Purdue Pharma’s OxyContin: Corporate Fraud With a Body Count

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Yves here. Some of the facts in this article are stunning. For instance, more Americans die from opoid overdose than from car accidents. And this article gives only a partial tally of Purdue Pharma’s predatory conduct. The drugmaker targeted overly-busy, not very well trained general practitioners in communities which were likely to have high incidence of pain (think communities with a lot of jobs that involved manual labor). In other words, it’s no accident that OxyContin has become a plague in rural America.

By Kathleen Frydl, an historian studying US state power, policies, and the institutions that shape American life. Originally published at Huffington Post

The LA Times investigation of Purdue Pharma’s manufacture and marketing of the narcotic painkiller OxyContin published last week should be regarded as a standard case study in corporate fraud.

Except this particular tale also features a body count.

This fact does nothing to call into question the validity of corporate fraud framework for understanding the story of OxyContin; it only makes its principal victims more visible, and the misbehavior in question more abhorrent, than is typical for the genre.

All the major features of Purdue’s handling of OxyContin conform to similar acts of corporate fraud perpetrated in recent years: it encompasses not only what the company did (lie to generate profit), but what government regulatory agencies failed to do (detect and expose those lies), as well as the absence of any serious legal or other penalties imposed on Purdue Pharma as a result (a $634.5 million fine on a drug that has earned it $31 billion in revenue, or 2 percent of earnings).

Still the story is peculiar in some key respects. Many times corporate fraud originates in some fairly innocent business model. Not so with OxyContin, a dubious affair from the start. As the LA Times investigation shows, Purdue formulated the drug because a patent on another its painkillers was set to expire. Anticipating competition from generic brands—and a subsequent loss of revenue—the company pursued an innovation that would render a narcotic painkiller eligible for a new patent, and consequently insulate it from competition. Purdue scientists pioneered a slow-release methodology designed to release a drug into a person’s system incrementally instead of all at once.

The problem was, although the innovation was real, the claims made on its behalf did not materialize for many of the drug’s users. In early drug trials, OxyContin failed to ensure twelve hours of pain relief in a substantial number of patients. But without twelve hour scheduling, the drug represented no genuine innovation, and no comparative advantage, when compared to other less expensive, long-lasting drugs.

So Purdue Pharma chose to simply ignore inconvenient data, and the Food and Drug Administration (FDA) chose to let them. They could not alter the facts, but they could try to avoid them. Nevertheless, as the saying goes, facts are stubborn things. One study conducted in 2002, seven years after Purdue secured application approval for OxyContin from the FDA, found that almost 87% of people taking the drug were taking it more frequently than every 12 hours. In drug trials and in subsequent clinical use, patients told their physicians that OxyContin wore off after five to eight hours, subjecting them not just to bouts of pain but narcotic withdrawal. Unwilling to forfeit the feature deemed necessary to persuading insurance companies to continue to reimburse for the high cost of the drug, Purdue formulated a disturbing response. According documents revealed by theLA Times, the company instructed doctors “to prescribe stronger doses, not more frequent ones, when patients complain that OxyContin doesn’t last 12 hours.” As the reporters note in a measured tone, this approach “creates risks of its own.”

More accurate would be the assessment of Professor Egilman, a family health doctor who has served as expert witness in lawsuits filed against Purdue: the 12 hour dosing schedule, he told the Times, is “an addiction producing machine.” Higher doses only compounded the withdrawal problems patients encountered. Periodically plunged into a ravine of agony, patients were subsequently guided to jump off a higher cliff. To this day, the FDA has not asked Purdue to change its recommendations regarding higher dosing, despite the fact that a recent examination of medical records in Ontario, Canada concluded that one in 32 patients on high doses of the drug fatally overdosed.

