Are the Pharmaceutical Companies Getting a Bum Rap on Opioids?

Back in the 1990s, OxyContin maker Purdue Pharmaceuticals went overboard promoting the medical profession on the idea that this drug had no addictive potential. In fact, like any opioid, about 10% of users will and did become addicted. Pill mills opened up in several states and pushed the pills out by the millions knowing they were intended to be used or resold  for recreational use.  The research on which Purdue had relied was found to be flawed and the company was eventually fined over 600 million dollars. Prescribing patterns by doctors continued for years and many honestly prescribed pills also entered the market. It took the DEA and the medical profession time to catch on. Walgreen and other outlets were frequently robbed, not for cash, but for pills. The opioid epidemic was in full swing.

But, the DEA and the medical profession did catch on, along with the pharma companies. There has since been a dramatic drop in opioid pill manufacture, and the medical profession is deeply engaged in trying to ascertain best practices in prescribing these medications. A new drug called Marcaine has been developed to chemically prevent post operative pain and further reduce the use of opioids. Journalist Holman Jenkins reports that “A federal survey finds misuse of prescription opioids peaked in 2012 and has returned to 2002 levels.

Yet, according to the American Council on Science And Health (ACSH) something near hysteria is going on in discussions about the “epidemic” of prescription opioid overdoses. Writing  for ACSH, Josh Bloom harshly critiques a piece by psychiatrist Andrew Kolodny  in which the opening line reads: “Drug overdose deaths, once rare, are now the leading cause of accidental death in the U.S., surpassing peak annual deaths caused by motor vehicle accidents, guns and HIV infection.”

True it is, as others have reported, there were 64,000 drug overdose deaths last year. But the Kolodny statement is sensationalist and misleading in a piece about  prescription opioid overdose, where a reader is entitled to assume all those deaths were due to prescription opioids. In fact they included anti-depressants, aspirin and the illegal drugs as well. Only half of them, about 30,000, involved any opioid, and that included illegal fentanyl and heroin.

Similar hyperventilating was on display in a Washington Post story mentioned by Jenkins. He states the Post’s main source was a former DEA official now consulting trial lawyers suing the drug makers. Oh, yeah, he’d be objective.

ACSH’s Bloom goes on to point out that of those 30,000 opioid deaths, prescription opioids accounted for about 17,000—half the number killed by accidental falls.  But, that figure, too, is misleading. Most of those deaths involved combining the drug with another drug type called benzodiazepines, which potentiate the effects of opioids. Take out those deaths that cannot be blamed on the prescribed medicine alone and the number of deaths attributable to prescription opioids is about 5,000. That is not more than “motor vehicle accidents, guns and HIV infection,” it  is less than one/fifth of auto accident deaths. NSAIDs, mostly aspirin and ibuprofen kill more than three times that each year.

Anyone wanting to find the real source of the problem, need not look far. There is ample evidence that teens looking for kicks, or medication of their anxieties, find these prescribed opioids in their parents’ medicine chests; that addicted real estate agents go early to open houses and make a furtive search for drugs in the bathrooms–to use or to sell; and that addicts everywhere are on the lookout for chances to “borrow,” (read steal) pills from friends and relatives. A major reason why these pills, oxycodone and hydrocodone compounds under various names, are so easy to find is that patients who are prescribed them often don’t use them all. As treating specialist Sally Satel, M.D. has noted, patients are more apt to skip taking their pain pills than to abuse them.

Despite lacking evidence that the companies are pushing these medications on naïve doctors, several state attorneys general are suing them. It will probably be less costly for the companies to pay some settlement money than win at trial–and so the politicians will get to say they took action to curb the opioid overdose crisis. And illegal fentanyl from China and Mexico will go right on killing tens of thousands. This is the kind of nonsense–nay, corruption–we get in a legal system that criminalizes adult drug use.

© Rights reserved to Dave Finch 10/25/2017

Visit my Reform Drug Policy Project site for additional information and to read Chapter One of my book’s second edition.

The second edition is now available at all major booksellers. It describes how toleration of adult drug use, coupled with a program of coaching and controls, would bring to a prompt end most of the troubles we are having with drugs in society under the prohibition regime.

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