The United States opioid crisis continues to earn front-page attention by the media, who normally never linger too long on any one topic due in part to the short attention spans of their audiences. Recently the New York Times Magazine, written and researched by some of the best journalists in the country, devoted multiple weekends of coverage to the opioid crisis, documenting deeply personal accounts of several young pregnant mothers with opioid addictions. Any mother or father of a young woman or man, or anyone with even a shred of empathy, couldn’t help but be deeply touched by reading these heartbreaking stories. Sadly these accounts aren’t the only one of their kind, as every local newspaper, television newscast, and National Public Radio affiliate have all produced stories chronicling people whose lives were irreparably altered, and even destroyed, by opioid addiction. What separates the opioid addiction from another addiction, is the speed at which it takes hold of the user, fueled by the level of euphoria experienced by the user.
Fueling the growth of epidemic in the U.S., there has been an enormous amount of funds devoted to the marketing, sale, distribution and political lobbying efforts of opioids. The pharmaceutical industry’s largest trade group, PhRMA, swelled their spending on lobbying during the year prior to the election, posting their largest flood of donations since 2009 when the group armored up in preparation for battle over the Affordable Care Act.
According to the National Institute on Drug Abuse, of those who began abusing opioids in the 2000s, 75 percent reported that their first opioid was a prescription drug. This fact generally wasn’t always thought to be the case. The wide-spread public opinion during the 1980s and into the 1990s was that first-time opioid users who were prescribed opioids for pain relief would not be at risk of becoming addicted. Trusted physicians were informed on prescribing opioids for pain treatment by research often funded by the opioid manufacturers. Keith Humphreys, Phd, Standford University researcher and addiction expert told DrugRehab.org, “The industry finances a large proportion of research and has favored short-term (e.g., 12 weeks) studies that do not reveal the long-term downsides of opioids.”
During these early days of the opioid epidemic, physicians and hospitals provided the opioids in larger quantities, sometimes without thoroughly checking a patient’s prescription history. The legitimate risks associated with taking that first pill were also rarely discussed. Trying over the counter non-addictive medication, or even asking a physician what other options were available wasn’t commonplace.
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The leading cause of death today for people under 50 years of age is opioid addiction, according to U.S. Attorney General Jeff Sessions.
Currently, the pipeline of irresponsibly distributed opioids is slowing as opioid manufacturers are being asked to account for the egregious sins of the past. DrugRehab.org looked into the new efforts that were collectively being harnessed to fight the opioid epidemic earlier this year.
If anyone thinks the United States has the same opioid drug problem that other countries must be facing, they should talk with Keith Humphreys. The noted Stanford professor and expert on pain management and substance addiction, Keith Humphreys has researched opioids and their impact for years.
“The biggest misconception is that the US is normal in how it handles prescription opioids. So let’s compare ourselves to another country. Japan, for example. Older population than us; you would think more aches and pains. Universal access to health care, so more opportunities to prescribe,” Humphreys said while speaking at a Stanford Medical School’s Medicine X conference.
“So consider the amount of standard daily doses of opioids consumed in Japan. And then double it. And then double it again. And then double it again. And then double it again. And then double it a fifth time. That would make Japan No. 2 in the world, behind the United States. Every other developed country does at least as good or as poor a job as we do managing pain — while not using opioids at anywhere near the same level.”
Change doesn’t happen overnight, but it does seem that the country as a whole is asking what they can do to help. States, counties and local governments are standing up to Big Pharma. With data provided by the Department of Justice on the number of painkillers sold, they are looking for retribution from the doctors, hospitals, pharmacies, manufacturers, and distributors.
Retribution shouldn’t be hard to prove in such astounding cases as this one DrugRehab.org wrote about. Between 2006 and 2016, out-of-state drug companies shipped nearly 21 million to two pharmacies within two blocks of each other in Williamson, West Virginia, a town with a population of 2,900. It is no wonder the state has THE largest percentage of death by overdose in the nation according to the Center for Disease Control statistics.
According to the Center for Disease Control, “There is an urgent need to implement a multifaceted, collaborative public health and public safety approach. Building on existing resources more rapidly available and comprehensive surveillance data are needed to track emerging drug threats to guide public action to prevent and respond to the epidemic through increased naloxone availability, harm reduction services, linkage into treatment and medication-assisted treatment, safe prescribing practices and supporting law enforcement strategies to reduce the illicit drug supply.
States Take Action
As of May 2018, more than 700 cities, counties, and states have filed lawsuits seeking to hold the manufacturers accountable for their part in the opioid epidemic. Some are still trying to negotiate a settlement, while others are pressing ahead with litigation based out of the Northern District of Ohio, which is the first case scheduled to go to trial in March 2019. Defendants include manufacturers, Johnson & Johnson, Teva Pharmaceutical Industries Ltd and Endo International Plc, and pharmaceutical distributors AmerisourceBergen Corp, Cardinal Health Inc, and McKesson Corp.
