Big Pharma and the Opioid Problem

Everyone knows we have a huge drug addiction problem in this country. Millions of pills daily misused, causing hundreds of millions, if not billions of dollars in healthcare costs, most not borne by the abuser. And, that pales in comparison to the toll taken by the number of deaths and disabilities caused by overuse and misuse of prescription medications.

According to the Centers for Disease Control, from 1999 to 2014, 165,000 people died from overdoses of prescription opiods. In 2014 alone, over 14,000 deaths were attributed to opioid prescription overdose. Today, at least half of all U.S. opioid overdose deaths involve a prescription opioid.

The most common drugs involved in prescription opioid overdose deaths include:

• Methadone
• Oxycodone (such as OxyContin®)
• Hydrocodone (such as Vicodin®)³

 Some sobering facts:
 
Among those who died from prescription opioid overdose between 1999 and 2014:

• Overdose rates were highest among people aged 25 to 54 years.
• Overdose rates were higher among non-Hispanic whites and American Indian or Alaskan Natives, compared to non-Hispanic blacks and Hispanics. 
• Men were more likely to die from overdose, but the mortality gap between men and women is closing.

Overdose is not the only risk related to prescription opioids. Misuse, abuse, and opioid use disorder (addiction) are also potential dangers.

• In 2014, almost 2 million Americans abused or were dependent on prescription opioids.
• As many as 1 in 4 people who receive prescription opioids long term for non-cancer pain in primary care settings struggles with addiction.
• Every day, over 1,000 people are treated in emergency departments for misusing prescription opioids.    

So what constructively is being done to stem the growing problem? Not that much, really. Some things have helped a bit, such as the CURES system that allows providers to cross check those who "doctor shop" to obtain additional prescriptions for opiods. But, that only works if the provider actually checks. Sure, the law says they must check, but do they really? I know some that do but would guess many do not.

Stricter enforcement of illicit sale and distribution of opiods has again been marginally successful. Taking one seller or dealer off the street usually means there is an open spot for yet another dealer. And by dealers, I include those who receive legitimate prescriptions and then sell their pills. Grandma and granddad are not exempt from the drug trade it appears.

Big pharmaceutical companies have manufactured and promoted pain medications, including several companies who have been  prosecuted for selling narcotics without approval for non-cancer pain. That promotion of off-label use has resulted in thousands of deaths, as a result of a new, and more dangerous drug coming on the market, increasing demand by and fueling the illegal usage by abusers. 

That said, people who are actually in constant pain, especially where the pain is going uncontrolled, can have the propensity toward addiction as a result of their continuous use of the drug, and increased dosage to control the pain, as prescribed by a respected medical doctor. Those people will be addicted but not abusers unless they take more than prescribed. In my opinion, there needs to be some logic by the government in separating "addicts" who through no fault of their own are addicted to prescription pain medications due to unrelenting pain, and the "abusers" who simply take medications to get high or do it through illicit channels. Lumping the person who has to live with chronic pain and becomes an "addict" with the abusers is patently unfair. Go after the abusers and those with no real physical need for drugs other than the need they self-created by taking medications illegally, or more than prescribed.  

I don't have an answer but I suppose tighter controls is what we all pay for a system that has allowed doctors to sell prescriptions for massive quantities of medications with virtual impunity. Nothing happens until someone screams foul. And it looks like the government, God forbid, is now calling foul for everyone, including all of the legitimate users, while the illicit drug trade will remain unabated.

Remember, one of the worst things you can ever hear is "We're the government and we're here to help."