Watching the Netflix series Painkiller, which looks back on the opiate crisis in the United States, one may be entitled to wonder if OxyContin has also wreaked havoc here.
OxyContin. Purdue Pharma, the Sackler family… if you have devoured the Painkiller series like many Netflix subscribers, then these words are familiar to you. The latest hit from the platform tells us about the opioid crisis that hit the United States several years ago and continues to wreak havoc today.
After seeing the series, it is quite logical to wonder if Oxycontin has been marketed in France and if so, how our country has implemented measures to prevent the same crisis as across the Atlantic.
Regulated care
OxyContin is a powerful anti-inflammatory (like fentanyl or morphine) that helps reduce physical pain. Derived from oxycodone, it is “indicated for the treatment of severe pain that can only be adequately treated with strong opioid analgesics; especially in cancer pain“, can we read on the public drug database.
Yes, OxyContin is delivered in France, but its use is regulated and strictly supervised, as the order of pharmacists explains to us: “Regarding the conditions of delivery, it must imperatively be a secure prescription [ordonnances au format papier qui répondent à des spécifications techniques précises ndlr] which, except in special cases, must be presented within 3 days of its date of establishment. In addition, the duration of treatment for a single prescription cannot exceed 28 days.
On it should appear:
- prescription registration number
- quantity delivered in dosage units
And when registering, you must provide:
- name and address of prescriber
- patient’s name and address
- name and address of the holder of the prescription when the latter is not the patient and if he is unknown to the pharmacist, the references of a document justifying his identity
- drug name
Finally, for security reasons, the copy of the prescription must be kept for 3 years.
It should be noted that the doctor must systematically inform his patient about the treatment and its discontinuation, and monitor his consumption to prevent the slightest risk.
In France, the situation is different for several reasons as explained by the ANSM (the national agency for the safety of medicines and health products), in a 50-page report published in February 2019: it “is not the same, insofar as the conditions for prescribing, dispensing, reimbursement of treatment with opioid analgesics and information for health professionals and the general public are different from those in the United States“.
As Painkiller illustrates, Purdue Pharma hired salespeople to go door to door with doctors to promote Oxycontin and offer them small gifts (soft toys bearing the company name, for example). ). A practice prohibited in France therefore.
netflix Purdue Pharma saleswomen in Painkiller
A worrying development
Last May, the French Society of Pharmacology and Therapeutics published an article on its website warning against the increase in the use of oxycodone in the management of pain: “In France, its involvement in toxic deaths by analgesics quadrupled between 2013 and 2017. In 2017, if in France morphine was still the first level 3 opioid analgesic used, it was closely followed by oxycodone, which is increasing sharply ( +738% since 2006), both in the city and in the hospital”.
More dangerous than morphine, for the same result, oxycodone worries for several reasons. Its more significant and lasting dopaminergic action than morphine may be associated with a more “addictogenic” profile. In other words, by approaching dopamine, also known as the pleasure molecule, oxycodone is more addictive than any other opiate.
An aspect rightly raised in the series, especially in this mind-blowing scene from episode 1 in which Richard Sackler (Matthew Broderick) wants to market his product on the notion of “fleeing pain to achieve pleasure”.
This opioid does not only worry the French society of pharmacology and therapeutics but also the ANSM. If their study agrees with an increase in the use of analgesics in France, it recalls that this is part of “the policy of improving pain management, in particular through the ministerial plans for the fight against pain that have been in place since 1998”. But. The agency points out the dangers of misuse and its use as part of a non-cancer treatment that must be monitored and continues to be monitored.
Useful sources:
Medication sheet: https://base-donnees-publique.medicaments.gouv.fr/displayDoc.php?specid=61200108&typedoc=R
The article from the French Society of Pharmacology and Therapeutics: https://sfpt-fr.org/pharmacofact-blog/1828-f012-l%E2%80%99increase-de-l%E2%80%99utilisation-de-l%E2%80%99oxycodone-in-the- pain-management
The ANSM report on the consumption of opioid analgesics and their problematic uses: https://ansm.sante.fr/actualites/antalgiques-opioides-lansm-publie-un-etat-des-lieux-de-la-consommation-en-france