Clearing away the myths surrounding the OxyContin "epidemic."

Correction appended. Click here to read the correction statement.

In a recent five-part series (Oct. 19-23), the Orlando Sentinel painted a stark picture of the opiate drug OxyContin: Prescribed for mild pain by a clueless doctor, the drug had destroyed a former policeman's life. Apparently, this story was typical: Thousands had been derailed by the deadly drug. Within weeks, however, the drug's manufacturer, Purdue Pharmaceutical, and the ex-cop's mother-in-law revealed that the man—called an "accidental addict" by the writer, Doris Bloodsworth—was a former cocaine abuser with a federal trafficking conviction.

This was not the only error the Sentinel had to account for in a 2,000-word correction: The paper had also omitted that an overdose victim profiled in the series had actually taken multiple drugs, along with OxyContin, and had previously overdosed on different medications. Even now, the Sentinel still hasn't clarified that most of the overdose deaths cited in the "investigations"— about 90 percent according to other research—were not, in fact, caused by OxyContin alone but by deadly combinations of drugs (OxyContin along with alcohol and/or other depressants like benzodiazepines).

If the Orlando Sentinel were the only news organization to run massively misleading stories on OxyContin, the misinformation could be chalked up to error. But the first substantive column by the New York Times' ombudsman Daniel Okrent also dealt with OxyContin bias, albeit of a different sort—Okrent wrote that the paper shouldn't have allowed Times writer Barry Meier, author of the anti-OxyContin book Pain Killer, to cover the drug in an article in its "Science" section. Meier's article claimed that researchers now believe that "accidental" addiction is more common than previously thought—never mind the fact that there has been no new research suggesting this since OxyContin was introduced in 1995, only increased pressure from law-enforcement agents.

Indeed, various media outlets—from NPR to the New York Post—claim that numerous new OxyContin addicts have been created by doctors who cavalierly prescribe the drug. Articles or news segments assert that overdose frequently occurs among the innocent patients of careless doctors, but the profiled "victims" are overwhelmingly prior drug users who now get their fix by snorting or shooting OxyContin. The featured subjects almost always turn out—like the Sentinel's—not to be "accidental" addicts but just plain druggies. (In a 2001 story about the supposed "epidemic" in Appalachia, the New York Times Magazine didn't cite a single case of doctor-caused addiction; instead, it portrayed "casual" drug users who faked pain or otherwise illegally obtained OxyContin in a sympathetic light, claiming these "accidental addicts" didn't know that prescription opiates are addictive!)

All of which raises the question: If accidental addiction is so common, why aren't there any telling anecdotes about the phenomenon?

In fact, the entire OxyContin "epidemic" is based on a false narrative that asserts that the majority of OxyContin addicts begin as drug-naive pain patients. The cop the Sentinel profiled was actually a typical Oxy addict—a prior drug user—but his real story wasn't what they wanted. If Bloodsworth had been looking for that, she would have noted that government data shows that 90 percent of OxyContin abusers have also taken cocaine, psychedelics, and other prescription painkillers. Readers would have been informed that investigators specializing in prescription drug abuse say the typical OxyContin addict has a lengthy history of multiple-drug abuse.

The paper also would have highlighted that addiction is the exception, not the rule, among people exposed to opiates. Studies consistently show that pain patients taking opiates are no more likely to become addicts than people in the general population (i.e., exposure alone does not cause addiction). That is to say, only between 1 percent and 20 percent of people in the general population experience a period of addiction to some substance, depending primarily on characteristics such as age, stress, family history of addiction, and mental illnesses. (Depression, manic depression, and schizophrenia all dramatically affect one's risk of addiction.) If you rule out prior abusers, the rate settles at the low end, in single digits. (Rush Limbaugh may be one such example, though we still don't know anything about his possible prior drug use.) Even among people who try the most demonized opiate, heroin, for recreation or in a situation of extreme stress, only a minority will become addicted. While nearly half of U.S. soldiers in Vietnam tried heroin while abroad, only 20 percent of users became addicts. And only 12 percent remained junkies—even though 60 percent of those addicted while in Vietnam tried heroin at least one more time back home. Research by the National Institute on Drug Abuse finds that most people simply don't enjoy the opiate "high," let alone want it daily.

Yet reporters don't like this narrative, so they ignore it. This tired, predictable story line leaves reporters with unsympathetic protagonists: Who wants to read about scummy addicts scamming doctors? Grandma's back pain making her into a pharmacy robber is much more compelling; unfortunately, it almost never happens.

In order to create their preferred story, reporters twist the facts. The Sentinel, for example, noted that prescribing rates for other opiates like morphine and Demerol increased 23 percent between 1996 and 2000—while the prescribing rate for OxyContin rose 2,000 percent. But these numbers say nothing about drug abuse. An analysis of rates of abuse as reported in emergency rooms compared with prescribing rates would be more informative.