Drug's maker says it's concerned by 'harsh nature' of his letter

Conn. attorney general blasts OxyContin

He recommends that only certain physicians and certain pharmacies be allowed to prescribe the painkiller.

The Roanoke Times

Beset by criticism of its best-selling product, Purdue Pharma received another bitter pill Monday when Connecticut's attorney general asked the pharmaceutical company to restrict marketing and distribution of OxyContin.

The company, which is based in Stamford, Conn., said it was concerned by the "harsh tone" of a five-page letter from Attorney General Richard Blumenthal.

Blumenthal said fatal overdoses and crime associated with abuse of OxyContin have escalated to the point where Purdue Pharma has a "moral, ethical and legal responsibility" to limit distribution of the prescription painkiller.

While generating sales of more than $1 billion last year, the drug has proven almost as costly when abused.

"I feel strongly that some decrease in sales of this very profitable prescription drug is a short-term consequence Purdue Pharma must accept," Blumenthal wrote.

Echoing some of the suggestions made earlier this year by the Drug Enforcement Administration, Blumenthal recommended that only doctors with experience in pain management prescribe OxyContin, and that only designated pharmacies carry the drug.

He also called on the company to use some of its profits to establish treatment programs for those who became addicted to OxyContin, "whether they acquired the drug legitimately or illicitly."

Since it was introduced in 1996, the potent narcotic had been highly effective in treating cancer patients and others in severe pain. But too often, Blumenthal said, it is prescribed for less severe ailments.

Oncologists wrote just 3 percent of the 6.5 million prescriptions for OxyContin last year, the letter stated. Family physicians accounted for 21 percent.

When overprescribed, the drug is more likely to fall into the wrong hands. Abusers can easily convert OxyContin into a street drug, grinding the pills into a powder that is snorted or mixed with water and injected. The result is a high similar to heroin's and a crime wave likened to crack's toll on inner-city neighborhoods.

OxyContin is different from other prescription drugs, Blumenthal wrote, because it is "more powerful, more addictive, more widely sold, more illicitly available, and more publicized."

In Southwest Virginia, more than 35 fatal overdoses have been linked to the drug's active ingredient. At the same time, police say, crime rates have soared in some coalfield counties as addicts steal, rob and cheat to support their habits.

Blumenthal said he was disturbed by a Purdue Pharma-financed Web site stating that addiction to opium-based medications such as OxyContin is rare when the drug is taken as prescribed. "This statement is simply not true," the attorney general wrote.

After OxyContin abuse became a problem two years ago, Purdue Pharma launched a public relations counteroffensive - pledging to continue supplying the drug to legitimate patients while touting its own efforts to curb abuse, which include distributing tamper-proof prescription pads to physicians and sponsoring medical education programs.

"While Purdue Pharma seems sincere in seeking to address the problems, no comprehensive effective solutions have been offered," Blumenthal wrote. "In short, it is time for Purdue Pharma to change its practices, not just its public relations."

In a statement released Monday, the company said it disagreed with the "tone and content" of Blumenthal's letter.

"We are concerned that the harsh tone of his letter will cause alarm among pain patients in Connecticut whose medical care would be compromised by some of the restrictive proposals he suggests," the company said.

In March, when Blumenthal first met with Purdue Pharma officials, the company downplayed the meeting's significance. Spokesman Robin Hogen said at the time that "the attorney general told us and we were pleased to learn that this is not really on his screen in Connecticut."

Purdue Pharma now says it has invited Blumenthal to meet with company officials again next week to explore ways to forge a "cooperative agenda for action."

With the company seemingly resistant to some of Blumenthal's recommendations, it remains to be seen how - or if - he will attempt to enforce them. The final line in Blumenthal's letter states that "this office will continue to identify and evaluate all of its options to remedy the problem."

One option would be a lawsuit similar to one filed by the attorney general of West Virginia. In June, a lawsuit brought by that state accused Purdue Pharma of excessive marketing practices - a theme that Blumenthal also sounded.

The company "must overhaul and reform its marketing practices, eliminating the videos and other promotional materials aimed at persuading patients to pressure doctors into prescribing" the drug, Blumenthal wrote in the July 31 letter to Purdue Pharma President Richard Sackler.

In recent weeks, OxyContin has come under increased scrutiny.

The Food and Drug Administration announced two weeks ago that it was putting its strongest warning possible on the drug's package insert. Later this year, the agency will hold hearings as it considers possible restrictions on oxycodone-based drugs.

Last week, Sen. John Warner, R-Va., called for Senate hearings on the problem of OxyContin abuse. It will likely be next month at the earliest before there is a decision on whether the Health, Education, Labor and Pensions Committee takes up the issue.

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