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While many sales people have sold controlled release opioids as having less abuse potential, the current situation has put us in an awkward situation,” the sales rep wrote. “I feel like we have a credibility issue with our product. Many physicians now think, OxyContin is obviously the street drug all the drug addicts are seeking.

The Kentucky OxyContin Task Force issues recommendations to eliminate illegal use of the drug. A year earlier, the report said, state officials had begun to see an uptick in problems related to OxyContin. By fall 2000, the problem had “grown to epidemic proportions” and in November 2000, federal, state, and local law enforcement joined forces to try and tackle the problem.

Prior authorization, it argued, “may only extend the period of suffering for patients, but also lead to greater expenses in the long term” due to additional staff time. If prior authorization is necessary, it continued, it should only be if the daily dose of OxyContin tablets exceeds 320 milligrams.

This presentation is misleading because you fail to present important risk information that describes patient populations where OxyContin use is contraindicated,” the FDA wrote.