surrounding the circumstances of Anne's original incarceration in an asylum, and her ominous return. Christopher Eccleston Doctor Who, Our Friends In The North and Paula Malcomson Deadwood starred in this moving family drama about a woman who has left her three children suddenly, with those she left behind picking up the pieces, asking themselves why and ultimately trying to move on from the abandonment. Watch Come Home on Amazon. When Jacko Argyle dies in prison, sent there for a crime he never committed, his family have to face the facts and find out which one of them really did the deed.
Watch Ordeal by Innocence on Amazon. This was a highly anticipated new thriller series from Fleabag creator Phoebe Waller-Bridge. Killing Eve is based on the Villanelle novellas by Luke Jennings, the 8-part adaptation stars Sandra Oh Grey's Anatomy as Eve, a bored MI5 security officer whose desk job does not fulfil her fantasies of being a spy. Doctor Foster 's Jodie Comer, meanwhile, will be Villanelle, a fearsome assassin clinging to the luxuries her violent job affords her.
When Eve is tasked with tracking down Villanelle before she can strike again, the two women are thrown into a cat-and-mouse game that turns the traditional spy-thriller on its head. What else would we expect from the rather remarkable Waller-Bridge? Watch Killing Eve on Amazon. Guy Pearce stars as a mysterious character in Netflix's eight-part supernatural teen drama from Hania Elkington and Simon Duric. The story revolves around Harry and June, a pair of young, star-crossed lovers who are determined to escape their repressive families and be together forever, but it turns out that they have both been gifted with strange powers beyond their control, and which may ultimately ruin their romantic plans.
Watch The Innocents on Netflix. Series two is underway. Watch McMafia on Amazon. Sky Atlantic ventured into the realm of historical epicness with Britannia , a ten-part series from Spectre and Black Mass co-writer Jez Butterworth. Expect period costumes and plentiful bloodletting. All ten episodes were available on demand from January 18th, and series two is coming soon. Jim Sturgess and Agyness Deyn play said detectives, who stumble onto proof of the impending end of days while investigating the death of a hacker. Watch Hard Sun on Amazon. It arrived on January 3rd.
Watch Girlfriends on Amazon. Based on her own childhood memories, McGee has crafted Derry Girls as a chuckle-worthy coming of age story dressed in grim s garb and set against a dark backdrop. The series premiered on January 4th and series two is currently airing on Tuesday nights on Channel 4. Dolly Parton, Kris Kristofferson and Merle Haggard number among the latter in this opening double bill, which goes deep into the American South to locate the origins of country music.
The opener finds its way, inevitably, to two of the founding legends of the genre, Jimmie Rodgers and the Carter Family, whose very different lives dictated the dichotomy at the heart of country: the draw of the road and the life of the rambler, versus the appeal of home and hearth. But Burns ensures that forgotten figures also receive their due as Nashville, the Great Depression and war exert their influence in the second instalment.
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