In Tennessee, Purdue Pharma is being sued by Attorney General Herbert H. Slatery III and a group of other State Attorney Generals, for its unlawful marketing and promotion of Oxycontin and other drugs and its role in causing and prolonging the opioid epidemic. According to Attorney General Slatery, “Our office has conducted an extensive investigation into Purdue’s highly aggressive marketing practices and other unlawful conduct. We believe Purdue’s conduct has been unconscionable, and we intend to hold the company accountable. Three Tennesseans are dying each day from opioid-related overdoses, and we are committed to the hard work that needs to be done to address this tragedy.” In addition to their marketing tactics and overstatement of patient benefits, the complaint also shows Purdue knew patients were dying from overdoses and that its drugs were being illegally sold to non-patients.
Big Pharma, Big Marketing
Robert Reich, economist, author, economist and former member of three Democratic presidential administration’s wrote recently in Newsweek “American drug companies spend hundreds of millions lobbying the government. Last year alone, their lobbying tab came to $171.5 million, according to the Center for Responsive Politics.
That’s more than oil and gas, insurance, or any other American industry. It’s more than the formidable lobbying expenditures of America’s military contractors. Big Pharma spends tens of millions more on campaign expenditures.”
“When Americans buy drugs in the United States, they really buy a package of advertising, marketing, and political influence-peddling,” Reich said.
The U.S. Department of Justice is joining six states in a lawsuit against one manufacturer, Insys Therapeutics Inc, for illegal marketing practices including providing kickbacks to physicians. The U.S. Department of Health and Human Services’ Special Agent Christian Schrank says “Insys allegedly bribed doctors who are more concerned with profits than patients. Encouraging the inappropriate use of this too-often deadly opioid is intolerable enough, but the abuse is compounded when taxpayers are forced to pick up the bill.” The opioid involved is mixed with fentanyl, which is a highly addictive painkiller.
Lawmakers Assisting DEA in Opioid Fight
The increase in opioid-related overdose deaths has mirrored the dramatic rise in opioid prescribing, with more than 33,000 deaths in 2015. Since 2005, Dick Durbin has served as a leader in the U.S. Senate. He holds the second highest ranking position as a Democrat, the Democratic Whip. For years he has used his influence to champion many healthcare issues, calling for the Department of Transportation to ban e-cigarettes on airplanes, working to prevent the tobacco industry from marketing to children, fighting to improve prosthetic care for U.S. Veterans, and advocating for affordable quality healthcare.
Led by Sen. Durbin, the Senate Judiciary Committee has passed a bipartisan bill, Opioid Quota Reform Act of 2018 that if passed by the House and signed by President Trump, will make it easier for the DEA to adjust annual opioid manufacturing quotas, allowing for DEA to react quickly to oversupply or undersupply if there are shortages.
“Tackling the opioid crisis requires a coordinated effort from government agencies, health care providers, drug companies, law enforcement, and the treatment community. We must make sure all stakeholders are doing everything in their power to prevent opioid addiction,” said Durbin. Durbin is asking that the 2018 opioid manufacturing quotas be lowered. “Fewer pills on the market means less addiction and, hopefully, fewer deaths.”
The bill is supported by groups including the National Association of County and City Health Officials, National Safety Council, National Association of Counties, Trust for America’s Health, and Safe States Alliance.
Opioid Crisis Now Impacting Shellfish off Seattle Coast
In Seattle, the city attorney, Peter S. Holmes, says the city is filing a lawsuit to hold the manufactures accountable for harm to the city and its residents. “To address the opioid epidemic defendants have unleashed, Seattle has spent and continues to spend millions of dollars of taxpayer money, including for police, fire, paramedic, opioid abuse treatment, human services, and criminal justice services. These are sums that, but for defendants’ conduct, Seattle could have devoted to other beneficial uses.”
Not related to Seattle’s opioid lawsuit, scientists from the Puget Sound Institute found mussels near Whidbey Island, 30 miles off the northern coast of Seattle, to contain traces of oxycodone. The mussels were used as a way to test what chemicals are making their way to the nearby clean waters via the solid waste disposal system. This isn’t the first time substances that are frequently abused were found by the scientists to be in shellfish. Past studies in these same waters have found cocaine and other drugs in shellfish.
Professor Humphreys responded when told of this by DrugRehab.org, “When a nation prescribes more opioids than any other country in the history of the world, this was bound to happen. It’s one of many harms of our opioid epidemic.”