Research has shown that marijuana’s negative effects on attention, memory, and learning can last for days or weeks after the acute effects of the drug wear off, depending on the person’s history with the drug. 52 Consequently, someone who smokes marijuana daily may be functioning at a reduced intellectual level most or all of the time.. Considerable evidence suggests that students who May 06, · Drug Abuse: Drug abuse is the non permissive consumption of certain substance that may lead to physical and psychological dependence. Popularized in the s by music and mass media, they invade all aspects of society. 6 The Comprehensive Drug Abuse Prevention and Control Act divided substances with abuse potential into categories based on the degree of their abuse potential and their clinical usefulness. _____ was the top-selling prescription drug. valium. Bristish Renaissance Poetry/Essay Test. 18 terms. taytessruz. Health Chapter 4. 33 terms
The Promotion and Marketing of OxyContin: Commercial Triumph, Public Health Tragedy
Try out PMC Labs and tell us what you think. Learn More. I focus on issues surrounding the promotion and marketing of controlled drugs and their regulatory oversight. Compared with noncontrolled drugs, controlled drugs, with their potential for abuse and diversion, pose different public health risks when they are overpromoted and highly prescribed. An in-depth analysis of the promotion and marketing of OxyContin illustrates some of the associated issues.
Modifications of the promotion and marketing of controlled drugs by the pharmaceutical industry and an enhanced capacity of the Food and Drug Administration to regulate and monitor such promotion can have a positive impact on the public health. An in-depth analysis of the promotion and marketing of OxyContin Purdue Pharma, Stamford, CTa sustained-release oxycodone preparation, illustrates some of the key issues.
When Purdue Pharma introduced OxyContin init was aggressively marketed and highly promoted. Under current regulations, the Food and Drug Administration FDA is limited in its oversight of the marketing and promotion of controlled drugs. However, fundamental changes in the promotion and marketing of controlled drugs by the pharmaceutical industry, and an enhanced capacity of the FDA to regulate and monitor such promotion, can positively affect public health, prescription drug abuse essay.
OxyContin's commercial success did not depend on the merits of the drug compared with other available opioid preparations, prescription drug abuse essay. The Medical Letter on Drugs and Therapeutics concluded in that oxycodone offered no advantage over appropriate doses of other potent opioids. made similar conclusions. The promotion and marketing of OxyContin occurred during a recent trend in the liberalization of the use of opioids in the treatment of pain, particularly for chronic non—cancer-related pain.
From toPurdue conducted more than 40 national pain-management and speaker-training conferences at resorts in Florida, Arizona, and California. More than physicians, pharmacists, prescription drug abuse essay, and nurses attended these all-expenses-paid symposia, where they were recruited and trained for Purdue's national speaker bureau. Through these profiles, prescription drug abuse essay drug company can identify the highest and lowest prescribers of particular drugs in a single zip code, county, prescription drug abuse essay, state, or the entire country.
Unfortunately, this same database would also identify which physicians were simply the most prescription drug abuse essay prescribers of opioids and, in some cases, the least discriminate prescribers. A lucrative bonus system encouraged sales representatives to increase sales of OxyContin in their territories, resulting in a large number of visits to physicians with high rates of opioid prescriptions, as well as a multifaceted information campaign aimed at them. From toPurdue increased its internal sales force from sales representatives toand its total physician call list from approximately 33 to 44 to approximately 70 to 94 physicians.
Bywhen the program was ended, approximately 34 coupons had been redeemed nationally. Purdue promoted among primary care physicians a more liberal use of opioids, prescription drug abuse essay, particularly sustained-release opioids, prescription drug abuse essay. Primary care physicians began to use more of the increasingly popular OxyContin; bynearly half of all physicians prescribing OxyContin were primary care physicians.
Prospective, prescription drug abuse essay, randomized, controlled trials lasting at least 4 weeks that evaluated the use of opioids for chronic, non—cancer-related pain showed statistically significant but small to modest improvement in pain relief, with no consistent improvement in physical functioning.
In the long-term use of opioids for chronic non—cancer-related pain, the proven analgesic efficacy must be weighed against the following potential problems and risks: prescription drug abuse essay opioid side effects, including respiratory depression, sedation, constipation, and nausea; inconsistent improvement in functioning; opioid-induced hyperalgesia; adverse hormonal and prescription drug abuse essay effects of long-term opioid treatment; a high incidence of prescription opioid abuse behaviors; and an ill-defined and unclarified risk of iatrogenic addiction.
