Mad Irony: Our Failed War on Drugs and a Devil Called OxyContin

“The first atrocity, the first war crime committed in any war of aggression by the aggressors is against the truth” - Michael Parenti

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(MYRTLE BEACH, SC) - It's obvious that the U.S. and Canada are losing the "war on drugs" in soaring deaths and addictions. The fact that the Federal Drug Administration (FDA) allows the war to be waged out of control by not reclassifying a lethal narcotic called OxyContin for severe pain only -- and not to treat moderate pain is the prime reason for losing this war, but there are also individuals who played a vital part in deaths and addictions of tens and thousands of victims. These "war crimes" were perpetrated on the medical profession at the launch of the lethal narcotic OxyContin in 1995 and continue today.

Beginning with Curtis Wright, M.D. employed by the FDA and involved in the approval process of OxyContin who left the agency to work for the maker of OxyContin, Purdue Pharma when the drug was approved and mass produced. Conflict of interest and questionable activity on the part of an FDA employee and the pharmaceutical company receiving approval for a narcotic? Ask the FDA -- or better ask Dr. Wright who was let go by Purdue Pharma several years after becoming gainfully employed by them.

Then there is the infamous drug war czar, J. David Haddox, MD, the gatekeeper at Purdue Pharma, who when OxyContin was launched tried to convince the medical profession that there was no such thing as "addiction" -- it was "pseudo-addiction." If a patient exhibited signs of "addictive" behavior, it was, in fact, "pseudo-addiction" and the dose should be increased. Ask Dr. Haddox where the scientific evidence is for the word he coined "pseudo-addiction" -- there isn't any scientific evidence. Haddox is currently Senior Medical Director, Health Policy and was President of the American Academy of Pain Medicine (AAPM). He was directly involved in the initial educational endeavors of Purdue, promoting OxyContin and distorting the data to drive up sales of OxyContin. Currently, Haddox is the Examination Director for AAPM (working with the American Board of Pain Medicine) marketing the term "undertreatment of pain" in America. The undertreatment of pain in America is as believable as Haddox's "pseudo-addiction."

Haddox was instrumental in convincing physicians when patients seek more frequent prescriptions or higher doses of opioids, which was a sign of addictive behavior --but with the “pseudo-addiction” approach — they aren’t addicts, they just need more pain relief.

But without adequate evidence, the term "pseudo-addiction" accomplished what Haddox set out to do -- he convinced the medical profession to push narcotics on patients thus driving up revenue for the pharmaceutical company, Purdue Pharma who hired him. It spread to the chronic pain literature, ranging from American Pain Foundation documents to the Federation of State Medical Boards, another national group that has received funding from opioid companies. The federation included pseudo-addiction in its model policy for the use of controlled substances in treating pain.

And a couple of years ago, a paid consultant for Purdue Pharma named Russell Portenoy, MD sent me an email (after I wrote an article (link provided http://www.salem-news.com/articles/november152009/purdue_ms.php). Portenoy's email read:

Dear Ms. Skolek, After reading your piece in the Salem-News.com, I wanted to write and urge you to remember the millions with poorly controlled pain as you pursue your advocacy agenda. The consensus report released by the committee that I co-chaired was not about opioid therapy, but rather, about the need for fundamental reform of a system that fails to help huge numbers of patients—of all ages—and is both inefficient and too costly. It is not surprising that your piece is based on innuendo and unjustified assumptions when it there is so little in our report that relates to your issue. Hopefully, an increasingly informed public will only mirror the disappointment that I felt when reading a piece that dismisses the needs of so many suffering people in a stretch to make a point.



Russell K. Portenoy MD Chairman and
Gerald J. Friedman Chair in Pain Medicine and Palliative Care
Department of Pain Medicine and Palliative Care
Beth Israel Medical Center Professor of Neurology and Anesthesiology
Albert Einstein College of Medicine Chief Medical Officer
Continuum Hospice Care Contact: Department of Pain Medicine and Palliative Care
Beth Israel Medical Center
First Avenue at 16th Street
New York, N.Y. 10003
212-844-1505
fax 212-844-1503

But now it seems that Dr. Portenoy has had a change of thinking as evidenced by this YouTube video http://www.youtube.com/watch?v=BhUqHQdcY_U. Here is an interesting statement made by Dr. Portenoy on this video: "I gave so many lectures to primary care audiences in which the Porter and Jick (Jane Porter and Hershel Jick) article was just one piece of data that I would then cite. And I would cite six, seven, maybe ten different avenues of thought or avenues of evidence none of which represented real evidence. And yet, what I was trying to do was to ... to create a narrative so that the primary care audience would look at this information in total and feel more comfortable about opioids in a way they hadn't before. In essence, this was education to destigmatize and because the primary goal was to destigmatize, we often left evidence behind."

