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A Man-Made Plague

Opinion: How opioid drugmakers created the perfect ecosystem of misinformation to create the war against opioids.

It is a calculated epidemic that has slowly tightened its grip on our nation. 

Each city, county, tribe, individual and hospital that have filed to join the multi-district litigation and state lawsuits against drugmakers has a unique story of hurt.   

The statistics are staggering, and far too many people can relate. 

Unintentional overdose deaths from opioid pain relievers has quadrupled since 1999, and millions of Americans continue to initiate non-medical prescription opioid use every day. 

The opioid crisis has transformed into a frightening fiasco at the forefront of our nation. 

Each entity involved has a familiar article in their local newspaper: “How One Small Town is Facing the Opioid Crisis”. 

The articles discuss combatting the epidemic, and being a small piece of the recovery puzzle—doing what a small town can to change the stigma and protect their communities. 

However, we must stop to think: how did so many communities get caught in a war that they did not voluntarily join? Trying to combat an epidemic that has not released its grip on communities for decades is not an easy fight, but people across the nation are not giving up. 

This war has been carried on for far too long, and there have already been far too many casualties. 

The opioid epidemic is, in essence, a man-made plague created by the perfect ecosystem of misinformation. 

It is now coming to light just who created this plague, and exactly how they did it.

Manufacturers, distributors, retailers, and some complicit physicians all played a part in creating the opioid crisis, sparking the national emergency that we see played out today. 

It was a covert mission hidden in the shadows, not seen by the public eye until it was too late. 

Many key opioid drugmakers worked together to create this perfect ecosystem of misinformation to shelter their cause and allow their products to flourish while watching humanity die off in the process. 

However, this was not natural selection or survival of the fittest—this was a man-made plague that wiped out a staggering number of Americans.

This plague was a calculated marketing scheme that told the public time and time again through scientific articles and trusted physicians that opioids were not addictive, and anyone who believed they were was simply incorrect. 

The bottom line of it all is deceptively simple.

  • Due to the drugmakers’ fraudulent marketing to doctors and the American public, innocent patients who had to take opioids for the pain from their injuries were overprescribed opioids.
  • The dosages prescribed did not last the full time length as advertised, and subsequently, individuals were prescribed more opioids and became addicted.
  • When people became addicted, drugmakers told doctors this was simply “pseudo-addiction”, that the patients again needed more opioids, and that doctors could increase dosage without risks for long-term use, creating more addiction.
  • All the while, the opioid drugmakers claimed alternative forms of pain relief posed greater risks than opioids, creating a monopoly of pain relief for their market. 

Like soldiers in a draft, the unsuspecting patients became addicts, plucked from their homes, jobs and families—the opioid drugmakers consuming them as yet another to fall victim to their war tactics. Many were wounded and many have overdosed on the battlefield that branches across the United States. 

People may ask how long American citizens have been combatting this man-made plague in the “War Against Opioids”, and it goes much farther back than individuals may perceive. 

The enemies’ presence in American culture was elevated back in the 1960’s when Arthur Sackler hatched a marketing scheme to sell Valium for a condition of his creation, “psychic tension”, which was essentially stress and anxiety.

Valium had virtually the same effect as another competing product on the market. Sackler simply represented his product in a different way to create a different public perception and unique need for Valium. The scheme was so popular that the drug became known as “mother’s little helper”. This successful marketing campaign was the grandfather of future opioid campaigns that would set the stage for the war that is currently raging in our nation today. 

However, there was more to these marketing schemes than simple catchphrases and uniquely crafted conditions. Sackler and his company, the Purdue Frederick Company, integrated advertising and medicine to create a newspaper and physician monitoring database.

Sackler created a biweekly newspaper called the Medical Tribune, which was distributed at no cost to doctors nationwide. This free newspaper promoted their products to doctors and patients directly, streamlining the advertisement process.  

Sackler also created IMS Health Holdings (now IQVIA), which works to monitor prescribing practices of every doctor in the U.S. and sells the data to allow pharmaceutical companies to target their sales pitches to individual physicians. They utilized this database to sell more opioids to the doctors statistically willing to prescribe them.

Key opinion leaders (KOL’s) in the medical community, paid off by pharmaceutical companies, wrote articles in journals sponsored by those same companies. 

This marketing scheme of misrepresentation became the core war tactics of future opioid campaigns that carried on throughout the decades to present day in our nation. 

Drugmakers claimed in marketing materials that patients prescribed opioids by a doctor would not get addicted, and their symptoms of addiction were only a “pseudo-addiction” due to inadequate pain management, requiring more opioids. Dr. Webster, a leading doctor in opioid research, said “pseudo-addiction is something debunked as a concept, and that led us down a path to harm as an excuse to give patients more medication.” 

