Who set the ball rolling? The first prescribers of OxyContin

OxyContin is probably the most controversial new drug launched in the last twenty years. The links between this opioid-based painkiller and addiction and crime are now resulting in public controversies that are far reaching in their consequences. Applying a hazard modelling approach to prescription data, we examine the factors that first led to the adoption of OxyContin among general practitioners in the UK and compare these to summarised results for 25 new drug launches. We find that the influences on early prescription are quite different for OxyContin compared to the typical drug. It was the general practitioner pain specialists who led the early adoption of OxyContin in our data. Thus, if inappropriate prescribing was the cause of OxyContin abuse, this might at least in part be addressed by better education of the ‘expert’ general practitioners.