Added to this disgrace is the way in which Purdue presented OxyContin as less addictive than its peer narcotics, and therefore a candidate for use in settings previously not treated with opioids. Just like a mortgage securitization machine that eventually resulted in mortgages for homeowners who did not qualify for them, Purdue Pharma recommended OxyContin be prescribed to patients and for durations unprecedented in modern medical practice. The LA Times makes the key point: other drug companies quickly followed suit. Since the approval of OxyContin in 1995, the United States has been overdosed with prescription narcotic painkillers—with only 5% of the world’s population, the US consumes 80% of its painkillers—and spiraling rates of addiction, suicide and deaths from overdose are the inevitable result. Only recently, in the face of complete and ongoing regulatory failure by the FDA, the Center for Disease Control stepped in to provide new recommendations for the protocols on prescribing narcotic painkillers. The dire circumstances of the opioid epidemic would seem to dictate more rigorous action, but a political establishment under the sway of large corporate donors has yet to summon the will.

Another recurring feature of corporate fraud makes an appearance in the OxyContin saga as well: the revolving door between government and industry. In an age of at least ostensible government regulation, no truly massive corporate fraud scheme can be perpetrated without government complicity, discernable as either a bewildering set of decisions or inexplicable complacency. At critical moments, sometimes nothing more than venal self-interest is in play. In the case of OxyContin, Dr. Curtis Wright, charged with medical review of the drug for the FDA, left the agency shortly after he approved the drug. According to the Times, Wright was working at Purdue on new product development within two years of his departure. In the absence of confession or other material evidence of motive, these sorts of career moves are more than merely suggestive; they are, in and of themselves, suspicious.

For all its similarities to other kinds of corporate malfeasance, the shadow of death cast by OxyContin, which, according to federal government surveys, has been abused by more than 7 million Americans over the past 20 years, places Purdue Pharma in exceptional standing among other serial offenders of corporate America.

That’s not just because of the incalculable harm that resulted from its actions. After all, other comparable incidents of fraud inflicted grievous personal damage as well—though the news media makes no serious or consistent attempt to measure or take account of this trauma. In the case of opioid overdoses, they sometimes have to. While newspapers decide what to print in their articles, they cannot tell people what to write in their death announcements.

Not surprisingly, thousands of obituaries submitted to commemorate the victims of opioid overdose omit any mention of a cause of death or addiction. Still, it’s undeniable that a growing number of families and loved ones opt to reveal both, often in unvarnished terms. As families refuse speak euphemistically or elliptically about the opioid use in their death announcements, an organic movement of “obit activism” is underway across America. Deprived of a voice on the front page, victims’ advocates find one in the few remaining media platforms available to them and under their control.

And it is agonizing to read what they have to say. The mother of Kelsey Endicott reminds us that it is “not true that everything happens for a reason;” her daughter’s death from overdose only weeks ago had “no possible reason to justify for the loss.” Another family chronicles a life of homelessness and injuries as the result of the untreated mental illness and substance dependence of Jaime Noelle Velarde, who died, in their words, “in a dry tent curled up in a warm sleeping bag.” The obituary for Alex Michael Hesse strikes a familiar note in the world of obit activism: “Growing up [Alex] was just like any other young man,” his family says, but “he made some mistakes that ended up costing him his life.” In his obituary, Sean Stem‘s family urged communities to “tear down whatever obstacles” exist in the way of treatment. “We have learned the hard way that no amount of love can cure this illness” of opiate addiction, his family acknowledged, in a confession that implicates us all.

In explaining their decision to declaim heroin overdose as cause of death in their daughter’s obituary, Alison Shuemake’s parents told USA Today that “Shame doesn’t matter now.” A Massachusetts father agreed, asking his local news station, “If parents are too afraid to put it in an obituary, how is the rest of the world going to see it?” Only days ago Molly Parks’ parents reached the same conclusion. “I see a lot of obituaries from families losing 20-somethings, 30-somethings, and 40-somethings and they are all saying they died suddenly,” her father said. “But that’s not the truth.”

In the United States, fatal overdose from opioids exceeded deaths from car accidents in 2014; it is the leading cause of acute preventable death in America. A non-trivial number of these deaths come at the hands of illicit heroin, not OxyContin or other prescription opioid. However, many of these victims found their way to an underground painkiller because of their initial use of a prescribed one. As government officials point out, almost half of all young people using heroin today “reported abusing prescription opioids” before they turned to the cheaper illegal street version of the drug.

