Dr. Strangedrug or: How I Learned to Stop Worrying and Love Big PhARMA

I watched the Super Bowl with my father, and as a cord-cutting member of the millenial generation I will admit that the most expensive ad buys of the year are a guilty pleasure. My fave was definitey Mt. Dew Kickstart’s “Puppy Monkey Baby”. Great dose of weirdness for a product I will never buy.

The real shocker though was an ad for a new drug, taking care of a problem one would like to think only a small, small minority of Americans face. Surely the market of people suffering from Opioid-Induced Constipation is not so great as to justify a multi-million dollar Super Bowl ad buy…. but apparently it is.

According to CNN there were 259 million prescriptions for opiates in 2012. Percocet, Vicodin, and the big daddy of them all OxyContin. The U.S. Pain Foundation says 1 in 3 Americans are in pain. If the market keeps growing the way AstraZeneca thinks, there will be 10 times more people who are suffering from OIC in 2019 than there are today.

The reaction to the ad was swift. Federal, state and local law enforcement took to Twitter to voice their disgust. Gov. Shumlin weighed in saying,

“The irrational exuberance with which opiates are handed out in America is driving the addiction crisis in this country…Now is the time to change that, not attempt to further normalize long-term opiate use by advertising a drug to help people take even more opiates during the most watched sporting event of the year.”

There is a huge disconnect between the public health crisis of opiate addiction and the pharmaceutical and healthcare industries promotion of these drugs. The fact that these drugs relieve terrible pain in a powerful, some would say “miraculous” way isn’t a justification for their liberal over-prescription.

My high school friend died from a heroin overdose, and got started by using pills like OxyContin. Another friend found his teenage son dead. These deaths are preventable. We could decide to treat these drugs with greater care. Limit their availability to those who are severe pain for whom non-opioid pain relief isn’t enough. That is not what we do. Opiates are the go to for post-operative pain management and chronic pain management.

I once went to the doctor with a friend who had a severe sore throat that wouldn’t go away. She walked out of a short visit with a big bottle of Hydrocodone. It was like prescribing a bazooka when a BB gun would do. She ended up just taking some Tylenol and resting up for a couple of days.Is the elimination of pain really a healthy goal for a society when the side-effect is the death of our children? Why are we doing this?

The answer is so obvious and so banal, it’s become cliche: PROFITS. Last year Forbes did a profile of the Sackler family and their $14 Billion net worth. It’s a sickening read. It describes the way in which the Sackler’s company, Purdue Pharma took generic Oxycodone, added a time-release mechanism to “prevent abuse” and expanded the market far beyond the cancer patients that a powerful opiate like this was originally prescribed to treat.

“Someone looking for a fix could just crush the pills to break the time-release mechanism, then snort the powder for a heroin-like high. Addiction, overdoses and accidental deaths followed, and Purdue Pharma found itself facing charges that it had misbranded OxyContin as far less risky than it was.”

They ended up paying $635 million in fines in 2007. I bet they still crack jokes at parties about the tiny percentage of their billions this amounts to. I wonder how many people they know are hiding their opiate addiction from their families, switching to heroin when they can no longer afford the pills and dying as a result of the Sacklers’ greed.

Yesterday I attended a “Congress in your Community” event with Rep. Peter Welch. Former State Senator Sara Kittell talked about the need for more support for treatment and recovery programs. We discussed the success of some local law enforcement efforts. Everyone looked at me like I had two heads when I brought up the idea of limiting the amount of prescriptions being written for these drugs. Before you work on the symptoms of blood loss from a patient, don’t you staunch the bleeding?

Local politicians pay a lot of lip service to this issue, but they haven’t been willing to demand that we do healthcare differently or put up the resources for access to treatment and recovery programs. We have got to have a shift in policy at the federal level, no doubt. However, we could do some things at the state level that would make prescription opiates less available. This requires challenging the pharmaceutical and  healthcare industry and our culture’s obsession with pain.

In a way I wonder if we’re all addicted to opiates. I’m not willing to watch people in my life become addicted to opiates and die from them and then pretend that there’s nothing we can do to prevent more deaths. We know what we have to do, but I fear we don’t have the will to do it. The fact that it has become acceptable to promote the sale of a drug to treat a side-effect from opiate use during the most-watched sporting event of the year should be evidence enough that we have a huge problem.

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