Below is from a piece out today. The Ohio AG wants to sue the big PHrMA companies for their part in the crisis. I wish him luck in this endeavor, but doubt he’ll get anywhere, given the money congress critters collect in donations from the drug makers. Thoughts?
"Historically, opioid pain medications were considered too addictive and debilitating for anything but short-term acute pain and end-of-life care. But as we lay out in our legal complaint, starting in the late 1990s, manufacturers designed sophisticated marketing campaigns to target primary-care doctors — the doctors a typical Ohioan would visit — to convince them that opioids could and should be used for chronic pain.
These companies changed the prescribing culture, convincing doctors that opioids were not very addictive, that addiction was easy to overcome, and that addiction could actually be treated by taking more opioids. In 2014 alone, pharmaceutical companies spent $168 million to dispatch sales reps to win over these doctors with smooth pitches, slick slide decks, and glossy brochures that downplayed the risks and highlighted the benefits of their branded drugs. As Endo Pharmaceuticals openly advertised, “People who take opioids as prescribed usually do not become addicted.â€
They hired doctors to serve as “key opinion leaders†on advisory boards and to be part of speaker bureaus. They funded professional societies and patient advocacy groups, which then heralded the benefits of these drugs. In 2011, they spent $14 million on ads just in medical journals.
And now, opioids are one of the most widely prescribed classes of drugs, raking in revenue of about $11 billion in 2014 and projected to grow to $17.7 billion by 2021. In 2012, Ohio patients received 793 million pills — enough to supply every man, woman, and child in the state with 68 pills each. By 2016, roughly 20 percent of Ohio’s population were prescribed opioids."
It’ll be a battle. But pharma and the medical community pretty clearly have a role in this. There’s already a lot of honest-sounding introspection among doctors on the issue.
I don’t know how it’ll end up, but the anti-opioid sentiment may have turned a corner.
On the flip side, this is why “legalizing drugs” isn’t a panacea. It alleviates some problems (filling up prisons with drug addicts). It doesn’t get rid of the social costs of use. And it can increase use.
I’m not “anti-legalization.” I voted for legalizing marijuana in my state (as a non-user). But I think legalization gets oversold sometimes. But I guess the reality of today’s politics is you have to over-sell an issue to get it pushed through.
Edit: I’m not comparing marjiuana to opioids in terms of destructive magnitude.
There was a push in medicine at some point to treat pain as a vital sign and do what was necessary to alleviate it. Not sure when that was or how it ties into this but it probably contributed to the problem.
There was a push in medicine at some point to treat pain as a vital sign and do what was necessary to alleviate it. Not sure when that was or how it ties into this but it probably contributed to the problem.
That’s true. Standard practice is to ask what pain is on a 1-10 scale, and then treat the pain. And there’s some good medical purpose behind that. Legitimate severe pain is bad for recovering from an injury. And just bad in general.
The bad part of that is that perception of pain is entirely subjective, and the system is easy to abuse on both sides.
i suspect it’s destined to be a noble failure. i think it’s simply too easy for pharma companies to argue that, whatever their advertising policies are, they don’t certify/qualify/vet doctors or pharmacist, nor do they write 'scrips or fill prescriptions. so on some level the basic agency is still in the doctor’s hands.
of course, i guess that argument hasn’t always worked for big tobacco - even though smoking is an individual choice. but in the case of opioids i’m not sure that pharma has hidden the medical consequences of using them, per se, but just tried to have them indicated in a wider and wider number of cases. (as they do with every other drug.)
good luck to them, but if i were gambling my own money i bet it fails.
It’ll be a battle. But pharma and the medical community pretty clearly have a role in this. There’s already a lot of honest-sounding introspection among doctors on the issue.
I don’t know how it’ll end up, but the anti-opioid sentiment may have turned a corner.
On the flip side, this is why “legalizing drugs” isn’t a panacea. It alleviates some problems (filling up prisons with drug addicts). It doesn’t get rid of the social costs of use. And it can increase use.
I’m not “anti-legalization.” I voted for legalizing marijuana in my state (as a non-user). But I think legalization gets oversold sometimes. But I guess the reality of today’s politics is you have to over-sell an issue to get it pushed through.
Edit: I’m not comparing marjiuana to opioids in terms of destructive magnitude.
i’m no expert, but i guess the pro-legalization argument is that legal pot would decrease reliance on opioids in the first place by giving people an effective treatment for chronic pain (but keeping opioids on the table for in-patient/acute cases).
i’d guess that most people don’t want to be hooked on opioids, so having a better option benefits them. those who are truly ‘junkies’ would be using opioids (down the cascade to heroin, i guess) regardless, and in a “legalize everything” scenario they too might benefit a bit - decriminalizing their activities makes it easier to bring them into the fold for care and rehab, and maybe frees up public money for it too.
There was a push in medicine at some point to treat pain as a vital sign and do what was necessary to alleviate it. Not sure when that was or how it ties into this but it probably contributed to the problem.
Yet, we can’t get the community to add physical activity as a vital sign (except for Kaiser Permanente)…
There was a push in medicine at some point to treat pain as a vital sign and do what was necessary to alleviate it. Not sure when that was or how it ties into this but it probably contributed to the problem.
I’m fairly certain that the doctor who was the major champion of, “pain is the fifth vital sign” turns out to have been a paid representative for the maker of Oxycontin. He was not just some altruistic guy that was worried about treating patient’s pain.
Opioid addiction is a huge problem and it is only going to get worse.
I have some opinions about the wussification of America and that everyone wants to feel good all of the time without putting in any effort to do so (health, work, wealth, etc) but they are not very popular.