And in fact, most overdoses do come at the hands of legal substances: “unintentional poisoning deaths” from prescription opioids quadrupled between 1999 and 2010, outnumbering deaths from heroin and cocaine combined.

Too often the call to deliver meaningful justice for corporate fraud is cast as a jeremiad, a retroactive bid to underscore our resentment. The case of Purdue Pharma, which admitted no wrongdoing in its financial settlement with the Department of Justice and was not forced to change the way it instructed physicians and dentists to prescribe OxyContin, shows us that justice has prospective, even preventive, components. Unless forced to change cost to benefit analysis, corporations will continue to defraud and endanger the American people. A metaphorical back page, community-driven “obituary section” exists for every meek corporate fraud settlement; in the case of Purdue Pharma, it happens to be real.

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  1. allan

    As with the banks, Purdue and its founders, the Sackler brothers, buy the approval of the elites and media acquiescence by generously funding philanthropic causes. It’s almost impossible to travel to a major Western city that doesn’t have the name Sackler on one or more wonderful cultural or scientific institutions – the Sackler Museum next to the Smithsonian on the Mall, the Sackler Faculty of Medicine at Tel-Aviv University, the Sackler Wing at the National Portrait Gallery in London, etc., etc.

    Behind every great fortune there is a crime. —Balzac

  2. Nick

    Infuriating and informative. I’m glad to see “obit activism” gaining momentum, but it would also be helpful with a chart of all of the political contributions made by Purdue and a complete list of revolving door employees like Curtis Wright. Transparency, which is often already available albeit buried in obscure places, and shaming, when properly wielded, can be extremely effective in cracking the armor of predatory drug lords like Purdue.

    Tony Montana would have been in awe of these guys.

  3. Wade Riddick

    As slavery was outlawed, British merchant vessels switched from slave trade to sugar then to opium. All three involve a loss of individual autonomy and free will – the first through political institutions and the other two through chemical compulsions we would call drug addiction today. Both sugar and opium are habit-forming through the same dopamine pathways.

    The pattern is the same – an attempt to usurp rational, free market democracy by undermining the very basis of free will needed to participate in it. By depriving the customer of full information about his choices and introducing an element of compulsion in the user, the supplier attempts to recreate old models of feudal dependency by turning the logic of the market against itself. When an addicted user returns for a hit, the new feudal lord simply claims he’s meeting market demand. For those libertarians who don’t understand this, there can never be any rational free market in addictive goods whose proper use robs you of that very rationality you need to participate in such a market. It’s by definition impossible.

    Which brings us to the rent-seeking sociopaths of today.

    Does anyone think it’s a coincidence that British soldiers went off to fight the opium wars and came back addicts and now our soldiers are going off to fight in the fields of Afghanistan and coming back with the same addictions?

    There are a dozen different approaches you can take to chronic neuropathic pain and for most sensible physicians opiates would be the absolute last yet somehow these injured vets are getting fistfuls of Oxy the minute they’re diagnosed. (Can we also talk about how their “Go” pills (e.g., legal meth) stokes the sympathetic nervous systems and makes PTSD more likely?)

    I was on Vioxx and I got lucky in a way when I saw how many people died from taking it. They falsified the clinical trials data on Vioxx and simply deleted the deaths it caused. 30-50,000 people a year died taking it for a total of more than a hundred times the number killed on 9/11 in the World Trade Center attack. When no one went to prison or died in a drone strike, I concluded corporate communist America could advertise any deadly poison to me, kill me and never suffer any punishment for it. I decided I would never go on another advertised drug and I’ve pretty much stuck to that promise (and saved a great deal of money).

    It was a sane instinct that kept me alive – and I thank my training in political economy, because guess what happened next. If you’ve got chronic pain, the other two main sources of traditional prescription relief today are Gabapentin and Lyrica – both of which come from companies criminally convicted for they way they marketed them. Welcome to corporate communist paradise. Enjoy your freedom and pick your favorite criminal drug syndicate.

