Philadelphia pharmacies loved OxyContin — until suddenly they didn't

Dec. 12, 2019

Philadelphia nearly led the nation in orders for name-brand OxyContin, Purdue Pharmaceutical's flagship drug. New evidence — millions of records unsealed in a lawsuit against Purdue and other drug manufacturers and distributors — shows how a huge amount of the drug was being diverted and abused. The effects are still being felt to this day. Read more.

From 2006 to 2010, Philadelphia pharmacies received thousands of shipments of buprenorphine, fentanyl, methadone, and other drugs.
But in Philadelphia, they were all dwarfed by the potent opioid oxycodone.
Oxycodone is the active ingredient in OxyContin, a powerful painkiller made by Purdue Pharmaceutical.
Purdue's drug accounted for nearly all of Philadelphia's increase in oxycodone drugs during those five years.
Not all OxyContin comes in the same dosage. The strongest version of the drug, with 80 milligrams of oxycodone, brought in the vast majority of OxyContin.
In 2009, Oxy 80s dominated the market. Similar high-dose oxycodone pills were much less common.
But by 2012, Oxy 80s had halved, completely displaced by high-dose oxycodone pills.
Take as an example Northeast Pharmacy.
Its orders for Oxy 80s surged during the summer of 2010.
But suddenly, in September 2010, that changed. The pharmacy's orders for the drug plummeted, and it almost never ordered the drug again.
That was when Purdue discontinued the original version of OxyContin. It began to sell a new, abuse-deterrent version that was harder to crush, snort or inject.
But the demand that had developed for high-power oxycodone drugs didn't dry up overnight. The pharmacy quickly moved into high-dose pills of oxycodone that didn't have the abuse-deterrent properties of the new OxyContin.
In 2011, Northeast's owner was arrested. He soon pleaded guilty to supplying a vast network of drug traffickers.
Across the city, the same pattern can be seen:
A sharp increase in Oxy 80s ...
... met by a sudden drop in Oxy 80s when the drug was reformulated ...
... followed by an immediate shift to similar high-dose pills of oxycodone.
But that pattern wasn't driven by the vast majority of pharmacies.
This shows how much OxyContin each pharmacy ordered during the three months before and after the drug became abuse-deterrent.
Most Philadelphia pharmacies catered to customers for whom reformulation made no effect: they ordered similar amounts of the drug after it changed.
But nearly all the biggest orderers of the drug reduced their orders drastically.
There wasn't a general predisposition toward abuse of OxyContin in Philadelphia. Once it got harder to abuse, the city's drop in OxyContin was driven by just a few pharmacies.
Additional reporting by Aubrey Whelan

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