LA Times series on OxyContin

If (like me), you were dimly aware of what OxyContin was, but had never really learned much about it, you'll certainly want to spend some times with this monumental, mesmerizing, harrowing, Pulitzer-worthy series that's been running in the L.A. Times:

• 'You want a description of hell?' OxyContin's 12-hour problem

  Narcotic painkillers work differently in different people. Some drug companies discuss that variability on their product labels and recommend that doctors adjust the frequency with which patients take the drugs, depending on their individual response.

  The label for Purdue’s MS Contin, for instance, recommends that doctors prescribe the drug every eight or 12 hours to suit the patient. The morphine tablet, Kadian, manufactured by Actavis, is designed to be taken once a day, but the label states that some patients may need a dose every 12 hours.

  Despite the results of the clinical trials, Purdue continued developing OxyContin as a 12­-hour drug. It did not test OxyContin at more frequent intervals.

• More than 1 million OxyContin pills ended up in the hands of criminals and addicts. What the drugmaker knew

  In L.A., Santiago kept writing prescriptions in ever larger numbers.

  To keep the OxyContin flowing, Lake Medical needed people. Lots of them. Age, race and gender didn’t matter. Just people whose time was cheap. For that, there was no place better than skid row.

  Low-level members of the Lake Medical ring known as cappers would set up on Central Avenue or San Pedro Street. The stench of urine was everywhere. People were lying in doorways, sleeping in tents, fighting, shooting up. Who wants to make some money, the cappers would shout.

  For as little as $25, homeless people served as straw patients and collected prescriptions for 80s. It required just a few hours at the clinic, filling out a few forms and sitting through a sham examination. They were then driven, often in groups, to a pharmacy, where a capper acting as a chaperone paid the bill in cash. He then took the pills back to the Lake Medical ring leaders who packaged them in bulk for sale to drug dealers.

• OxyContin goes global — “We’re only just getting started”

  In this global drive, the companies, known as Mundipharma, are using some of the same controversial marketing practices that made OxyContin a pharmaceutical blockbuster in the U.S.

  In Brazil, China and elsewhere, the companies are running training seminars where doctors are urged to overcome “opiophobia” and prescribe painkillers. They are sponsoring public awareness campaigns that encourage people to seek medical treatment for chronic pain. They are even offering patient discounts to make prescription opioids more affordable.

  U.S. Surgeon General Vivek H. Murthy said he would advise his peers abroad “to be very careful” with opioid medications and to learn from American “missteps.”