    Having already been poisoned by dental mercury when the Vioxx controversy hit, I didn’t need to be hit in the head again to sense a pattern. I searched Pubmed for two years trying to find a better solution based on cheaper, safer, generic chemicals. I combined low-dose naltrexone (effective by itself for back pain), methyl-cobalamin shots, leucovorin and other methylators along with vitamin D3, magnesium, physical therapy and DMSO. It’s a bit messy but at least I don’t do business with organized crime.

    The FDA and the price-fixing cartel known as the Pharmacy Benefit Managers/Purchasing Managers Organizations are hard at work trying to remove these cheap generics from the market. These chemicals are in the public domain, which means nobody patents them and nobody has monopoly rights on them. The same way public goods are getting destroyed everywhere else by the rent-seekers, it’s happening with generic cancer drugs, pain management chemicals and a million other medications to which healthy people never pay attention until it’s too late. Oncologists think hundreds of people a year have been dying because of these engineered shortages that don’t happen anywhere else.

    And yet in this environment of epic shortages, the FDA has been attacking the sole remaining independent direct connection to drug manufacturers outside the PBM/PMO chains – compounding pharmacies – and trying to take things like methylcobalamin (B12) shots off the market (yeah, the addicts are all lined up shooting that, aren’t they?). On the other end, pharma cartels have merged into behemoths that are often the single source of a drug and they can then shut down factories making them or jack up the price (the extortion of a captive market that Turing CEO Martin Shkreli euphemistically referred to as “price inelasticity”).

    The PBMs/PMOs literally legalized kickbacks in the pharma chain in a way that would result in stiff jail terms in other industries. This is why prices keep going up faster than inflation. More expensive drugs pay bigger kickbacks to the pharmacy chains, thus pushing the cheaper stuff off the market. We have a price-fixing drug cartel system that supplies our life-saving medications. You guys should really cover the bigger picture. Talk to Phillip Zweig at Physicians Against Drug Shortages.

    If you expect money and education to save you from all this, you’re sadly mistaken. An awful lot more people are going to die from what’s happening in American medicine before it’s all over.

    1. RUKidding

      Congratulations for finding a way to stay off Vioxx or other deadly drugs prescribed for you by your Dr.

      My goal? Stay off all drugs for as long as feasible. I watched my aging relatives ingesting many drugs – none quite as bad as the opioids, but still one has to wonder at the efficacy and need for many of them.

      If I wasn’t willing to do a lot of homework myself and also to “Just Say No” to my Dr, I could today be on a plethora of “meds” for various non-conditions. I am also lucky enough to earn enough money to buy really good quality supplements, which helps a lot (given our soil is depleted and even organic veggies & fruits may not have quite the same nutrients they used to), plus I can pay out of pocket to see alternative health care professionals, who can assist me in choosing good alternative supplements.

      Most of the medications prescribed aren’t needed if people ate in a more healthy way, took good quality supplements and got the right kind of exercise. But there’s not enough money to made doing that. Ergo: the first thing your Dr says to you is: here’s a scrip – go take these pills.

      No thanks. BigPharma = BigCrook.

    2. OpenThePodBayDoorsHAL

      Given the monstrous scale and power of pervasive corporate corruption across every industry, from accounting to banking to health to bomb-making, I find myself pining for a countervailing force with sufficient clout to ride herd. Naturally that means the machines of State: regulators, laws, and their enforcers. A deeper look makes it seem an intractable problem, as the machines of State are well and truly greased and operated by fountains of money from the wrong-doers themselves. The only answer seems to be the citizen relying on his own protections: being informed, avoiding Wall St financial products, trying desperately to take care of his own health. But that doesn’t seem like a civilized society any more….it’s “every man for himself”. Depressing. We can’t all go to upstate Vermont and grow our own food…can we?

    3. TheCatSaid

      Great comment. In particular

      When an addicted user returns for a hit, the new feudal lord simply claims he’s meeting market demand. For those libertarians who don’t understand this, there can never be any rational free market in addictive goods whose proper use robs you of that very rationality you need to participate in such a market. It’s by definition impossible.

