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Prescription Opiate Crisis: The Climax 2019

Updated: Nov 6, 2019

Has history repeated itself? As the opiate epidemic comes to a head, we reflect how a similar substance was unleashed on the American people a century ago. We will also take a look at what caused this epidemic, the results, and the solution.




(Editor's note: In this article, we will use opioid and opiate interchangeably

Opiate definition: a drug derived from or related to opium; Opioid definition: a compound resembling opium in addictive properties or physiological effects - Oxford Dictionary)


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. Heroin tormented 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


What caused the recent opiate epidemic?


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.1


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? Marketing of a Deadly Substance


· 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.


· 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”.


“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.


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.3


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. 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 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 in revenues. This misleading marketing campaign led to the epidemic of addiction to Oxycontin all over America.





Results: Legal Repercussions and Lives Destroyed


A family caught in the deadly cycle of addiction, desperately using prescription opiates with a child in their vehicle. This type of extreme behavior is not uncommon amongst those addicted.


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 three billion opioid prescriptions were dispensed in the United States alone, peaking in 2012 with 255 million prescriptions.4


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.5 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 opioid lawsuit with West Virginia.6


In August 2019, Endo Pharma, makers of Opana painkiller, agree to an $11 million settlement in Ohio.7 and Johnson & Johnson was ordered to pay $572M in damages to Oklahoma.8


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 2017 with 70,237 drug overdoes deaths in the US alone. That is 192 people dying per day. Although deaths might have involved more than one drug, prescription and/or illicit opioids were involved in 66.4% of these drug overdose fatalities.9 Also, as the prescriptions decline, individuals are turning to more available and deadly substances, such as black-market heroin or Fentanyl.



Everyday, new individuals are introduced to opioids and opiates, trusting their doctors who prescribe them to these pain pills for injuries and such. They then unknowingly find themselves in the downward cycle of addiction, and when the prescription runs out, they find themselves desperate for more of the substance due to the effect it has on the brain’s chemicals. In other cases, those overprescribed may find themselves selling their pills to financially make ends meet. Perhaps they cannot afford medical bills, or they are unable to work. The overprescribed Oxycontin could at one time be sold for a street value of 1$ per mg. Clients who were prescribed two 80 mg Oxycontin per day could potentially sell their month prescription for $4,800. These reason among others have caused the streets to be flooded with pills and normal people to be caught in addiction. These people become lost and hopeless, being blinded to the effects that these drugs are having on their life.


This drug does not discriminate but has found itself in to countless households in America. These individuals become hooked on this substance with no way out, so there is a great need for effective recovery. While the overprescribing trend is on the decline and conditions are beginning to improve, America needs help with this crisis!


The Solution: A 78% Success Rate of Recovery


At Adult & Teen Challenge of Oklahoma, we are “Putting Hope within Reach” of every addict, especially those struggling with Opiate Addiction. We believe that the effects of opiates are so damaging on the body, mind and spirit that a long term, residential program is by far the most successful form of recovery. 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 a 78% success rate these methods are effective. In Oklahoma, we have programs for men, women, and adolescent boys and girls. Adult & Teen Challenge is a Christian 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. We have a solution for the opiate/opioid epidemic. Please contact us at 405-600-1920 or go to www.okteenchallenge.org to find out more about how we can help.


Sources:

1- https://www.newyorker.com/magazine/2017/10/30/the-family-that-built-an-empire-of-pain

2- https://www.washingtonpost.com/graphics/2018/national/amp-stories/oxycontin-how-misleading-marketing-got-america-addicted/

3- https://www.washingtonpost.com/graphics/2018/national/amp-stories/oxycontin-how-misleading-marketing-got-america-addicted/

4- https://www.cdc.gov/drugoverdose/maps/rxrate-maps.html

Facts/History

https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis

5- https://www.cbsnews.com/news/purdue-pharma-settlement-oxycontin-maker-reaches-tentative-deal-opioid-crisis-today-2019-09-11/

6- https://finance.yahoo.com/news/oklahoma-reaches-85-million-settlement-teva-pharmaceuticals-ahead-160807547--finance.html

7- https://www.inquirer.com/business/endo-opioid-lawsuits-settlement-trial-20190820.html

8- https://www.foxbusiness.com/healthcare/johnson-johnson-verdict-in-17b-opioid-lawsuit

9- https://www.cdc.gov/nchs/products/databriefs/db329.htm

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