Let us face the truth, America has a drug problem.
One should be able to trust that doctors and pharmacists will be honest with us and that they do not prioritize money over our well-being. I have told my doctor often that I am just a Guinea pig to him.
Our doctors and pharmacists pushed opioids and got many of our citizens hooked on the drugs.. When the government finally decided to step in and do something about it, many of the now hooked users turned to the streets to get their medicine. Of course, the large pharmaceutical companies were complicit with what occurred.
In the United States, opioid use disorder (OUD) and opioid overdose were once rare. But over the past 25 years, the number of Americans suffering from OUD increased exponentially and in parallel with an unprecedented increase in opioid prescribing.1 Today, OUD is common, especially in patients with chronic pain treated with opioid analgesics,1 and opioid overdose is the leading cause of accidental death.2
The high prevalence of OUD has led to an array of health and social problems. The United States has seen record high rates of neonatal opioid withdrawal syndrome, more children entering foster care,3 rising heroin and fentanyl use,4 outbreaks of injection-related infectious diseases,5 and a decline in workforce participation in areas with relatively high rates of opioid prescribing.6 The Centers for Disease Control and Prevention (CDC) has aptly described the crisis as the “worst drug overdose epidemic in [US] history.”1
Using the term epidemic to describe the sharp increase in OUD and overdose deaths is appropriate. But we should recognize that, unlike communicable disease outbreaks, the opioid crisis was not caused by a pathogen. As a federal judge presiding over hundreds of county and state cases against opioid manufacturers and distributors recently found: “It is accurate to describe the opioid epidemic as a man-made plague, 20 years in the making.”7
Much of the responsibility for the opioid crisis rests with the pharmaceutical industry’s promotion of aggressive opioid prescribing. Indeed, in a first-of-its-kind trial against opioid manufacturers, a state court in Oklahoma last year found that the “exponentially increasing rates of addiction,” “overdose deaths,” and babies born exposed to opioids were caused by “false, misleading, and dangerous marketing campaigns” for opioid medications.8 But the fact that opioid manufacturers disseminated false claims regarding the risks and benefits of opioids for the past 25 years points to a dereliction of duty by the US Food and Drug Administration (FDA)—the federal agency charged with regulating pharmaceutical companies.
Purdue Pharma and the opioid epidemic
The role of Purdue Pharma and its blockbuster drug oxycontin in causing the opioid epidemic which has killed over 450,000 people in the past two decades has been well described in books like “The Empire of Pain” by author Patrick Keefe and in reports of investigative journalists that have appeared in leading U.S. newspapers.
From these and other sources it is estimated that in nearly one half of the cases drug addiction began with a doctor’s prescription. Although other drug companies and drug distributors were involved, Purdue with its blockbuster drug oxycontin was the leading supplier of prescription opioids to patients.
Purdue used “thought leaders” in medicine like Russell Portenoy, MD, Chairman of the Department of Pain Medicine and Palliative Care at Beth Israel Hospital in New York, to promote the safety of opioids. Purdue and other pharmaceutical companies paid large sums of money to Portenoy and his department. Purdue also paid many other physicians to tout the benefits of oxycontin.
Purdue also instructed its pharmaceutical representatives all over the country to tell physicians that oxycontin was not addictive primarily because of its slow-release properties. Purdue told its representatives to tell doctors that only persons with an “addictive personality” became addicts.
Our companies, doctors, pharmacies, and government are responsible for the epidemic, not China, Mexico, and Canada.