For most of the past 20 years, prescription opioid abuse was treated like the weather: Everyone complained about it but no one ever did anything about it. As a result, it exploded into a national epidemic that killed 17,000 Americans in 2016. Add to that about 35,000 overdose deaths from heroin and synthetic opioids — often used by addicts when they can’t get prescription drugs any more — and you’re approaching a Vietnam War death toll every year.
Public awareness and outrage are starting to change things. In that regard, a Senate Homeland Security Committee investigation led by Sen. Claire McCaskill, D-Mo., has been helpful, even though most of Congress hasn’t been. The committee’s latest report, released Feb. 12, detailed how opioid manufacturers spent almost $9 million between 2012 and 2017 supporting pain treatment advocacy groups that promoted use of the manufacturers’ products.
“By aligning medical culture with industry goals in this way, many of the groups described in this report may have played a significant role in creating the necessary conditions for the U.S. opioids epidemic,” McCaskill’s report states. The advocacy groups defended the objectivity of their work.
McCaskill’s findings amplify earlier studies that detailed how manufacturers marketed their drugs to doctors as an effective, low-risk way to control short-term and chronic pain.
Beginning in the mid-1990s, drug firms, doctors, advocates and lobbyists formed a kind of Pain Inc. Often with good intentions, sometimes in pursuit of bigger profits, Big Pain inadvertently turned prescription opioids into a poor man’s heroin. Mexican drug cartels, seeking to exploit an expanding addiction market, have flooded the streets with cheap heroin.
The negative attention is prompting action. State and local lawsuits have surged against big opioid manufacturers and distributors, many brought by the mass-tort law firm Simmons Hanly Conroy of Alton. Purdue Pharma of Stamford, Conn., a frequent target of those lawsuits, announced this month that it would stop marketing the time-release opioid Oxycontin to physicians. Purdue sold $1.94 billion worth of Oxycontin in 2017, down about $1 billion from its record high in 2013.
In addition, some states (though not Missouri or Illinois) have passed laws limiting the number of days for which opioid painkillers can be prescribed without an authorized refill. Express Scripts of St. Louis, and CVS Caremark, the nation’s largest pharmacy benefits managers, have imposed a seven-day limit on opioid prescriptions without prior approval from a doctor.
All of this could reduce the number of new addicts, but it does little for the 2.1 million Americans who already have what the government calls an “opioid use disorder.” For them, Congress authorized $6 billion in new spending in the recently passed budget bills, roughly 6 percent of what a presidential commission recommended. But Congress had to pay for tax cuts first.