How drug companies helped drive the opioid crisis

The abuse of opioids has become a major public health concern; more than 28,000 people died by overdose in 2014. According to reporting by STAT News, drug companies downplayed the addictive effects of opioid drugs in the late 1990s, assuring doctors that they could be safely used for chronic pain and incentivised their use. Hari Sreenivasan talks to journalist David Armstrong.

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    The abuse of opioids remains a major public health concern around the country.

    The federal government says more than 28,000 people died by overdose in 2014. That's the most recent year for nationwide data. The health news site STAT has been reporting on the problem and what has been driving it.

    Journalist David Armstrong sat down with Hari Sreenivasan recently.


    David, your investigation looks at a number of big pharmaceutical countries that you say helped sow the seeds for some of this epidemic that we have today. How so?


    Well, the way they sowed the seeds was by making this drug widely used.

    And the way they did that was to downplay the addictive properties of this drug when marketing it to doctors, in a way that was later shown to be false and misleading.


    Now, doctors can prescribe drugs off-label for something that it wasn't originally designed to, but how were the pharma companies abusing this?


    Well, they were primarily abusing it in the way they were assuring doctors that these powerful opioids that are a controlled substance would not be addictive in the way that they later proved to be addictive and could be used for things like chronic pain, which we now know they're not very effective at.

    So they were able to broaden the market through a series of misrepresentations and through a series of aggressive marketing tactics.


    How much money are we talking about? What did they stand to gain?


    Well, let's just look at OxyContin.

    When that came on the market in 1996, sales of the drug were about $50 million. By 2002, sales of this drug were $1.6 billion, and they have continued at that clip ever since, exceeding well over $30 billion in sales. That's just one drug. So that gives you an idea of the scale here of the amount of money involved.


    You were also able to take a look at documents through Freedom of Information Act requests that were sealed that show how these drugs were being marketed. Explain that.



    So, one of the interesting things is, in the case of OxyContin, Purdue Pharma, which manufactures the drug, and its partner in marketing at Abbott Laboratories, they were sued over 1,000 times collectively for problems related to this drug.

    But in a lot of those cases, in fact, the vast majority of them, the documents involved in those cases were either destroyed or sealed. So we have been trying to unseal some of those in several jurisdictions, and we have been successful.

    So, in West Virginia, for instance, we saw some of the tactics that Abbott used. They did things like a dine-and-dash program. This is where they would meet a doctor at a restaurant, pay for his takeout order, and while waiting to pay for the order, sell him on the benefits of OxyContin.

    And then we wrote about a doctor, a surgeon who had a sweet tooth, a fondness for junk food. And these salespeople brought him a sheet cake filled with donuts and snack cakes spelled out to say OxyContin. And that did the trick. He was interested in hearing more about the drug at that point, and they would go back every week and get him to switch patients over to OxyContin. Those are just a few of the things.


    And the sales reps were rewarded for these tactics?


    Very generously. They were rewarded with luxury trips. There were $20,000 scratch tickets that were sent out to them as rewards.

    So the compensation was very lucrative to get these doctors to switch patients to these powerful opioids.


    There are people who do need significant pain medications. I mean, they're the ones who kind of get the short end of the stick as this abuse happens.

    What's the government's role in oversight of this?


    Well, you're now seeing, because we're dealing with a public health crisis — we have tens of thousands of people dying each year now from these overdoses.

    You're seeing governments, state governments in particular, move to restrict the prescription, primarily in making sure that prescriptions are a limited number of days. Before, they would be 30, 60 days, and there would be plenty of pills left over. And those would get misused. So that's one way, and also educating prescribers.

    Nobody wants to see a prohibition of painkillers for people who need them, but one of the keys is to make sure doctors are educated in who truly need them and they are prescribing the right amount and the right drug.


    All right, David Armstrong of STAT joining us from Boston, thanks so much.


    Thank you.

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