      I’ll post below about a resource that’s one of my mainstays.

  4. Torsten

    Re: “The US consumes 80% of the world’s painkillers. ”

    Reflecting on the empathy study Yves posted a few days ago, I suppose this explains our soulless predation: “Sorry, we just don’t feel your pain.”

  5. Robert Coutinho

    It’s what I have been saying for a long, long time. “Outlawing murder is bad for business. Think of all those enterprising assassins and their families. They are just trying to make a living by killing.”

  6. divadab

    The cost to me under an Obamacare bronze plan for 30 vicodin (oxycontin+tylenol) – $6 bucks. Easy as pie – a cheap route to addiction, and the tylenol causes kidney damage if you OD.

    Win-win for the predatory insurance-pharma cartel.

    And to get authorization to use cannabis medicine grown by me I have to show that vicodin doesn’t work or has unacceptable side-effects.

    Completely backwards, what a fucked up mess. This is the result of parasitic, traitorous leadership at the highest levels, justified on an ideology that glorifies greed, selfishness, and self-gratification and demonizes vitrues of thrift, hard work*, and responsibility.

    *note that under this ideology, wage slavery in busy-ness, where putting in your time is the key requirement, is how the parasites define “work”.

    1. Dugless

      Vicodin does not contain oxycontin. The opiate in dividing is hydrocodone which is less potent. Opiates may be useful for short term acute pain but should rarely be used for chronic pain. It is a travesty that the big pharmaceutical companies get away with pushing these drugs for this indication. Acetaminophen alone is a very safe and effective pain reliever but can cause liver injury if used improperly.

      1. Dugless

        That should have said the opiate in vicodin is hydrocodone. This is the problem with self correcting programs.

    2. John M.

      “And to get authorization to use cannabis medicine grown by me I have to show that vicodin doesn’t work or has unacceptable side-effects.” The top paragraph above is your starting point, with the second paragraph (the one-line one) possibly providing a further boost by showing the corruption and the mens rea.

      1. Yves Smith Post author

        “Have to show”? I once used vicodin (lost the clot after a wisdom tooth extraction, which is horribly painful, like even huddled in bed it hurts like hell). It did nada for the pain and made me feel even worse (nausea, unable to sleep). I was reduced to taking aspirin every hour, and the next day, Aleve every hour. That made a little dent in the discomfort.

        How do you prove something makes you feel like crap? Just tell them you are still in pain and can’t eat due to the pain and nausea.

        1. John M.

          Oh, my sympathies. I hope my comment didn’t sound callous… If it did, I’m sorry.

          Sounds easy enough to prove, as you put it. Obstructive procedural tactics could stall it or prevent it.

      1. tegnost

        I can usually locate a word or phrase that sends me into the queue, they show up in most cases later on.

    1. diptherio

      What’s the difference between an addict and a repeat-customer? Nothing if you’re slinging smack, whether it’s legal or not.

      The f#@%ers in control at the FDA, the Pharma companies, the Justice Dept, etc. are all criminals. They are LITERALLY killing us. They got my cousin not six months ago. And why do they do this? To get rich. They say it over and over again, but nobody listens. “We have an obligation to maximize shareholder value.” They don’t care about providing useful medications, or improving lives. They don’t care about the effects of their actions on other people. The don’t care about ANYTHING except getting rich. Why can’t we take them at their word and treat them accordingly: like the the f#@%ing psychopaths that they are?

      Everybody looks down on street-dealers, usually poor kids who have the option to sell dope or be destitute. These corporate a-holes could make a decent living doing something that doesn’t destroy countless lives, but they choose not to. The real criminals live in mansions…and we’re all to blame for allowing it to continue.

      In Brazil the police had to keep an angry mob from breaking into the house of the corrupt new President after the release of some incriminating emails. Good for the Brazilian mob! They have some dignity, some self-respect. Where’s ours? Which powerful crooks have we frightened lately? Which elite criminals have we caused to wet themselves in terror and beg forgiveness from an unhearing God for their many sins? Not a single one…which is one major reason why we have the situation that we do today. Shame on us.

