The Role of Big Pharma in the Opioid Epidemic
By Sean Lally, Staff Writer
It’s no secret that the pharmaceutical industry has contributed to the opioid epidemic. To date, certain companies have been sued for their role in the crisis, but the government has yet to intervene in any meaningful way. President Trump did express interest in addressing the opioid crisis when he signed an executive order that created The President’s Commission on Combating Drug Addiction and the Opioid Crisis. However, the commission doesn’t include plans to hold Big Pharma accountable for its deeply negligent sale of opioid pain killers.
The Opioid Epidemic, an Overview
In the 90’s, physicians faced a great deal of pressure by advocacy groups and the federal government to deal with the widespread problem of debilitating pain. In response to the tens of millions of people suffering from chronic pain, doctors began turning toward opiate pain killers such as Vicodin, Percocet and Oxycontin, which are extremely potent drugs that bind to receptors in the brain to inhibit the sensation of pain.
However, according to the Annals of Internal Medicine, there isn’t sufficient evidence to show that opioids reduce pain in the long term and in fact opiate pain killers may exacerbate chronic pain issues.
Ignoring this evidence, companies, such as Purdue, capitalized on the need for pain relievers, promoting drugs like Oxycontin, while aggressively downplaying their addictive quality. Purdue eventually paid a $634.5 million fine for its misleading marketing strategy.
In 2015, about 33,000 cases of drug overdoses were opioid-related. That’s about two-thirds of all overdoses in the U.S. And since people who are addicted to opiate pain killers are 40 times more likely to get addicted to heroin, heroin overdoses are also on the rise. Between 2002 and 2015, heroin overdoses increased by a factor of six, rising from 2,000 overdoses to approximately 13,000.
Big Pharma Makes a Profit
About 254 million opioid prescriptions were given out in 2010. That’s enough drugs to medicate every adult in America for a month. And from those prescriptions, the pharmaceutical industry reaped $11 billion in profits. Additionally, according to the National Institute of Drug Abuse, in 2013, 1.9 million Americans battled opioid addiction and that number has continued to rise. In fact, according to the Annual Review of Public Health, addiction treatment and opioid-related deaths have increased proportionately with opioid sales since 1999.
Failing to Hold Big Pharma Accountable
So will Trump hold the pharmaceutical industry accountable for marketing drugs that since 1999 have caused over 165,000 deaths? So far, it appears Trump has no plan:
- to prevent the pharmaceutical industry from actively pushing addictive drugs onto the market.
- to stop Purdue from funding “more than 20,000 pain-related educational programs […] to encourage long-term use of OPRs [opioid pain relievers] for chronic non-cancer pain.”
- to prevent the dissemination of misleading science suggesting “addiction” is different than “physical dependence” and “physical dependence” is “clinically unimportant.”
Instead the President has suggested lowering drug prices and reducing regulations on Big Pharma by 75 percent. He has suggested “streamlining” the FDA approval process to make it easier for drugs to reach the market. Additionally, Trump’s pick for FDA commissioner, Scott Gottlieb, has ties to several Big Pharma companies, so we can’t be sure that, if approved, he will work to protect consumers.
The Positive Effect of Lowering Drug Prices
It should be noted that lowering prices could have a positive effect on the crisis. After all, Kaleo Pharmaceuticals increased the price of naloxone, an opioid overdose antidote, by 500 percent, from $690 in 2014 to $4,500 in 2016. If Trump is serious about implementing a Medicare drug price negotiating program, the pharmaceutical industry could be forced to lower prices for vital drugs such as naloxone. However, to bring about such a program, the political tide would have to turn, as price negotiation is an idea usually backed by Democrats. House Ways and Means Committee Chairman, Kevin Brady (R.-TX) has already refused to support such a program.
A Plan to Investigate
For now, we’ll have to wait and see if anything comes of Senator Claire McCaskill’s (D-MO) investigation of five major pharmaceutical companies. Senator McCaskill requested internal marketing materials, addiction studies and independent contributions to advocacy groups that prevent regulations on opiate pain killers. However, the investigation may not be ideal as it excludes one of the top opioid suppliers, Mallinckrodt.
In short, though more attention has been given to the opioid epidemic and the role Big Pharma has played, there is still much to do in terms of regulating an industry that has irresponsibly endorsed the usage of an addictive and potentially deadly drug.