Opiate addiction

The news was grim.

“I received a call that people were pouring into the emergency room dead on arrival after taking counterfeit Norco laced with fentanyl,” Sacramento County Public Health Officer Dr. Olivia Kasirye told health professionals gathered at the Prescription Drug Awareness Conference held at Sacramento State University on May 20.

Trying desperately to prevent additional deaths, Kasirye says she went into overdrive to get the word out about this dangerous batch of fake Norco. Norco is a prescription painkiller, but this batch contained fentanyl, a powerful painkiller hundreds of times stronger than heroin.

Luckily, she was able to. Otherwise, this could have been much worse. Fifty-two patients were admitted for fentanyl overdoses, and eventually 12 people would die. But this will probably make up less than 10 percent of the Sacramento County residents who will die this year from drug poisoning.

Americans are misusing opiates at a frightening rate. According to the Center for Disease Control, in 2014, there were more than 47,000 drug-related deaths, 40 percent more deaths than from car accidents. An estimated 2 million Americans abuse or are dependent on prescription opioids.

It is this crisis that brought together Rep. Ami Bera, representatives of the Department of Justice, Pain Management Specialist and California Medical Association board member Dr. Lee Snook, and other local healthcare leaders, to discuss how prescription drug abuse affects the healthcare industry.

How did we get into this mess? The speakers agreed on the facts. For many years, patients were undertreated for pain, due to fears of addiction to pain medications. In the mid-1980s, there was talk about reducing unnecessary pain for patients. This led to new regulations encouraging pain relief. But, the most effective pain medications are opiates, which are very addicting, and doctors were still reluctant to prescribe them.

In 1996, Purdue Pharma came out with a new drug called OxyContin, which they heavily marketed as being less addictive than other painkillers on the market, in one of the most aggressive marketing campaigns for any narcotic ever. As a result, the company made billions of dollars in sales. But as sales of OxyContin skyrocketed, overdose deaths rose at about the same rate, and new studies came out that showed that OxyContin was, in fact, highly addictive. In 2007, Purdue Pharma had to pay $600 million in fines for misleading doctors and patients.

But the addiction problem continued to grow. According to the CDC, in 2013, a quarter-billion prescriptions were written for opioids. This is more than enough to give every American adult his or her own bottle of pills.

When I asked the Department of Justice speaker why her department lets the company that created the opiate problem continue to make money selling this abused drug, she had no answer. People can go to jail for passing a few bad checks, but the banks who earned billions of dollars from fraud got a bailout. Drug dealers on the corner go to prison, but the pharmaceutical industry makes billions of dollars from these highly addictive drugs, with minimal consequences.

So what has been the response of the pharmaceutical industry to this opiate epidemic? Will it donate a percentage of its profits to help those whose lives it has destroyed? Probably not.

Instead, Big Pharma wants to eliminate low-cost generic drugs and to replace them with similar, much more expensive, patented drugs. What a surprise.

Instead, Big Pharma has used its political muscle to prevent the federal government from negotiating drug prices for Medicare—the largest government purchaser of health care.

At this workshop, I heard about a plan to have pharmacies that disperse prescriptions be required to take back leftover drugs so that they will not be used or disposed of. This is being done in Canada and could be paid for by a small fee levied on drug companies. A few pennies per prescription, and it might make a small dent in this problem.

But Big Pharma opposes this plan. Again, not a surprise.

The U.S. is the only country in the world facing this ballooning prescription drug problem. Our capitalist system treats health care as just another profit opportunity, one reason that we pay more than 50 percent higher costs than other industrial countries for inferior health outcomes. Unless this changes, or the government steps in to put controls on these pharmaceutical companies, it’s going to be very difficult to contain this epidemic.