  7. sharonsj

    No one is addressing how concerns over opioid addiction negatively impacts people who actually need these drugs. I am 72, handicapped, and I live in a rural area. Thanks to idiot legislators, my doctor can no longer prescribe the drug and fax the prescription to my local pharmacy. Now I must show up in person once a month and prove I am me (although I’ve been going there and getting the drug for the last 10 years). The drive is 35 miles round trip and consumes an hour or more. I can’t make the trip in bad weather and I wonder what will happen when I get too infirm to make the trip at all. I live alone with no relatives. Is some idiot legislator going to bring me my prescription? Hardly. Do they give a fuck? No.

    1. OpenThePodBayDoorsHAL

      Eventually heart-breaking stories by individuals such as yourself pile up…and the corrupt overlords and their systems are swept away. We seem to be a very long way away from that happening in America, at least in Brazil and Chile and France they have the remaining dignity and love of themselves and their fellow man to get mad and get active. Our culture teaches us to hate and be ashamed of ourselves and others so we just whimper back to some quiet corner, curl up in a ball and navel gaze while we try and remind ourselves why we are to blame.

    2. Dugh

      Your heartbreaking situation illustrates the forgotten half of the story. People who benefit from the proper use of opioids are being squeezed by the rampage to deal with misuse.

      Some powerful words I ran across the other day in an article on chronic pain:

      “What people who have never experienced chronic, persistent, relentless pain don’t realize is how it impacts, and largely takes over, one’s life.

      Chronic means the pain is always there. It’s like a toothache that never stops, except that over time the pain radiates through every cell in your body. It may come and go, recede and attack, and you may learn to live with it (indeed you must), but it never goes away, at least not on its own.

      Living with chronic pain day in and day out means managing every moment of your life around it; learning to move in ways that don’t exacerbate it; being hyper-aware of your physical limitations and staying within them; anticipating situations that will cause you pain and avoiding them and disappointing a lot of people who want and expect you to behave like a “normal” person — i.e., a person without pain.

      Furthermore, chronic pain saps your energy, drains your spirit, darkens your mood and makes pretty much everything in life that much less pleasant. It takes a lot of the fun out of living and tends to focus the mind on one elusive goal — reducing and, if possible, eliminating the pain.

      Sometimes, opioids are the only escape.”

      “Routine is important, because it allows you to live within your comfort zone. Break the routine and you introduce all sorts of variables that you might not be able to control. The walk from your parking space to the restaurant might be too long, forcing you to spend the entire meal in quiet agony. The item you’re looking for at Target might turn out to be on other side of the store, beyond your mobility zone. It could be one of a thousand things, but if you can stick to your routine, you know how much pain to expect, and can plan for it.

      Vital Rituals
      What I call “rituals” are routines too, but they’re more important. Rituals are the things you must do every day in order to cope. Medication is part of that. I only resort to opioids (Vicodin, in my case) when everything else fails.”


  8. JustAnObserver

    Just a small anecdote to show just how insidious prescription of opioid painkillers can be:

    About 10 years ago I had a snowboarding accident while skiing in the French Alps. After an XRay the local doctor told me I’d cracked a rib, hence the fairly severe pain esp. when I coughed. Since these days ribs are just allowed to heal up on their own he just prescribed a strong painkiller called Ixprim. Didn’t tell me what it was but just said take these tablets 3 times per day, 10 (14?) days supply. Well … the stuff was nothing if not effective, made the pain move way off into the far distance along with, apparently, all the rest of the world and I felt very peaceful, dreamy even.

    Flew back to London 4 days later but kept on these things for a few days more then my normal dislike of taking pain killers kicked in & I stopped one morning just to see how much pain was left. Several hours later I found my self feeling increasingly depressed. O.k the board crash was stupid but this was more than that. A few hours more and a I find myself heading back to the fridge to take one of these things without even thinking about it.

