Opioid’s: Common Sense Has Been Abandoned

  • States are suing Purdue pharma because “they all want a slice of the pie”. More than 1,500 pending civil lawsuits, filed mostly by state and local governments, allege that deceptive marketing claims helped fuel a national epidemic of opioid addiction and thousands of overdose deaths.
  • In reality a checks and balances system failed at all levels.
  • HCP’s, insurers and wholesalers all are equally responsible for the opioid addiction problem that’s going to cots out healthcare system hundreds of millions of dollars to solve.

The pain epidemic

An analysis of data from the 2012 National Health Interview Survey (NHIS) has found that most American adults have experienced some level of pain, from brief to more lasting (chronic) pain, and from relatively minor to more severe pain. The analysis helps to unravel the complexities of a Nation in pain. It found that an estimated 25.3 million adults (11.2 percent) experience chronic pain—that is, they had pain every day for the preceding 3 months. Nearly 40 million adults (17.6 percent) experience severe levels of pain. Those with severe pain are also likely to have worse health status. The analysis was funded by the National Institutes of Health’s National Center for Complementary and Integrative Health (NCCIH) and was published in The Journal of Pain.

  • An estimated 23.4 million adults (10.3 percent) experience a lot of pain.
  • An estimated 126 million adults (55.7 percent) reported some type of pain in the 3 months prior to the survey.
  • Adults in the two most severe pain groups were likely to have worse health status, use more health care, and suffer from more disability than those with less severe pain. However, approximately half of individuals with the most severe pain still rated their overall health as good or better.

Purdue Pharma

Two decades ago, Purdue Pharma produced thousands of brochures and videos that urged patients with chronic pain to ask their physicians for opioids such as OxyContin, arguing that concerns over addiction and other dangers from the drugs were overblown, company records reveal.

Purdue said it handed out thousands of copies of the brochure, which emphasized consumer power in treating pain, as well as a videotape. “The single most important thing for you to remember is that you are the authority on your pain. Nobody else feels it for you so nobody else can describe how much it hurts, or when it feels better,” the pamphlet states

We have learned the hard way that many patients develop opioid [addiction] when using these medicines as prescribed. In 1998, as Purdue hawked OxyContin for conditions such as arthritis and back pain, it decided to “increase communications” with patients, company records show.

Dr. Michael Barnett, a physician and assistant professor at the Harvard T.H. Chan School of Public Health, said that some of Purdue’s early marketing claims may have seemed reasonable to many doctors 20 years ago. But he faulted the medical profession for not demanding scientific evidence that opioids were in fact safe and prudent for widespread use.

“I think a lot of physicians are coming to the realization that a lot of what we were taught about pain management was pure conjecture,” he said. “I feel foolish for believing it.”

Addiction vs. Dependence

When people use the term “dependence,” they are usually referring to a physical dependence on a substance. Dependence is characterized by the symptoms of tolerance and withdrawal. While it is possible to have a physical dependence without being addicted, addiction is usually right around the corner.

Addiction is marked by a change in behavior caused by the biochemical changes in the brain after continued substance abuse. Substance use becomes the main priority of the addict, regardless of the harm they may cause to themselves or others. An addiction causes people to act irrationally when they don’t have the substance they are addicted to in their system.

So what happened?

1ne: Purdue failed to conduct scientific studies on opioid addiction and dependence and educate HCP’s about warning signs.

2wo: Doctors are trained to treat the condition rather than the patient leading to an increase in opioid Rx’s.

3hree: Physiicans never should have “bought in” to any sales pitch that didn’t talk about the downside of opioids.

4our: Wholesalers continued to ship massive quantities of opioids to drug stores without raising alarms because they were sales dollars.

5ive: The FDA failed to implement correction action of Purdue marketing materials. They, above all, should have known better.

6ix: Insurers should have done more to limit Rx’s for opioids.

7even: Hospitals should have limited opioid Rx’s for patients except in patients who are/were in chronic pain as verified by two physicians.

Conclusion

Yes, Purdue Pharma has to take some of the blame for the rise in opioid sales, but there should have been a system of checks and balances to ensure this didn’t happen. States all want a piece the possible lawsuit pie which could be huge. Lost in all this are the patients who really are in need of pain management and now have to jump through hoops to get medication for their pain.

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