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Chronic Pain

Pharma Corruption Started the Opioid Epidemic

What can we do to stop it?

Everyone is alarmed by the deadly opioid epidemic sweeping our country. But most of the discussion about causes and cures misses the most fundamental issue.

Pharma is the main culprit in starting and maintaining the problem. And it should be held responsible for cleaning it up.

During the past two decades, US drug companies have been only marginally less ruthless than Mexican drug cartels in pushing opioid drugs and addicting millions of Americans to them.

I have previously described the hypocritical role of the highly esteemed Sackler family. Much of their famous philanthropy has been financed by blood money earned from their Purdue Pharma—a leader in the fraudulent marketing that triggered and maintained the prescription opioid epidemic.

Drug companies and drug company executives must be exposed and punished. They have been responsible for hundreds of thousands of deaths and deserve massive fines needed now to help those who are currently addicted.

I have asked Art Levine to provide insights on what has happened and what needs to be done. He is an award-winning investigative journalist and author of the new book, Mental Health, Inc.: How Corruption, Lax Oversight and Failed Reforms Endanger Our Most Vulnerable Citizens.

Art writes: “It's hard to remember, amid all the daily outrages committed by President Trump, that he actually promised to do something in late August about what he declared to be a "national emergency" created by the opioid crisis that is driving most of the 64,000 drug overdose deaths a year.

As usual with Trump, nothing happened as a result of his comments. His administration hasn't gotten around to actually taking the necessary actions to invoke federal emergency powers that could allow the government to better help substance abusers.

What you don't see under serious consideration by the Trump administration is any meaningful crackdown on drug industry fraud or its corruption of researchers and government officials that fueled the opioid crisis in the first place.

And the recently established federal interagency pain advisory panel has many members with financial conflicts of interest connecting them to the drug industry that our government should be investigating—not obeying it like lapdogs.

Opioids have become the new corporate gold rush, with over a third of Americans being prescribed the drugs, mostly for short-term use.

Starting in the 1990s, Purdue Pharma used grants, subsidies and artful fakery to spread the notion among leading medical organizations that opioids- especially its new long-lasting, abuse-proof narcotic, OxyContin—weren't addictive for chronic pain patients.

Flush with drug industry money, non-profits such as The Joint Commission, the leading regulator of hospitals, and industry front-groups parading as "pain specialists" led the drive to evaluate hospitals and doctors on how aggressively they were treating patients to relieve pain; they promoted the unfounded, opioid-pushing view of pain as the "Fifth Vital Sign."

All this was boosted by the exaggerated claim that less than one percent of chronic pain patients become addicted, ostensibly justifying a nearly 300 percent increase in nationwide opioid prescriptions from 76 million to 207 million between 1991 and 2013.

For some states, such as West Virginia with the highest overdose rate in the country, it's become a modern-day plague. Over a six-year span through 2012, this year's Pulitzer Prize-winner Eric Eyre reported, "Drug wholesalers showered the state with 780 million hydrocodone and oxycodone pills, while 1,728 West Virginians fatally overdosed on those two painkillers."

In mid-September, 41 states announced they would band together to investigate drug companies and wholesalers for potential civil and criminal fraud violations.

That's on top of dozens of states and localities already suing the pharmaceutical industry for the opioid epidemic.

Jurisdictions in hard-hit states such as Kentucky and West Virginia are also contending that wholesalers knowingly broke the law by flooding the market with millions of needless opioid pills- while apparently complicit DEA officials looked the other way, thanks in part to the drug companies and distributors luring dozens of regulators with lucrative jobs.

In 2007, Purdue Pharma was fined a mere $600 million for the “misbranding” of OxyContin as only modestly addictive. That is just "chump change," critics say, compared to $35 billion in revenues these fraudsters earned.

While its three top executives did plead guilty as individuals, no one served prison time. Until drug industry executives actually serve time in a prison, don't expect any change at all in drug industry behavior.

Indeed, Purdue's deadly crimes just reflect broader patterns of corruption and lax enforcement throughout the pharmaceutical industry—standard business practice for decades.

During the last 25 years, Pharma has paid in fraud settlements only a tiny fraction of earnings—$35 billion out of$711 billion in worldwide net revenues. Fines for illegal marketing are treated as a cost of doing business.

The 20 percent reduction in opioid prescribing since 2010 and slow-moving sanctions imposed on drug companies are too little, too late.

And the pendulum has swung too far in the other direction: The risk of suicide is already mounting steadily for those addicted and/or with chronic pain who are abruptly cut off from opioids in a drastic way that focuses narrowly on arbitrary opioid dosage limits rather than on patient well-being.

It turns out that drug industry fraud, joined by insurance restrictions on time-consuming counseling, has fueled the irresponsible, rushed care that plays a major role on both sides of the deadly opioid pendulum."


Thanks so much, Art, for this and for your tireless crusading against the evil of Pharma corruption.

How does Pharma get away with this and all its other many outrages against patients and taxpayers?

Follow the money. The drug industry spends about $250 billion a year lobbying politicians. This is the equivalent of bribes or hush money—allowing it to go almost completely unregulated and unpunished.

The hundreds of thousands of deaths caused by Pharma-initiated opioid addiction far exceed all the deaths suffered from war or terrorism since World War II.

If a foreign enemy were inflicting this carnage, our government would respond urgently and aggressively. But this enemy is within and has paralyzed out government through regulatory capture.

Pharma owes us a cure to the national disease it has created. The template is clear. Big Tobacco was tamed by a combination of massive public outrage that turned politicians against it and lawsuits that funded a massive and successful anti-smoking campaign. Pharma deserves the same treatment.

The addicted victims of Pharma should receive free lifetime treatment using clawed-back Pharma money.

There will be no one size fits all. Some will choose gradual detox and extended rehab. Some will choose medicine-assisted treatment. Some may require lifelong maintenance.

And we must immediately stop the practice of carelessly prescribing risky opioids. Doctors and patients must be re-educated about the risks and very narrow indications. Practice habits must be monitored to ensure that conservative guidelines are followed with chronic pain patients already on opioids that balances the benefit and harm of taking them away.

The more general lesson—Pharma is not ever to be trusted. Its power over Washington must be busted. No industry requires closer regulation. It cannot be allowed free rein to prey on the American public.

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