OxyContin, a popular opioid, first hit the market in 1996 and brought with it a massive marketing campaign. Most of that marketing was direct to doctors and, in a 2009 research study, was deemed misleading. Purdue Pharma, based in Stamford, was accused of downplaying the drug’s effects and lying about the potential for addiction.
In subsequent studies and multiple landmark legal settlements, Purdue Pharma has been found to be one of the primary drivers of the current opioid epidemic. But a new study from Yale University has linked that aggressive marketing to the long-term effects of intravenous drug abuse.
The paper, which was published in the journal Health Affairs on July 19th, “evaluated the effects of exposure to initial OxyContin marketing on the long-term trajectories of injection drug use-related outcomes in the US.” The researchers compared the results of states with high exposure to OxyContin marketing to those with lower exposure.
They found that those who were exposed to large amounts of OxyContin marketing early on had statistically higher amounts of specific negative outcomes related to injection drug use. These included overdoses, Hepatitis (types A, B, and C), and endocarditis, an infection of heart tissue.
OxyContin’s relationship to intravenous drug use is, in part, a result of a reformulation of the drug in 2010. At that time, it was becoming more evident that the drug was addictive and patients had been crushing and snorting their pills to get the entire effect at once. To combat this, the company changed the pills to make them harder to crush. Those who were already addicted (and who became addicted after this) would then turn to street drugs like heroin or fentanyl.
This study is the latest in a series of projects tracking the long-term effects of Purdue’s reckless marketing campaign. Previous work found links to higher rates of opioid deaths in areas with high cancer rates, and that Purdue did less marketing in areas with stricter prescribing rules which also saw fewer opioid deaths.
Purdue has paid out millions of dollars in settlements to states that saw the worst effects of the opioid crisis but many, especially those who lost family and friends to opioids, don’t think they’ve done enough. Many want the Sacklers, the family who owned Purdue Pharma, to face criminal charges for their direct role in the misleading marketing.
Meanwhile, Connecticut is among many states wrestling with how to handle the continued fallout from the opioid epidemic. Study co-author and Yale post-doctoral associate says that states should consider limiting the ability of drug manufacturers to market to doctors and should support communities harmed by addiction.
“Policymakers can promote harm-reduction services to try to reduce the spread of infectious disease and reduce overdoses, and they can also take steps to expand access to treatment for opioid use disorder,” Dennett said in an interview with Yale News.
Connecticut has been making some progress on harm reduction services. The state legislature approved a bill that would all organizations to distribute Narcan – a nasal spray that combats overdoses – in vending machines. Activists and organizers, however, are concerned about restrictions that could lessen the benefit of the policy.
Meanwhile, harm reduction centers were part of a larger healthcare bill in the General Assembly this session. While the bill passed, the definition of a “harm reduction center” differs from a common understanding of the service. In states like New York, harm reduction centers serve as sites where patients suffering from a substance abuse disorder – often heroin – can take drugs safely. These sites allow addicted individuals access to medical professionals who can intervene in the case of an overdose and provide counseling and other services to help them seek recovery.
Proponents of these sites say they offer a better alternative to taking drugs alone or in unsafe environments, dramatically decreasing the number of overdose deaths and infectious diseases.
Connecticut’s definition, however, does not include so-called “safe injection sites.” Instead, it defines a harm reduction center as a place where those suffering from addiction can receive services like counseling, drug testing, and laundry facilities, as well as information on drug antagonists and treatment services.