Hi everyone,

This is a particularly bad time for me to address this topic. Last week our hospital had a speaker from Physicians for Responsible Opoid Prescribing

http://www.supportprop.org/index.html

give a presentation.

Basically, he presented very compelling evidence that our current epidemic of rx pain pill abuse is due to Purdue Frederick, and their marketing of OxyContin in the early 90s. Essentially, thru their advertising and marketing, as well as their funding of "independent" organizations, they changed chronic high dose opoids from a specialty drug to a primary care drug, and they changed the clmate of opiate prescribing from sparingly used only in terminal cancer, to close to first line for any pain. He also gave evidence that Purdue influenced JCAHO to emphasize pain, including "the fifth vital sign."

He also gave evidence of extreme misrepresentation and distortion of the medical literature to support the safety, and effectiveness, of long term/high dose narcotics.

I remember all of this. I remember the ads, and the marketing,and the detailing. I remember the rep visits too.

How much of this is our fault, being blindly led? Probably not that much. When the literature "supports" something, and "thought leaders" advocate it, we usually follow.

But I was left feeling sick afterward. The deliberate distortion from Purdue has seriously harmed countless patients.

I remember a visit from the Rezulin rep, assuring me of the safety of the drug. 2 days later it was pulled from the market. I remember a similar situation with the Vioxx reps.

Anyone remember how much was made of the HOPE trial, and the many benefits of Altace, that were disproven by followup studies?

I am now much more suspicious of any pharmaceutical marketing.

Is this the fault of the FDA, the pharma industry, the individual rep, or of us? I am not sure, but the most direct influence on me is the rep.

Gene

Gene Nallin MD solo family practice with one PA Cumberland, Md