By Lowlan Breaux

October 16, 2019

2019 Update on the Prescription Opioid Epidemic

Did History Repeat Itself? 

In 1874, an English Chemist by the name of C.R. Alder Wight first synthesized a drug that would later be known as heroin. In 1895, the pharmaceutical company Bayer began a marketing push to sell this drug as a cough suppressant and safe alternative to Morphine, a powerful opiate that troubled the 19th century society. Little did they know at the time, they had unleashed one of the most powerful and addictive substances onto the American people and the world that would torment the people of the 20th century and continues to burden society today.

"Those who cannot remember the past are condemned to repeat it." George Santayana

In 1995, Purdue Pharma released Oxycontin, a prescription opiate with the main ingredient being oxycodone, a substance with double the power of morphine. Like heroin, they marketed this prescription drug as a safe alternative for pain management. While oxycodone and other opioids were previously in existence, they were never marketed with quite the fervor as Oxycontin, creating a “breaking -of-the-floodgate” type reaction to prescription opiates.

Before Oxycontin, doctors were cautious about prescribing opiate prescriptions and oxycodone related drugs, realizing the dangers and risks of addiction. That paradigm all changed when Purdue unveiled their “safe alternative” to the pain management world. 2 According to the Washington Post, from 1996 to early 2000s, Purdue unleashed a marketing campaign to sell Oxycontin, which would persuade doctors to prescribe opioids despite the known risks of this class of drugs.

How did they do this?

  • Promotional videos on the drug were sent to tens of thousands of doctors. These videos manipulated the fears of opioid addiction to being seen as blockers to compassionate pain treatment.

  • Well-known doctors were hired by Purdue to create educational videos about the drug’s effects. These educational videos were used to market Oxycontin and helped receive buy-in from countless doctors. These videos included testimonies of “successful” opioid treatment. Many of the individual’s used in these testimonies were later found to have serious issues as a result of this medication.

  • Purdue pushed to redefine the scope of addiction as a more acceptable practice towards pain management. Pain became considered a 6th sense. Patients were encouraged to reveal their pain level from a 1 to 10 ranking. Based on their ranking they would administer powerful sedatives. The quality of the patients treatment was many times recognized by the doctors ability to treat this pain, pressuring the doctors to use a higher dosage of these opioids to receive positive ratings from insurers.

“It became almost a movement, almost a religious-like fervor, around expanding access to opioids.” Said Dr. Andrew Kolodny, the co-director of opioid policy research at Brandeis University. Pain became a treatable symptom via Oxycontin and other opioids with little regard for the consequences.

  • Purdue manipulated statistics in the New England Medical Journal to show a low addiction rate with their medication.

  • They utilized a massive sales force that pushed Oxycontin on doctors through personal visits and “educational conferences”.

In a GAO analysis of Purdue data, the available sales representatives increased 73% in the first 7 years of Oxycontin’s release. Sales reps were rewarded with cash prizes and vacations. They went from spending $700,000 in 1996 to $4.1 million by 2001 in marketing and ads in reputable medical journals. Their ads were misleading to say the least. As a result, The Pharmaceutical Research and Manufacturers of America issued voluntary guidelines for the promotion of prescription drugs, that did not exist before Purdue’s marketing effort. They had clearly taken their marketing to a new level that had not existed with a Schedule II controlled substance.

Purdue pushed this dangerous substance on the American people with seen public marketing campaign, utilizing renown doctors to receive public buy in and a massive sales force to spread the prescription into doctor’s offices around the country. Before Purdue, doctors were cautious about the way they treated pain and prescribed pain pills. Purdue changed the way that society looked at pain, becoming viewed as an easily manageable and treatable symptom. The treatment came with terrible consequences, costing hundreds of thousands of Americans their lives and countless more individuals and families of individuals misery and torment through addiction. Prescriptions to Oxycontin for non-cancer pain increased 10-fold as a result of Purdue’s marketing campaign. In 1997, doctors wrote 670k Oxycontin prescription for non-cancer pain, and by 2002, that number had increased to 6.2 million prescriptions that year, resulting in billions of revenue.

Three top executives from Purdue have since pled guilty to misbranding their product. These men paid a total of 34.5 million dollars. An outrageously menial amount when you think of the lives destroyed as a result. Comparing this to the Enron scandal, where executives were given prison sentences, there appears to be a misrepresentation of justice.

 

The resulting effects of the marketing push by Purdue created a wave of doctors overprescribing not only this opioid but also a variety of other prescription pain killers, such as Vicodin, morphine, Percocet, Loritab, Oxycodone, fentanyl, Demerol, and others. Since 2006, close to 3 Billion opioid prescriptions were dispensed in the United States alone, peaking in 2012 with 255 million prescriptions. 8- https://www.cdc.gov/drugoverdose/maps/rxrate-maps.html

As a result, the United States government and many states are retaliating and looking for financial retribution. Although these drugs were approved by the FDA, many feel these drugs were falsely marketed and overprescribed. Several states have received settlements from various pharmaceutical companies and a number of doctors have received prison sentences as a result of their over prescribing. 

An agreement to settle thousands of opioid cases has been made where Purdue will file for a structured bankruptcy and pay as much as $12 billion overtime, with about $3 billion coming from the Sackler family. -4 Many states are not agreeing to these terms and may seek further retribution.

In March 2019, Purdue and members of the Sackler family reached a $270 million settlement to avoid trial in Oklahoma.

Other Opioid Settlements

In May 2019, Teva Pharmaceutical Industries LTD ordered to pay $85M to Oklahoma and distributor McKesson Corp. settles opiod lawsuit with West Virginia.

In August 2019, Endo Pharma, makers of Opana painkiller, agree to an $11 million settlement in Ohio.-6 and Johnson & Johnson were ordered to pay $572M in opioid case in Oklahoma

While many cases are still open and are awaiting trial or settlement, you can see that the opioid epidemic has become a large enough issue that the US government is seeking justice.

While the number of dispensed prescriptions has declined, the consequences of this wave are as prevalent as ever with many people continuing the trend of overdose and need an opioid rehabilitation program. According to Centers for Disease Control and Prevention, a record number of drug overdoses deaths occurred in 2016 of  63,632, a rate of 19.8 per 100,000 persons. Although deaths might have involved more than one drug, prescription and/or illicit opioids were involved in 66.4% (42,249) of these drug overdose fatalities. Also, as the prescriptions decline, individuals are turning to more available and deadly substances, such as heroin or Fentanyl. Everyday new individuals are introduced to opioids and opiates and are finding themselves in the cycle addiction. They become lost and hopeless. There is a great need for effective rehabilitation.

At Adult & Teen Challenge of Oklahoma, we are “putting hope within reach”. Unlike many costly, inpatient rehabilitation programs, Adult & Teen Challenge will not be a financial burden for you or your family. For over 60 years, we have utilized methods that are proven, and with around an 80% success rate these methods are effective. In Oklahoma, we have programs for Men, Women, Boys & Girls. Adult & Teen Challenge is a faith-based, inpatient, long-term recovery program. If you or someone you know is struggling with opiate or opioid addiction, prescription addiction, or any other life controlling issue, we are here to help.  

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