A consistent feature in the promotion and marketing of OxyContin was a systematic effort to minimize the risk of addiction in the use of opioids for the treatment of chronic non—cancer-related pain. One of the most critical issues regarding the use of opioids in the treatment of chronic non—cancer-related pain is the potential of iatrogenic addiction. Both of these studies, prescription drug abuse essay shedding some light on the risk of addiction for acute pain, do not help establish the risk of iatrogenic addiction when opioids are used prescription drug abuse essay for a prolonged time in treating chronic pain.
There are a number of studies, however, that demonstrate that in the treatment of chronic non—cancer-related pain with opioids, there is a high incidence of prescription drug abuse.
Prescription drug abuse in a substantial minority of chronic-pain patients has been demonstrated in studies by Fishbain et al. Misrepresenting the risk of addiction proved costly for Purdue.
Although research demonstrated that OxyContin was comparable in efficacy and safety to other available opioids, 1163 marketing catapulted OxyContin to blockbuster drug status. The remarkable commercial success of OxyContin, however, was stained by increasing rates of abuse and addiction, prescription drug abuse essay. Drug abusers learned how to simply crush the controlled-release tablet and swallow, inhale, or inject the high-potency opioid for an intense morphinelike high.
Purdue's own MS Contin had been abused in the late s in a fashion similar to how OxyContin was later to be; byMS Contin had become the most abused prescription opioid in one major metropolitan area. Opioid prescribing has had significant geographical variations. In some areas, such as Maine, West Virginia, eastern Kentucky, southwestern Virginia, and Alabama, from throughhydrocodone and non-OxyContin oxycodone were being prescribed 2. Bythese same areas had become high OxyContin-prescribing areas—up to 5 to 6 times higher than the national average in some counties Table 1.
In West Virginia, the first methadone maintenance treatment program opened in Augustlargely in response to the increasing number of people with OxyContin dependence. By Octoberprescription drug abuse essay, West Virginia had 7 methadone maintenance treatment clinics with patients in treatment M. Moore, Office of Behavioral Health Services, Office of Alcoholism and Drug Abuse, West Virginia, written communication, March 16, In southwestern Virginia, the first methadone maintenance treatment program opened in Marchand within 3 years it had admissions E.
Jennings, Life Center of Galax, Galax, Virginia, written communication, March 12, Distribution of OxyContin, Oxycodone Excluding OxyContinand Hydrocodone per Population: Virginia, West Virginia, and Kentucky, Office of Diversion Control, Drug Enforcement Administration.
Data are for the counties or independent cities with the highest quantities of opioids in grams prescribed in each of the 3 states. With increasing diversion and abuse, opioid-related overdoses escalated.
The high availability of OxyContin in these 5 regions seemed to be a simple correlate of its abuse, diversion, and addiction. With the growing availability of OxyContin prescriptions, the once-regional problem began to spread nationally. The increasing OxyContin abuse problem was an integral part of the escalating national prescription opioid abuse problem.
Liberalization of the use of opioids, particularly for the treatment of chronic non—cancer-related pain, increased the availability of all opioids as well as their abuse. In terms of illicit drug abuse, prescription opioids are now ahead of cocaine and heroin and second only to marijuana. Under the Food, Drug, and Cosmetics Act and implementing regulations, the FDA regulates prescription drug abuse essay advertising and promotion of prescription drugs and is responsible for ensuring that prescription drug advertising and promotion are truthful, balanced, and accurately communicated.
There is no distinction in the act between controlled and noncontrolled drugs regarding the oversight of promotional activities. Although regulations require that all promotional materials for prescription drugs be submitted to the FDA for review when the materials are initially disseminated or used, it is generally not required that these materials be approved by the FDA prior to their use.
The FDA has prescription drug abuse essay limited number of staff for prescription drug abuse essay the enormous amount of promotional materials.
Infor example, 39 Prescription drug abuse essay staff members were responsible for reviewing roughly 34 pieces of promotional materials, prescription drug abuse essay. InPurdue distributed 15 copies of an OxyContin video to physicians without submitting it to the FDA for review, an oversight later acknowledged by Purdue. InPurdue submitted to the FDA a second version of the video, prescription drug abuse essay, which the FDA did not review until October —after the General Accounting Office inquired about its content.
After its review, the FDA concluded that the video minimized the risks from OxyContin and made unsubstantiated claims regarding its benefits to patients. Prescription drug abuse essay Julyto reflect the available scientific evidence, the label was modified to state that data were not available for establishing the true incidence of addiction in chronic-pain patients. The labeling also deleted the original statement that the delayed absorption of OxyContin was believed to reduce the abuse liability of the drug.