So answer me this Dr. Portenoy -- why were you quoting from a Porter and Jick article which was written for the New England Journal of Medicine on January 10, 1980? Misleading by using outdated reports to distort the dangers of opioids? Why quote from a report dated back to 1980 when there was overwhelming evidence showing deaths and addictions especially to OxyContin were spinning out of control since the drug was approved in 1995?

Portenoy is further quoted as saying in the You Tube video "Clearly if I had an inkling of what I know now then, I wouldn't have spoken in the way that I spoke. Uh, it was clearly the wrong thing to do. And, uh, and to the extent that some of the adverse outcomes now are -- are as bad as they have become in terms of endemic occurrences of addiction and unintentional overdose deaths -- uh, it's -- it's quite scary to think about how the, the growth in that prescribing driven by people like me, uh, led, in part to that occurring." Interesting Dr. Portenoy since we now know that in the last 10 years, per capita sales for opioids in the U.S. increased by 600%. There was also a dramatic increase in overdose deaths and addiction to opioids in this time span. Even pain specialists such as Dr. Portenoy, who has had extensive financial ties to pharmaceutical companies pushing narcotics, acknowledge that the concept of pseudo-addiction in chronic pain was not supported by evidence. “The term has taken on a bit of a life of its own,” said Portenoy -- “That’s a mistake.” Ready for yet another mistake? Lynn Webster, MD, a Utah pain specialist as well as an officer of the American Academy of Pain Medicine. who has worked as a consultant and adviser to most of the companies that make opioids, as does Dr. Portenoy, said: “We overshot our mark, all well-intended, I believe. We certainly have a lot of reverse education that needs to occur.”

"Well-intended and overshot our mark" is that any consolation Dr. Webster for the thousands and thousands of lost lives due to your well intentions? Doesn't fly with me and my guess is that families dealing with the deaths and addictions of loved ones don't buy what you are selling either. And about the criminal use of the word "pseudo-addiction", Dr. Webster said “It obviously became too much of an excuse to give patients more medication. It led us down a path that caused harm. It is already something we are debunking as a concept.”

On February 25, 2012 the American Academy of Pain Medicine held a "2012 Safe Opioid Prescribing Course" in Palm Springs, California. Session 1 "Understanding the Public Health Problem of Opioid-Related Harm and the Regulatory Response" led by J. David Haddox, MD and Lynn R. Webster, MD. Kind of like asking Charles Manson to run a seminar on preventing home invasion, don't you think?

Maybe the "war on drugs" in the U.S. could be won if there were consequences for the destruction of human life by criminal activity in promoting lies. Let's start with "International War Crimes Tribunals" defined below which fits the war we are losing in this country and in Canada -- let's call it accountability and consequences for criminal actions, International war crimes tribunals are courts of law established to try individuals accused of war crimes and crimes against humanity. It has become common practice to offer the accused an opportunity to explain his or her actions in front of the victims and their families, as well as the media.

Salem-News.com Investigative Reporter Marianne Skolek, is an Activist for Victims of OxyContin and Purdue Pharma throughout the United States and Canada. In July 2007, she testified against Purdue Pharma in Federal Court in Virginia at the sentencing of their three CEO's - Michael Friedman, Howard Udell and Paul Goldenheim - who pleaded guilty to charges of marketing OxyContin as less likely to be addictive or abused to physicians and patients. She also testified against Purdue Pharma at a Judiciary Hearing of the U.S. Senate in July 2007. Marianne works with government agencies and private attorneys in having a voice for her daughter Jill, who died in 2002 after being prescribed OxyContin, as well as the voice for scores of victims of OxyContin. She has been involved in her work for the past 8-1/2 years and is currently working on a book that exposes Purdue Pharma for their continued criminal marketing of OxyContin.

Marianne is a nurse having graduated in 1991 as president of her graduating class. She also has a Paralegal certification. Marianne served on a Community Service Board for the Courier News, a Gannet newspaper in NJ writing articles predominantly regarding AIDS patients and their emotional issues. She was awarded a Community Service Award in 1993 by the Hunterdon County, NJ HIV/AIDS Task Force in recognition of and appreciation for the donated time, energy and love in facilitating a Support Group for persons with HIV/AIDS.

Marianne Skolek
National Activist for Victims of OxyContin and
Purdue Pharma - a criminally convicted pharmaceutical company
Investigative Reporter, Salem-News.com

www.purduepharma.com/pressroom/app/news_announc/USGovt_reponse_Main.pdf

judiciary.senate.gov/hearings/testimony.cfm?id=2905&wit_id=6612

hi.bnet.com/blogs/sebelius-response.pdf

www.vawd.uscourts.gov/PurdueFrederickCo/default.asp