Purdue Pharma’s 1996 release of OxyContin led to increased opioid overdose deaths in the past two decades and was a primary cause of the opioid epidemic plaguing the country, according to a new study.
“This research contributes to our understanding of what initially sparked the opioid crisis,” wrote the authors of the paper, circulated Monday by the National Bureau of Economic Research. “We demonstrate that the introduction and marketing of OxyContin explains a substantial share of overdose deaths over the last two decades.”
Health and government officials have long speculated that OxyContin was a leading contributor to the opioid epidemic, and Purdue Pharma faces over 2,000 lawsuits that claim the company’s advertising of the drug is to blame for addictions nationwide. The new study, written by economists at the University of Pennsylvania, University of Notre Dame, and the RAND Corporation, is the first to provide an empirical basis for those theories.
The researchers compared Purdue’s advertising plans in states without “triplicate” prescribing programs, which require that prescriptions go to both a pharmacist and a state agency that monitors narcotics use nationwide, with those that did have triplicate programs in place.
The authors estimated that if states without the triplicate program had the same level of exposure to OxyContin as states that had the triplicate prescribing program in place, they would have had 36% fewer drug overdose deaths and 44% fewer opioid overdose deaths on average in each year from 1996-2017.
“We find that OxyContin distribution was about 50% lower in ‘triplicate states’ in the years after the launch,” the authors wrote. “While triplicate states had higher rates of overdose deaths prior to 1996, this relationship flipped shortly after the launch and triplicate states saw substantially slower growth in overdose deaths.”
Internal Purdue documents showed that the company saw the triplicate programs as a significant barrier to distributing OxyContin because many doctors said that filling out triplicate forms to prescribe the drug “was more trouble than others,” and thus decided that fewer resources should go toward marketing in states “because of the lower expected returns.”
“Overall, we find strong evidence that the marketing practices of OxyContin interacted with state-level policy conditions led to dramatically reduced overdose death rates in triplicate states,” the authors wrote.
In 2017, three prescription opioids — Oxycodone, which includes OxyContin, Hydrocodone, and Methadone — contributed to over 35% of all prescription opioid overdose deaths, according to the Centers for Disease Control and Prevention.
Purdue is involved in thousands of lawsuits accusing the company of driving the opioid crisis and filed for Chapter 11 bankruptcy in September as part of a settlement deal with state attorneys general. While Purdue pleaded guilty in a 2007 case alleging that OxyContin’s labeling downplayed the drug’s addictive qualities, the company will not take ownership of its key role in fueling the epidemic: “No pharmaceutical manufacturer has done more to address the opioid addiction crisis than Purdue,” the company has said.