OxyContin appears to be as efficacious and safe as other available opioids and as oxycodone taken 4 times daily. Compared with noncontrolled drugs, controlled drugs, with their potential for abuse and diversion, pose different public health risks when overpromoted and highly prescribed. Several marketing practices appear to be especially questionable, prescription drug abuse essay.
The prescription drug abuse essay amount of money spent in promoting a sustained-release opioid was unprecedented. During OxyContin's first 6 years on the market, Purdue spent approximately 6 to 12 times more on promoting it than the company had spent on promoting MS Contin, or than Janssen Pharmaceutical Products LP had spent on Duragesic, one of OxyContin's competitors.
Although there are no available data for evaluating the promotional effect of free starter coupons for controlled drugs, it seems likely that the over- and misprescribing of a controlled drug are encouraged by such promotional programs and the public health would be well served by eliminating them.
The use of prescriber profiling data to influence prescribing and improve sales is imbedded in pharmaceutical detailing. Very little data are publicly available for understanding to what extent this marketing practice boosts sales.
Regulations eliminating this marketing tool might decrease some potential overprescribing of controlled drugs. The public health would be better protected if the FDA reviewed all advertising and promotional materials as well as associated educational materials—for their truthfulness, accuracy, balance, and scientific validity— before dissemination.
Such a change would require a considerable increase prescription drug abuse essay FDA support, staffing, and funding from what is currently available. Public monies spent on the front end of the problem could prevent another such tragedy.
The pharmaceutical industry's role and influence in medical education is problematic. Particularly with controlled drugs, the potential for blurring marketing and education carries a much higher public health risk than with uncontrolled drugs. At least in the area of controlled drugs, with their high potential for abuse and diversion, public health would best be served by severing the pharmaceutical industry's direct role and influence in medical education.
Marketing and promotion by the pharmaceutical industry have considerably amplified the prescription sales and availability of opioids. A number of factors have contributed to the marked growth of opioid abuse in the United States, but one factor is certainly the much increased availability of prescription opioids.
I thank Michael McNeer, MD, for his thoughtful review of the essay and helpful suggestions. National Center for Biotechnology InformationU. National Library of Medicine Rockville PikeBethesda MDUSA. NCBI Skip to main content Skip to navigation Resources How To About NCBI Accesskeys My NCBI Sign in to NCBI Sign Out, prescription drug abuse essay. PMC US Prescription drug abuse essay Library of Medicine National Institutes of Health.
Search database PMC All Databases Assembly Biocollections BioProject BioSample BioSystems Books ClinVar Conserved Domains dbGaP dbVar Gene Genome GEO DataSets GEO Profiles GTR HomoloGene Identical Protein Groups MedGen MeSH NCBI Web Site NLM Catalog Nucleotide OMIM PMC PopSet Protein Protein Clusters Protein Family Models PubChem BioAssay PubChem Compound PubChem Substance Prescription drug abuse essay SNP SRA Structure Taxonomy ToolKit ToolKitAll ToolKitBookgh Search term.
Journal List Am J Public Health v. Am J Public Health. doi: Prescription drug abuse essay PMC Art Van ZeeMD. Author information Article notes Copyright and License information Disclaimer. Corresponding author. Requests for reprints should be sent to Art Van Zee, MD, Stone Mountain Health Services, St Charles Clinic, Box S, Prescription drug abuse essay Charles, VA e-mail: ten. aihpleda eeznavtra. Accepted May 9, Copyright © American Public Health Association.
This article has been cited by other articles in PMC. Abstract I focus on issues surrounding the promotion and marketing of controlled drugs and their regulatory oversight. PROMOTION OF OXYCONTIN From toPurdue conducted more than 40 national pain-management and speaker-training conferences at resorts in Florida, Arizona, and California.
Prescription Drug Abuse: Red Flags for Pharmacists and Pharmacy Technicians
, time: 12:34Substance Abuse Essay Examples - Free Research Papers on blogger.com
Find The Best Drug & Alcohol Rehab Center Near You. If you or a loved are struggling with an addiction to drugs and/or alcohol, get the help you need today. We will find a top-rated treatment program Prescription Drug Abuse And Prescription Drugs Words | 6 Pages. Prescription Drug Abuse Prescription Drug Abuse has increased in an alarming rate over recent years! Prescription drug related deaths now outnumber those from heroin and cocaine combined. The abuse in prescription drugs in America goes back more than a hundred years ago NIDA's mission is to advance science on the causes and consequences of drug use and addiction and to apply that knowledge to improve individual and public health. NIDA is
No comments:
Post a Comment