In America, almost 100 people are dying from opioids every day.
Some experts predict that half a million more people will die over the next decade . Others think it will be closer to 650,0001 – the population of Miami, or Atlanta, or Sacramento. President Trump has rightly declared the crisis a “public health emergency”.
Last week Trump’s commission on ‘Combatting Drug Addiction and the Opioid Crisis’ published its recommendations. The report has had a lukewarm reception, not least as the question of funding remains unanswered. Yet much of what it does say – from cracking down on the illegal importation of opioids to expanding drug courts and removing barriers to treatment – is sensible (we’ll park the report’s proposal for a ‘just say no’ media campaign for now).
The problem with the report lies in what it doesn’t say. Because while it traces the role of big pharma in the development of the opioid epidemic, and it seeks greater oversight of prescribing, it fails to adequately link the two. In reality, the financial relationship between pharmaceutical companies and doctors is killing people.
Like big tobacco before, big pharma is being called to account
The opioid epidemic can be traced back to false advertising by big pharma in the 1990s, who peddled opioid-based painkillers as having lower risk of addiction than existing pain pills.2 More specifically, Purdue Pharma executives gave false information about their narcotic OxyContin, and doctors duly prescribed it – between 1996 and 2001 annual prescriptions increased almost 20-fold.3 Over that period, OxyContin made Purdue Pharma almost $2.8 billion.4
In 2007, Purdue Pharma finally agreed to pay $634.5 million in fines for those misleading claims, and three top executives pleaded guilty to criminal charges. 41 states are now suing the producers and distributors of opioid painkillers,5 reminiscent of the mass litigation against tobacco companies. If these companies are also found to have made misleading claims, to have behaved negligently in doling out obscene volumes of highly-addictive pills (Vox reports that enough pills were prescribed in 2016 to almost fill a bottle for every US adult), massive settlements will follow.
But as the lawsuits snowball, there’s a danger we’re missing a longer-term opportunity to protect patients.
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