There's only one way to end the opioid epidemic, and so far — despite all the noise around Wednesday's meeting of a White House commission on the issue — it doesn't look as if the White House wants to touch it.
You see, what was discussed by the commission isn't just a plan in its early stages; it's a clear step in the wrong direction.
In a Wednesday press briefing following a meeting of this White House commission, the White House press secretary, Sean Spicer, blamed the crisis on "cheap heroin" flooding the market, and he credited President Donald Trump with already taking action against drug cartels. He framed the battle against the epidemic as one for the Drug Enforcement Administration and law enforcement.
If that's what the White House is focused on, it has the situation all wrong.
The problem here isn't with drug cartels; the problem is big pharma and its multidecade campaign to normalize the prescription and sale of highly addictive opiate pain medication. It's usually only after prescriptions for this medication run out, or become too expensive, when addicts turn to cheap heroin.
If Trump isn't going after big business, he's not going after this problem. Period.
Since the 1990s, big pharma has paid off doctors to encourage them to write prescriptions for opioid painkillers, it has generated studies that made the effects of these drugs seem way less destructive than they are, and it has greased the wheels of the US healthcare system to make insurance payments easier to collect.
Here's an example of this behavior. Last month two Alabama doctors were found guilty of making millions by running an opioid "pill mill." They were getting patients addicted, overcharging them and their healthcare providers for treatment, and accepting payments from Insys Therapeutics, a maker of fentanyl.
Another one: In 2009, the American Geriatrics Society created guidelines recommending that doctors use opioids to treat all kinds of pain. Of the 10 experts on the panel, however, at least five had ties to big opiate producers.
You may recognize some of the names in this game, and you might not: Purdue, Janssen/Johnson & Johnson, Insys, Mylan, and Depomed, to name a few.
More companies are involved in the rise of the opiate crisis, but those five are a start. At least, they're a starting point for Sen. Claire McCaskill, the Missouri Democrat who on Tuesdayannounced an investigation into the marketing practices of companies that manufacture opioids and the drugs that are meant to treat opioid overdoses. According to the press release announcing the investigation, McCaskill requested from those five companies:
- Documents showing any internal estimates of the risk of misuse, abuse, addiction, overdose, diversion, or death arising from the use of any opioid product or any estimates of these risks produced by third-party contractors or vendors.
- Any reports generated within the last five years summarizing or concerning compliance audits of sales and marketing policies.
- Marketing and business plans, including plans for direct-to-consumer and physician marketing, developed during the last five years.
- Quotas for sales representatives dedicated to opioid products concerning the recruitment of physicians for speakers programs during the last five years.
- Contributions to a variety of third-party advocacy organizations.
- Any reports issued to government agencies during the last five years in accordance with corporate integrity agreements or other settlement agreements.
"All of this didn't happen overnight — it happened one prescription and marketing program at a time," McCaskill said in the statement. "The vast majority of the employees, executives, sales representatives, scientists, and doctors involved with this industry are good people and responsible actors, but some are not. This investigation is about finding out whether the same practices that led to this epidemic still continue today, and if decisions are being made that harm the public health."
Of course, the ways a White House policy could deflect blame for the opioid crisis away from the pharma companies have been out in the ether for a while, and no one has articulated them better than Sen. Joe Manchin of West Virginia.
Manchin, a Democrat, would have the government focus on the Food and Drug Administration's classification of opioids, maybe have the agency slow down approval for new opiates, and have a "one-penny fee on every milligram of opiates that are produced and sold in America" to be collected for treatment.
As a side note, Manchin's daughter Heather Bresch is the CEO of the drug company Mylan, one of the five companies McCaskill is going after.
Manchin also called marijuana the gateway drug to opioids.
This is a joke, and it's an insult to the people whose "gateway" to addiction was a doctor who said these medications would be safe.
Please stop joking.
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