The drugmakers also promoted the idea that only pre-existing drug addicts without a prescription could truly get addicted. To further their agenda, the companies gave doctors predictive tests to screen if their patients had addictive personalities before giving them drugs. This was done with no reliable scientific evidence that these predictive tests would materially limit the risk of addiction. 

This scheme was successful, and due to the many moving parts of this game that the companies have been—and are still—playing with the American public, tens of thousands die of overdose deaths each year. The death tolls continue to rise, casualties ever increasing.

However, that does not concern the opioid drugmakers, for their plan has worked to perfection: another successful scheme to worsen the outbreak of their man-made plague. 

The opioid drugmakers have even still continued to profit off of the opioid crisis, selling new formulations of opioids to deter abuse, but in fact increasing abuse more than ever.

Statistics show numbers have spiked after opioid drugmakers released abuse deterrent formulations, such as Opana ER which actually increased abuse by injection by almost 500%. 

Physicians have suggested that the long-term use of opioids was a de-facto experiment on the population of the United States. Many have explained that it wasn’t randomized, it wasn’t controlled, and no data was collected until they started gathering death statistics.

The opioid drugmakers have already won a series of battles in this war against opioids. 

There has been a different battle almost every decade, and even though sometimes the opioid drugmakers have been punished for their actions, they have not seemed to have learned their lesson. 

A timeline of just one opioid drugmakers’ battle plan: 

In the 1990’s: 

Mislead: In 1996, OxyContin, a drug of pure oxycodone, was launched, ushering in the modern opioid epidemic—the beginning of the war. The company utilized the American public’s confusion between codeine, a less powerful drug, and oxycodone, a more addictive substance, to market the drug with a low risk of abuse, with chance of addiction as less than 1%. 

In the 2000’s: 

Refocus: In 2001, in front of the House of Representatives, Purdue dismissed cases of overdose and death as something that would not befall legitimate patients, and claimed the negative statistics were from people abusing the medication, not under treatment of a healthcare professional. The company sales reps were told to refocus doctor’s fears, that legitimate pain patients would not get addicted, leaving doctors with false impressions about opioids.

Evade: In 2007, Purdue acknowledged using the misconceptions of Oxycodone to their advantage, and pled guilty to misbranding. After the guilty plea, Purdue continues to increase their sales 4-fold by evading responsibility and selling opioids through the controversy.

In the 2010’s: 

Remarket: In 2017, The Sacklers and Purdue moved to push opioids in other countries in new markets under the name of Mundipharma.

These decades of misinformation telling doctors and the public that opioids were rarely addictive were all a scheme to widen the market for opioids. 

Just last year, in 2018, the opioid epidemic was made a public health emergency. 

In the current year of 2019, the time has come to take the opioid drugmakers to the greatest battle of all: a legal battle to take place in the courtroom on state and national levels. 

There are a few key trials to watch: 

National Prescription Opiate Litigation: The national multi-district litigation trials bellwether case is set to begin next week on Monday October 21st, with well over 2000 soldiers marching behind it, representing countless cities, counties, hospitals, and individuals that have experienced casualties because of this war. 

There are countless governmental and sovereign entities involved in the legal battles that are or will be occurring within the next two years, where it seems almost no place has been unaffected by the opioid epidemic. 

Some are comparing the opioid crisis to the tobacco trials from the 90’s, and time will show if drugmakers will settle, and wave the white flag, or go to the final battle at trial. 

While this war is being fought, there are more casualties every day on the home front, residual from the carnage caused by the opioid drugmakers’ schemes. 

Time will tell how the war ends, but what concerned Americans can and should do is stay informed and educate themselves on the reality of the War Against Opioids. 

To stay informed on the war effort, visit News.Law for your daily opioid updates on national and state cases. 

Sources:

Barry Meier, Pain Killer: A “Wonder” Drug’s Trail of Addiction and Death, 204, at 201-303 (Rodale 2003)

CDC

David E. Weissman & J. David Haddox, Opioid Pseudoaddiction – An Iatrogenic Syndrome, 36(3) Pain 363-66 (Mar. 1989), https://www.ncbi.nlm.nih.gov/pubmed/2710565. (“Iatrogenic” describes a condition induced by medical treatment.)

Drug Abuse (Overdose Death Rates)

NCBI

Nevada Amended Complaint

Ohio Courts

Pew Trusts 

Theresa Cassidy, The Changing Abuse Ecology: Implications for Evaluating the Abuse Pattern of Extended-Release Oxymorphone and Abuse-Deterrent Opioid Formulations, Pain Week Abstract 2014, https://www.painweek.org/assets/documents/general/724- painweek2014acceptedabstracts.pdf.

White House

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