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Belltown Spine & Wellness Blog

Prescription for Addiction


Heroin was once thought of as an inner city problem, not something you would hear about in small towns throughout America--a drug used by the lower income class. Today the landscape has dramatically changed and it has become a nationwide epidemic hitting rural areas, suburbs, and small cities including Seattle.

The rise in heroin addiction has resulted from over prescribed opioid painkillers such as OxyContin. As restrictions have tightened on prescribing these painkillers, addicts have turned to the streets and discovered heroin to be a cheaper and stronger way to get high. An OxyContin pill can cost around $80 on the street, while a hit of heroin is $10-$20. Over half of heroin addicts reportedly started abusing prescription painkillers before they ever used heroin.

OxyContin was created by the Sacklers family under their company, Purdue Pharma, which they purchased in 1952. In the 70’s they developed a controlled drug release system called Contin and twelve years later released the patented pill, MS Contin, an extended-release formulation of morphine for cancer patients. In the early 90’s, the patent on MS Contin was expiring and Purdue Pharma was set out to develop a new painkilling moneymaker and did so with oxycodone.

Oxycodone was created by German scientists in 1916 after the Bayer corporation’s drug, heroin, was banned in America. It was introduced in America in 1939 and was released for prescription in 1950 as Percodan in combination with aspirin. By 1963, it was the source of one-third of all drug addiction in California, and in 1970 oxycodone was listed by the DEA defined as having a high potential for abuse and considered dangerous.

Yet Purdue Pharma took the generic painkiller oxycodone and installed a timed-release mechanism, which allegedly allowed the drug’s effects to spread over 12 hour periods. Not long after OxyContin’s launch in 1995, primary care doctors were prescribing it for a laundry list of painful symptoms.

The drug crisis began in West Virginia and eastern Kentucky. These rural areas are primarily populated with laborers in industries such as coal mining and timbering that were prone to injuries and pain. The promise of living pain-free with prescription opioids such as OxyContin and Vicodin was marketed very aggressively throughout these states the 1990s and early 2000s. Sales hit $1.5 billion by 2002 and today they have reached over $3 billion.

Addiction problems started to arise when pain relief wasn’t lasting as long as promised. Some were experiencing the return of pain in under eight hours that came with withdrawal side effects. Purdue insisted that the formula was correct and encouraged physicians to provide stronger dosages to patients complaining of the pill not lasting instead of prescribing it more frequently. The stronger dose didn’t increase the length of pain relief and instead caused worse withdrawal effects and in turn a demand for more.

It was also discovered that not only had more cases come about with OxyContin not lasting, but that it wasn’t abuse-resistant as reported. If the pill was crunch up and snorted, it would break the time-release mechanism for an immediate heroin-like high.

Florida soon became the center of the opioid epidemic with the ability prescribe the pill with ease. The state’s southern corridor was even named “Oxy Express.” This brought in shady business practices and the creation of “pill mills” due to the state’s liberal laws on prescription medication. Eventually Florida had to change its law, but not before it had already facilitated tens of thousands of addicts. When those addicts couldn’t get prescription opioid anymore, they turned to heroin.

The strict laws on prescribing opioid has been enforced across the country, which has caused the rise of heroin addiction resulting in the current epidemic, especially in the Pacific Northwest. Even though fatal drug overdoses by prescription opioids are at their lowest point in a decade, heroin fatal overdoses have tripled in King County since 2009 and treatment adm