Sure, it&#x27;s an opioid. That&#x27;s not the point. The point is that it&#x27;s made from an inexpensive generic opioid feedstock: oxycodone.  The supposed value-add isn&#x27;t the painkiller, it&#x27;s the timed-release agent.<p>Unless these reporters are simply lying, there&#x27;s evidence of great variability in the effectiveness of that timed-release agent. But the company&#x27;s market position depends on the 12-hour dose. If the drug&#x27;s needed every six hours, the only difference between it and the cheap stuff is price. In that case, most doctors won&#x27;t prescribe and most payers won&#x27;t reimburse the expensive stuff.<p>So, a doctor can ask a patient, &quot;are you willing to take a pill every six hours?&quot;  If the patient agrees, the prescription can be very inexpensive and effective. And, wide swings in blood concentration are controllable, which helps avoid both grogginess and withdrawal struggles.<p>A friend who develops instruments for anesthesiologists has told me that a well-controlled minimal effective dose of pain med works, and manages risk very well.  Peoples&#x27; rates of clearing these compounds vary a lot, and the timed-release compound doesn&#x27;t appear to reduce that variability, contrary to the what the marketer is implicitly claiming.<p>If the treatment is for acute short-term pain (post-op, etc) a six-hour regime isn&#x27;t a big burden, and the reduced risk of addiction justifies some inconvenience.<p>If the treatment is for chronic pain, a wise patient and doctor might start by trying the more frequent doses, and move to &quot;time-release&quot; doses if the first treatment doesn&#x27;t work. Patients and doctors tune their meds all the time. Why not start trying for minimal effective dose, and move to a more addiction-prone regime if the first one desn&#x27;t work?<p>But that would foul up the business of Oxycontin&#x27;s marketer.<p>A weekly Narcotics Anonymous meeting just moved out of the hall of a church I serve to a bigger hall, because they&#x27;re gaining members fast. That&#x27;s not good.