More than 17,000 people are dying every year in the United States from opioid overdoses. Emergency room admissions for opioids other than heroin leaped from 299,000 in 2001 to 885,000 in 2011 and are still growing. Narcotics, once limited to acute pain after injury and surgery and terminal illnesses, have made a comeback for two reasons: Younger clinicians lack the addiction awareness of their older peers, and the drug industry has pushed them.
As problems with addiction and diversion of opioids (also called narcotics) surfaced in the 1960s and 1970s, regulations were put in place to restrict their use and tighten their control. But by the 1990s, the pendulum had swung back, thanks to new pills like OxyContin and the profit motive.
Soon “pill mills” and “pain clinics” proliferated dispensing opioid painkillers with few questions asked. Some had armed guards, which should have been a tip-off. The pill mills usually required no appointments, took no insurance, and gave only cursory attention to medical records and physical examinations. One Florida mill lured 12 doctors to its operation who made $37,500 a week—at $100 per prescription.
Drug companies began to pay doctors to recommend narcotics for mild conditions that once would have never warranted such extreme drugs. The pills were not only prescribed for back pain, fibromyalgia, and hip replacement, they also were prescribed for depression, divorce, and boredom.
The American Geriatrics Society changed its guidelines in 2009 to recommend opioids in place of the cheaper and nonaddictive pain drugs ibuprofen and naproxen. Half the experts on the panel who made the recommendations “had financial ties to opioid companies, as paid speakers, consultants, or advisers at the time the guidelines were issued,” reports award-winning journalist John Fauber. The University of Wisconsin’s Pain & Policy Studies Group took $2.5 million from opioid makers even as it pushed for looser use of narcotic painkillers, he reports.
A pain guide called “Finding Relief: Pain Management for Older Adults,“ endorsed by the American Geriatrics Society and funded by the drug company that makes the opioid products Duragesic, Ultram ER, and Nucynta, claimed that opioids ”allow people with chronic pain to get back to work, run, and play sports.” In truth, study after study shows patients became less active on opioids and return to work is delayed. The guide defends the safety of long-term opioid use though studies show no value in long-term opioid use, but serious harm.
Many physicians and medical groups also downplayed opioid dangers, either because of drug company marketing or because they had seen few opioid-addicted patients themselves. In either case, there was a new impression in much of the medical community that opioid drugs were somehow no longer dangerous.
Abuse of opioids has worked its way into the sports world. In 2014, the Drug Enforcement Administration (DEA) investigated opioid misuse in the National Football League after attorneys representing about 1,300 NFL retirees filed a class-action lawsuit. The suit charged that the NFL illegally provided prescription painkillers to keep players playing without disclosing long-term risks.
Some states and counties whose employees and citizens were flattened by the opioid epidemic have sued. Santa Clara County, in California, sued opioid makers Purdue Pharma, Cephalon, Janssen Pharmaceuticals, and others. “Defendants’ deceptive marketing campaign deprived California patients and their doctors of the ability to make informed medical decisions and, instead, caused important, sometimes life-or-death decisions to be made based not on science, but hype,” said a lawsuit.
One of biggest myths floated by drug companies trying to sell opioids is that they are not inherently addictive—that addiction boils down to the personality of the “person.” Tell that to the families of the 17,000 users who die a year from opioids.
Martha Rosenberg is author of the award-cited food exposé “Born With a Junk Food Deficiency.” A nationally known muckraker, she has lectured at the university and medical school level and appeared on radio and television.
