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Opioids

What’s the problem?

Recently, Trump declared America’s opioid epidemic a public health emergency. Indeed, the crisis is devastating; for Americans under the age of 50, drugs are the leading cause of death, killing 59,000 people a year (more than the total number of Americans killed in the Vietnam War).

What’s more, there is a severe price tag to this addiction. According to the Harvard Business Review, “researchers estimate the economic cost of the U.S. opioid epidemic may be as high as $80 billion a year.”’

How did it happen?

America’s opioid crisis is a slow-moving train wreck that emerged in the 1990s. What began as a seemingly well-intentioned effort by doctors to relieve their patients’ pain eventually surfaced as a lavishly funded and ruthlessly marketed campaign by pharmaceutical companies across the country.

Here’s a brief timeline:

  • 1911-1990: Opioids used for only acute pain and cancer. Physicians did not treat pain seriously.
  • Early 1990s: New, long-lasting opioids developed and prescribed, even for moderate pain.
  • 1995: OxyContin approved
    • Push in medical field to address pain. Pharmaceutical companies lobbied for opioids and advertised heavily.
    • FDA (pressured by lobbyists and pharmaceutical companies) released statement supporting OxyContin prescriptions, even asserting the drug is much less addictive than other painkillers (this was later proved false).
  • 1999: 4 million people using prescription drugs non-medically, with 2.6 of these people misusing their pain relievers.
  • Early 2000s:
    • Joint Commission on Accreditation of Healthcare Organizations (responsible for accrediting hospitals and funded partly by Purdue Pharma– a large pharmaceutical company) stated that there is no correlation between pain-relief medication and addiction, referring to the concerns of many in the field as “inaccurate and exaggerated.”
    • Large increase in opioid prescriptions: abuse/misuse rates of opioids doubled between 1998 and 2008
    • Statistics:
      • 6.2 prescription drug abusers – 2002
      • 730,000 emergency visits – 2009 (double the rate in 2004)
    • 2003: FDA expresses concerns about misleading advertisements for OxyContin.
  • The epidemic continues
    • Although opioids like OxyContin are now almost universally recognized as harmful and addictive (with many lawsuits against companies like Purdue Pharma), our country remains dependent on painkillers.
    • OxyContin is a gateway drug to the more affordable, available, and fatal heroin.
      • Four out of five heroin users are originally legal opioid addicts.

Where’s the blame?

Pharmaceutical companies continue to block the road to recovery. Purdue Pharma labels itself a “pioneer in developing medications for reducing pain, a principal cause of human suffering). Purdue aggressively marketed its drugs, sending $1.5 billion in marketing in 2002 alone. It targeted high-risk areas (see “The Promotion and Marketing of OxyContin: Commercial Triumph, Public Health Tragedy”):

“Drug companies compile prescriber profiles on individual physicians—detailing the prescribing patterns of physicians nationwide—in an effort to influence doctors’ prescribing habits. A drug company can identify the highest…prescribers of particular drugs in a single zip code, county, state, or the entire country. [Purdue targeted] the physicians who were the highest prescribers for opioids across the country. The database would help identify physicians with large numbers of chronic-pain patients. Unfortunately, this same database would also identify which physicians were simply the most frequent prescribers of opioids and, in some cases, the least discriminate prescribers.

A lucrative bonus system encouraged sales representatives to increase sales of OxyContin in their territories, resulting in a large number of visits to physicians with high rates of opioid prescriptions, as well as a multifaceted information campaign aimed at them.”

Later, Purdue paid over $600 million in fines for false advertising and misleading information. However, the company continued to push its drugs.

If you agree that we must tackle our nation’s addiction to opioids and hold companies like Purdue Pharma accountable, please look below for this weeks actions.

If you disagree with our stance on this, please leave us a comment. We are here to encourage discussion, and would love to feature alternative views.

If you need more information, here are some sources we suggest:

 

A history of opioid addiction:

http://www.theatlantic.com/sponsored/purdue-health/a-brief-history-of-opioids/184/

FDA information on drug addiction:

https://www.fda.gov/downloads/drugs/drugsafety/informationbydrugclass/ucm332288.pdf

A detailed background on Purdue Pharma:

https://www.newyorker.com/magazine/2017/10/30/the-family-that-built-an-empire-of-pain

Sources:

http://www.theatlantic.com/sponsored/purdue-health/a-brief-history-of-opioids/184/

https://www.fda.gov/downloads/drugs/drugsafety/informationbydrugclass/ucm332288.pdf

www.opioidaddiction.org

http://www.modernhealthcare.com/article/20160419/NEWS/160419907

https://www.cdc.gov/drugoverdose/epidemic/index.html

https://www.nytimes.com/interactive/2017/06/05/upshot/opioid-epidemic-drug-overdose-deaths-are-rising-faster-than-ever.html)

 

One Comment

  1. Lyla Stettenheim Lyla Stettenheim December 6, 2017

    I think this is a really important issue, especially here in New England. I definitely agree that companies such as Purdue need to be held accountable, and it sounds like they starting to be (with the fines and such). And while I think this is good and should be continued, this doesn’t seem to have stopped the company’s tactics. So I think this problem also needs to be tackled from the other side: the medical side, addressing the physicians who prescribe the drugs. Vermont has a pretty new “hub and spoke” program that involves the expertise of people who specialize in addiction medicine and a whole support network with treatment for addicts. It seems to be really effective, here’s the link for it https://www.vox.com/policy-and-politics/2017/10/30/16339672/opioid-epidemic-vermont-hub-spoke

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