What every parent should know about OxyContin for children

January 11, 2016

Kent Runyon, Executive Director of Novus Medical Detox Center,

The FDA recently approved the prescription painkiller OxyContin for use by adolescents as young as 11, but there are several things you should know about this. Prescription drug abuse is trickling down to children. A new government report found that more than 10.3 million Americans illicitly use prescription painkillers; and 1 in 10 of those users—nearly 1.2 million in total—are between 12 and 17 years old.

Pharmaceutical drug addiction, consisting mainly of opioids like OxyContin, has been classified by the Centers for Disease Control and Prevention (CDC) as an epidemic. Although it’s a global problem, the U.S. is the biggest addict, consuming 80 percent of all the OxyContin manufactured.

OxyContin is the brand name for a timed-release formula of oxycodone, a narcotic analgesic (medication that reduces pain). It's used to relieve pain from injuries, arthritis, cancer and other conditions. Oxycodone, a morphine-like drug, is also found along with non-narcotic analgesics in a number of prescription drugs.

According to the U.S. Drug Enforcement Administration (DEA), oxycodone has been abused for more than 30 years. But with the introduction of OxyContin in 1996, there has been a marked escalation of abuse.

A chief complaint among opponents of the FDA’s decision to approve OxyContin for children was the agency’s failure to convene an independent advisory committee to review the proposed pediatric use of OxyContin. Dr. Andrew Kolodny, executive director of Physicians for Responsible Opioid Prescribing, and Dr. G. Caleb Alexander, director of the Center for Drug Safety and Effectiveness, both maintain that a scientific advisory board would not have voted in favor of approval.

Dr. Kolodny warns that teens are at greater risk for developing an addiction since the brain does not fully mature until individuals are in their 20s, while Dr. Alexander fears manufacturer Purdue Pharma will begin marketing and promoting OxyContin for children’s use. Direct to consumer drug advertising, illegal in almost every other country, is a multi-billion dollar budget here in the U.S.

FDA officials defended the agency’s decision and emphasized OxyContin is only indicated for pediatric use in severe cases requiring long-term pain management, such as for cancer, extensive trauma or surgeries. But physicians already had the ability to prescribe opioids in acute pediatric cases. Formal FDA approval was unnecessary and may act as a misguided confirmation of the drug’s safety and efficacy for broader use.

Dr. Alexander notes the obvious concern is that this approval will change the pattern of use. If doctors start prescribing OxyContin for wisdom tooth surgery, athletic injuries or other such uses, we’re likely to begin seeing more adolescents with substance use disorders and dependency.

Even before the approval, research shows nearly 1 in 6 children treated for migraines/headaches is prescribed opioid medication, though use of the drug can cause the condition to become more chronic and treatment-resistant and may increase the risk for drug addiction.

Yet despite the proliferation of opioid use, National Institute of Health (NIH) researchers noted there is limited evidence of the drug’s safety and effectiveness and reported that 40 percent to 70 percent of individuals with chronic pain do not receive proper medical treatment. NIH also outlined potential harms; beyond the risk of developing an opioid use disorder, prescription painkillers are associated with an increased risk of falls/fractures, myocardial infarction and other side effects.

Every parent should be familiar with where their pediatrician stands on prescribing opioid drugs and how they approach pain management in general. There are many resources beyond drugs. Understand that the pharmaceutical manufacturers as a whole made over $1 trillion dollars in sales in 2014 and strategically fund FDA budgets, special interest lobby groups, political campaigns, medical training, research, independent drug trials and broad advertising campaigns. They are investor driven to create large profit margins. They have the clout to mold opinion – perhaps even your physician’s.

Ask your doctor what the options are for pain management for children. But don’t stop there. Do your own research. Drug ads have muddied the field, but real knowledge gives you viable choices should the need suddenly arise to deal with pain management.

Educating your children, especially adolescents, about opioid prescription drugs and serious addiction can help arm them against peer pressure to abuse them. Everyone knows that shooting up heroin can lead fairly quickly to dependence, but prescription pills can seem relatively harmless.

As the Executive Director of Novus Medical Detox Center, I see the face of addiction every day. Most of our patients came from normal lives that have spun out of control. Many of them were ignorant about what they were getting into with painkillers. We’ve helped many opioid users successfully overcome OxyContin addiction but I can’t help but think how much time, life and money would have been saved if they never got addicted in the first place.

Kent Runyon is the Executive Director of Novus Medical Detox Center, a Joint Commission Accredited inpatient medical detox facility in New Port Richey, Florida. Novus is licensed by the Florida Department of Children and Families and is known for minimizing the discomfort of withdrawal from prescription medication, drugs or alcohol by creating a customized detox program for each patient.

References:

Saint Louis, Catherine. “F.D.A. Approval of OxyContin Use for Children Continues to Draw Scrutiny”; The New York Times; October 8, 2015. nytimes.com/2015/10/09/health/fda-approval-of-oxycontin-for-children-continues-to-draw-scrutiny.html
Szabo, Liz. “FDA approves OxyContin for kids 11 to 16”; USA Today; August 14, 2015. usatoday.com/story/news/2015/08/14/fda-approves-oxycontin-kids/31711929/
Center for Drug Evaluation and Research. “CDER Conversation: Pediatric Pain Management Options”; FDA website; August 14, 2015. fda.gov/Drugs/NewsEvents/ucm456973.htm
Reuben, David B.; Anika A.H. Alvanzo; et al. “National Institutes of Health Pathways to Prevention Workshop: The Role of Opioids in the Treatment of Chronic Pain”; Annals of Internal Medicine; February 17, 2015. annals.org/article.aspx?articleid=2089371
Substance Abuse and Mental Health Services Administration. Results From the 2014 National Survey on Drug Use and Health: Detailed Tables; September 10, 2015. samhsa.gov/data/sites/default/files/NSDUH-DetTabs2014/NSDUH-DetTabs2014.pdf
Firger, Jessica. “FDA Approved OxyContin Use for Children as Young as 11”; Newsweek; August 17, 2015. newsweek.com/fda-approves-oxycontin-use-children-young-11-363606
“Manchin Condemns Outrageous FDA Decision to Approve OxyContin for 11 Year Olds”; press release issued by Senator Joe Manchin; August 17, 2015. manchin.senate.gov/public/index.cfm/press-releases?ID=033e661e-e3c9-49e2-b025-ce0b4ff02f97