    At that point something in my brain went Alarm! just what the fuck is this stuff !? A quick Google and found it. Ixprim = acetominophen + an opiod called tramadol (vicodin equivalent) (*). There it was. Just 7 days on this stuff and stopping gave me the first whispers of withdrawal symptoms. If I’d ever done any opiate – opium, morphine, heroin – I’d have recognized that dreamy, disconnected, state for what it was but I’d never even had morphine in hospital.

    A Coda: A couple of months later I was at my doctor’s for something else and I mentioned this little incident. He was furious, said that that stuff was lethal and, in his experience, far more addictive than any of the manufacturers would admit. He’d stopped prescribing that class of drugs unless absolutely required and when he did he’d give the patient a warning over possible withdrawal symptoms; at the time not required.

    (*) According to the Google search Ixprim was about to be restricted or banned in France.

  9. Isolato

    And let’s not forget that Afghanistan went from nearly eliminating the cultivation of opium in the year before our invasion (the Taliban had ruled it “unislamic”) to the world’s largest producer. Thereby secretly funding the CIA now that the magic of crack cocaine from South America has lost its luster.

  10. JimTan

    It’s interesting that Pharmaceutical companies like Purdue have somehow sold doctors on the idea that long term use of Opioid painkillers is not addictive, which common sense tells most people is not true. Purdue is just one firm riding a larger wave of profitable and ‘predatory conduct’ by Pharmaceutical companies that goes unprosecuted. The abuse of clearly addictive Pharmaceuticals includes opioids (molecularly similar to street heroin), amphetamines (used to treat ADHD and molecularly similar to street Methamphetamine), and who knows what else. A good portion of all Pharmaceutical grade opioid and amphetamine use in the U.S. is likely related to drug abuse.

    The FDA approves and certifies drugs, including opioids, for the treatment of specific ailments. I’m sure if someone tried to match the annual number of cases of ailments treated by opioids (NCHS databases) against the annual number of opioid prescriptions filled (IMS Health database), they would find prescriptions FAR outpacing the annual number of corresponding ailments they are approved to treat. These are quantitative ways to track if pharmaceuticals are prescribed for intended use, and if not, which specific retailers (physician and pharmacist) are benefiting most. If lawmakers are willing to look hard enough they have all the tools they need to build deterrents against manufacturers (pharmaceuticals), and retailers (doctors, pharmacists) profiting from drug addiction.

  11. Jacob

    “So Purdue Pharma chose to simply ignore inconvenient data, and the Food and Drug Administration (FDA) chose to let them.”

    The quote refers to the drug maker’s own test data which they submit to the FDA for approval. The FDA doesn’t test drugs for safety and effectiveness; instead, it has a review board which relies on drug makers’ own test data. As with other regulators, Congress has systematically defunded the FDA, rendering it unable to conduct drug testing even if it wanted to test them. To learn more about this, search for “does the FDA test drugs?” or see “Development & Approval Process (Drugs)” at the FDA website.

  12. TheCatSaid

    Great post. I’ve heard Bernie Sanders mention heroin addiction problems and I bet a significant percentage is due to opioid addictions that started from prescription drugs.

    Not just for pain, but for anyone whose current medical team leaves something to be desired, in 1991 a friend gave me a copy of the book “MAP: The White Brotherhood Co-Creative Medical Assistance Program”. It’s now in its 3rd edition, also available in a download pdf version from the Perelandra-ltd website. I can’t recommend this program enough, it doesn’t cost anything to use it and it coordinates beautifully with whatever conventional or alternative medical approaches one chooses to use.

    I told a friend about it a couple weeks ago (back problem for months/years and getting worse; he know I was a former healthcare professional) and when he was visiting again this past weekend he told me he’d started using it and it was already almost all gone. It’s a tool but at least the MAP teams will never bill you and all levels (physical, mental, emotions, soul) are considered together.

  13. flora

    Eugene O’Neill’s play “Long Day’s Journey into Night”:

    It was written about a time before the FDA existed. It could be written again today, when the FDA exists in name only.

    1. flora

      In the play Mary’s addiction began and continued with her doctor’s prescriptions for morphine to treat her pain.

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