One of the current villains in the opioid epidemic is pharma marketing. It is as if the country just woke up and realized that marketing by opioid manufacturers is contributing to – or possibly responsible for – the problem.
What bothers me about this?
In 2001 – that's 16 years ago, yes 16 years -- 13 young people in my area of Florida died in opioid-related deaths. They all reportedly got their drugs from the same doctor, a general practitioner with a one-doctor practice in a strip mall. Kids lined up every day to pay their $65 office visit fee and get their prescriptions.
At a visit about a week before he died, this doctor wrote my then healthy son prescriptions for 100 oxycodone, 120 hydromorphone, and 100 Xanax (alprazolam). My son tried to report her for drug dealing, telling the county prosecutor and a county drug court judge what she was doing.
My son didn't live to see what they did, which was to conduct a sting on that doctor and catch her on tape.
She was tried and convicted of manslaughter, a decision that was later overturned. A retrial ended in a hung jury. She avoided a third trial with a negotiated plea that prevented her from practicing medicine again.
The doctor's insurance company called the victims' families and proactively settled with all of them to the limits of the doctor's policy. It wasn't much, but the families didn't have to litigate or fight for the money.
Yet, one of the things that truly bothered me through all of this was that the amount of opioids this doctor prescribed was so outrageously high. In a single year, she reportedly wrote more than $1 million in Medicaid prescriptions for OxyContin (oxycodone).
How could Purdue Pharma not know?
How could the Purdue sales rep, whose salary was likely volume-based, not know?
And how could they not think something was wrong with a single practitioner in a strip mall office – not a pain clinic – writing prescriptions for that many opioids?
"About 9 million hydrocodone pills were shipped over 2 years to a single pharmacy in a rural town of fewer than 400 people," the Huffington Post reported last week. When I read that, I thought again of that Florida doctor tied to my son's death.
And I wondered how many more doctors there are that Purdue and other opioid makers know exist, yet do nothing to control?
The drug makers say it is not their job to police the doctors, but I think it is.
They police copycats, patent breaches, trade secrets, but don't protect the patients their drugs are designed to help.
I am not anti-opioids, and I have not written about this before.
I have family members who today take opioids responsibly from appropriate sources.
There is not a single villain in the opioid story, but why has it taken 16 years to realize that pharma must take some of the blame?