The Opioid Epidemic Part I: Financial Motives of Opioid Drug Companies

The Opioid Epidemic Part I: Financial Motives of Opioid Drug Companies

 A couple weeks ago I posted about how the opioid epidemic has personally affected me. Today I am sharing Part I of a two-part series about the opioid epidemic and its catastrophic impacts. Predatory drug companies like Purdue Pharma targeted people in pain and continue to devastate countless lives.

Prior to the 1980s multidisciplinary chronic pain treatment that included a variety of therapies was considered best practice (Bernard et al. 2018). However, insurance providers, medical providers, and patients criticized these protocols as too costly and labor-intensive (Murral et al. 2019). Seeing a moneymaking opportunity, Purdue Pharma began aggressively marketing the opioid OxyContin as a cost-saving “miracle” treatment for long-term chronic pain. 

Purdue Pharma provided outlandish bonuses to medical providers who had the highest numbers of OxyContin prescriptions (Bernard et al. 2018). Upwards of 20,000 pain education programs, such as the creation of the American Pain Society (APS) and the American Pain Foundation (APF) that received $2.5 million and $2.9 million respectively, were funded by Purdue (Lurie and Little 2021). All told, Purdue Pharma made contributions in excess of $18 million to pain groups.

In response to pressure by organizations like APS, in 2012 the Center for Medicare and Medicaid Services (CMS) began conditioning 30% of emergency department reimbursements on patient satisfaction survey outcomes, which emphasized pain management (Bernard et al. 2018). To ensure patient satisfaction and reimbursements, opioids were frequently pushed. Emergency department providers reported being punished if they did not administer opioids.

In 2016 one in three Medicare Part D (prescription coverage) beneficiaries were prescribed opioids, equal to approximately 14 million people (U.S. Government Accountability Office 2018). Over 214 million opioid prescriptions were dispensed in the U.S. in general in 2016, equal to over 65 prescriptions per 100 people (Centers for Disease Control and Prevention 2021). At its peak in 2012, over 80 opioid prescriptions per 100 people were made.

As became evident by the surge in opioid addiction in the U.S., the campaigns citing OxyContin as safe and largely non-addictive were based on erroneous and criminally exaggerated information (Bernard et al. 2018). Between 2017 and 2019, over 14,000 people died from prescription opioid overdoses (down from over 17,000 in 2017), which account for nearly 30% of an approximate total of 50,000 opioid deaths in 2019 (National Institute on Drug Abuse 2021). In 2011 the Centers for Disease Control and Prevention (CDC) declared the opioid crisis an epidemic (Centers for Disease Control and Prevention 2011); it was escalated to a National Public Health Emergency in 2017 (Assistant Secretary of Public Affairs 2021).

Additionally, data show that people from low income communities have been 63% more likely to be prescribed opioids than patients with more socioeconomic privilege who were prescribed multiple non-pharmalogical treatments (Bonakdar, Palanker, and  Sweeney 2019). Due in large part to rampant medical racism and anti-Blackness, opioid misuse and addiction have largely affected white communities. In contrast to drugs like crack cocaine that have historically been targeted at Black, Indigenous, and other people of color (BIPOC), the opioid epidemic has received much greater attention and concern.

In September 2021 Purdue Pharma was dissolved as part of a bankruptcy settlement filed in 2019 but the Sackler family, owners of Purdue Pharma, is getting off nearly scot-free (Hoffman 2021). With the exception of a $4.5 billion personal payout that amounts to pocket change for the Sackler family, they are free to proceed with their lives virtually untouched. This is despite being responsible for and profiting handsomely from knowingly destroying hundreds of thousands of lives.

For the many people with chronic pain who are not addicted but rely on opioids the nightmare of not being able to access these essential medicines is ongoing. Check back at the end of November for the second installment of this series covering how opioid prescribing restrictions are harming chronic pain endurers.

• Read “Inside Purdue Pharma’s Multimillion-Dollar Payouts to Politicians and Pill-Pushers” for a detailed breakdown of the over $115 million Purdue Pharma donated to organizations in the interest of increasing OxyContin distribution and profitability.

Other posts you might like:

• Remembering my Aunt Marcy (cw: death, opioid addiction)

• How Health Insurers Hurt People in Pain Part I: Benefit Restrictions

• How Health Insurers Hurt People in Pain Part II: Financial Gain Over Patient Wellbeing

• How Health Insurers Hurt People in Pain Part III: The For-Profit Insurance Takeover

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Sources

Assistant Secretary of Public Affairs (ASPA). “What Is the U.S. Opioid Epidemic?” HHS.gov. https://plus.google.com/+HHS, February 19, 2021. https://www.hhs.gov/opioids/about-the-epidemic/index.html.

Bernard, Stephen A, Paul R Chelminski, Timothy J Ives, and Shabbar I Ranapurwala. “Management of Pain in the United States—A Brief History and Implications for the Opioid Epidemic.” Health Services Insights 11 (2018): 117863291881944. https://doi.org/10.1177/1178632918819440.

Bonakdar, Robert, Dania Palanker, and Megan M Sweeney. “Analysis of State Insurance Coverage for Nonpharmacologic Treatment of Low Back Pain as Recommended by the American College of Physicians Guidelines.” Global advances in health and medicine. SAGE Publications, July 29, 2019.

Centers for Disease Control and Prevention. (2021, November 10). U.S. opioid dispensing rate maps. Retrieved November 19, 2021, from https://www.cdc.gov/drugoverdose/rxrate-maps/index.html

Hoffman, J. (2021, September 01). Purdue Pharma is dissolved and Sacklers pay $4.5 billion to settle opioid claims. Retrieved November 21, 2021, from https://www.nytimes.com/2021/09/01/health/purdue-sacklers-opioids-settlement.html

Lurie, J., & Little, R. (2021, October 8). Inside Purdue Pharma’s Multimillion-Dollar Payouts to Politicians and Pill-Pushers. Retrieved November 19, 2021, from https://www.motherjones.com/crime-justice/2021/10/how-purdue-pharma-paid-out-to-politicians-and-pill-pushers/

Murray, Matthew, Alexander Stone, Virginia Pearson, and Glenn Treisman. “Clinical Solutions to Chronic Pain and the Opiate Epidemic.” Preventive Medicine 118 (2019): 171–75. https://doi.org/10.1016/j.ypmed.2018.10.004.

National Institute on Drug Abuse. “Overdose Death Rates.” National Institute on Drug Abuse, February 25, 2021. https://www.drugabuse.gov/drug-topics/trends-statistics/overdose-death-rates.

Centers for Disease Control and Prevention. “Prescription Painkiller Overdoses at Epidemic Levels.” November 1, 2011. https://www.cdc.gov/media/releases/2011/p1101_flu_pain_killer_overdose.html.

U.S. Government Accountability Office. Prescription Opioids: Medicare Needs to Expand Oversight Efforts to Reduce the Risk of Harm, May 17, 2018. https://www.gao.gov/products/gao-18-15.