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Before Uber there was the meteoric rise of Oxycontin

By Aaron Blackledge, MD

We are all familiar with the incredible stories of remarkable new products or services that come out of nowhere and dramatically alter the landscape faster than anyone could imagine. That first OMG moment where you are like why would I ever go back and use a cab again. Well, in 1996 something very similar happened with a prescription drug launch that changed everything. That drug launch was called Oxycontin. To understand why, first one needs to look at the numbers. A patient following the doctor’s rules and a paying their drug co-pay could get a typical #90 tab prescription of OC 80mg pills and then sell them in bulk on the streets of Seattle, Lexington, or Anchorage for around $7,000. If they lacked insurance the pharmacy price was around $1,000.

These numbers are shocking and we thought it might be helpful if more doctors and loved ones knew some of the details you might have not known. What the drug company called, time released and addiction resistant safeguards, was actually just a thin outer film you can lick off in two seconds or chew through immediately. In the drug game, it was immediately seen as brilliant product branding, with a doctor approved safety standards confirmed with an FDA seal. This told buyers that the magical elixir on the other side of the film was guaranteed to be “safe” and the same product every single time. To heroin traffickers at the time, the thin film must have looked like almost the perfect packaging for easy concealed transport and a product that had eliminated problems of they had to deal with like product loss by theft or during repackaging. I imagine many must have said to themselves, “I wish I would have thought of this.” To the addicts it must have felt like a tremendous innovation to have packaging that disappeared on your tongue. They might have mistakenly thought that they would never have to deal with frantic cleanups of little glass vials or plastic baggies when their moms visited. We say mistakenly because often Oxycontin addiction often leads addicts back to heroin which remained much cheaper due to its poor branding and limited quality assurances.

But like cab companies, what they couldn’t see was the incredible potential market out there for new users. On the inside, just beyond that thin packaging was a something when unleashed on unsuspecting people grabs you and takes over your life. Something most describe as remarkably similar to something called China White Heroin. And in a pill culture increasingly geared to matching your pathology to a prescription, a disaster was the unavoidable result.

When told not to do something, we humans invariably test the waters by dipping at least one toe in to see if it’s really that bad. With millions of dollars being spent on ad campaigns, patients everywhere began receiving prescriptions for this new supposedly safe drug to treat pain. Unfortunately the only thing protecting patients using the drug as prescribed was a thin little film that one accidental bite or a 30 second delay in getting your glass of water had the potential to change your life forever.