It’s no secret that America is in the midst of the worst opioid addiction crisis in history. For the past twenty years, the epidemic has gained steam as it aggressively has progressed, peaking within the last decade. Much speculation has circulated in regards to the catalyst of the epidemic, with the general consensus landing on big pharma as the culprits. Senator McCaskill, the Democratic senator from Missouri, also shares the same suspicion. As the opioid addiction crisis continues to ravage the country this year, McCaskill has begun addressing the issue in her own way. She seeks to uncover the truth behind the epidemic in hopes that by discovering the means by which these drugs are falling into the wrong hands, it can be stopped.
Origins of Opioids
The opioid addiction crisis as mentioned above began about twenty years ago. Opioids are a class of drug that possesses pain-relieving abilities, but also present a high propensity for addiction and abuse. They present long-term health effects on both mind and body. Some examples of prescription grade opioids would be Oxycontin, Vicodin, and Morphine. These drugs are closely related to the illicit drug heroin, in both their effects on the user and side effects.
In the 1990’s, opioids came to the forefront of big pharma’s marketing strategies. In an effort to saturate the prescription market with their product, Oxycontin, Purdue Pharma created the marketing campaign that would forever change the world. Oxycontin was marketed as a “non-addictive drug” for treating chronic pain or any type of pain symptoms. Doctors immediately began prescribing the drug in droves, touting its safety to patients who were unknowingly ingesting a highly addictive opioid.
Thus, began the opioid addiction crisis. Millions of people were being exposed to the highly addictive drug, ignorant to its propensity for dependency and unaware of what they were doing to their bodies. Over time, millions began developing opioid addictions. Eventually, the issue was “addressed” and the company was fined $635 million dollars for false advertising penalties, which paled in comparison to the multiple billion dollars grossed in sales and production.
A Generation Hooked
Although it became public knowledge that no opioid was necessarily “safe” and “non-addictive”, for many it was too late. Those unlucky enough to become dependent upon the medication were stuck. They would either have to undergo an extremely uncomfortable withdrawal and detox process or continue on using the medication. Stuck between a rock and a hard place, many took the easier route and continued using the drugs.
Over time, regulations regarding the prescribing practices for these medications have gotten stricter, and the prescriptions themselves have gotten more expensive. As a result, many addicts were forced to turn to the street drug alternative, heroin, for both its cost-effectiveness and accessibility.
The opioid addiction crisis has skyrocketed in the numbers of overdose deaths and those addicted, especially in the last few years. The death figures represent a larger portion of Americans than the Vietnam War in its entirety. What’s even more disconcerting is the number of prescription opioids finding their way onto the black market and into the hands of addicts around the nation. The reason why and how is what Senator McCaskill is trying uncover.
McCaskill and Big Pharma: Round 1
Senator Claire McCaskill is no stranger to taking on big pharma and questioning the ethics involved in their practices in response to the opioid addiction crisis. Earlier this year, she went to bat for the nation by initiating a congressional investigation into the top five pharmaceutical companies in opioid production: Purdue, Johnson & Johnson, Insys, Mylan, and Depomed.
McCaskill believes that these companies intentionally marketed their product irresponsibly, putting quotas on the number of opioid prescriptions to be filled. She believes these companies pressured doctors and pharmacies to dole out the medications, even in situations that did not necessarily call for the pills.
Letters were sent back in March in regards to their practices. In the letters, McCaskill questioned the companies about their sales, marketing, and educational strategies for the past five years. She asked for access to the internal estimates of the risk of misuse, addiction, abuse, diversion, or death arising from the use of any opioid product. She also requested the estimates of these risks produced by third-party contractors of vendors.
McCaskill is in search of answers regarding whether these companies are in fact culpable for using unethical marketing tactics and causing the opioid addiction crisis. She also was curious to understand why the DEA, Drug Enforcement Administration, stopped their investigation into these companies for potentially violating laws designed to prevent pain pills from reaching the black market and subsequent hands of addicts around the country.
McCaskill and Big Pharma: Round 2
Almost five months later, the investigation continues. McCaskill still questions the actions taken by these companies in preventing these medications from entering the black market. The companies have not responded to requests for comment, however, McCaskill has received tens of thousands of documents from the companies.
Last week, the senator has expanded her reach into the investigation even further by sending letters to even more pharmaceutical companies: Mallinckrodt PLC, Endo International PLC, Teva Pharmaceutical Ltd., and Allergan PLC. Letters were also sent to the distributors McKesson Corp., Amerisource Bergen Corp., and Cardinal Health Inc. McCaskill has asked these companies to describe their monitoring programs for suspicious opioid orders and to detail any suspicious orders reported to the DEA.
McCaskill seeks to understand how hundreds of millions of opioid painkillers found their way into the black market, exacerbating the opioid addiction crisis in America. She wants these companies to be held accountable for turning a blind eye to practices resulting in their product finding its way into the wrong hands.
The War Wages On
Despite the noble efforts of the senator, as well as efforts of others around the country, the opioid addiction crisis continues to spiral out of control. While the senator waits for responses from big pharma and the DEA, millions of lives are being destroyed and lost in the wake of this epidemic. The country currently spends over $78.5 billion a year dealing with opioid addiction-related matters.
Hopefully, in the coming months, Senator McCaskill will find the information she’s looking for and be able to hold the correct people accountable for their actions. In the interim, we must remain resilient fighting in the trenches. The war is not over; there is still time to turn this epidemic around.
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