A Doctor's Response: Pharmaceutical industry misleads on opioid-addiction epidemic
The "Statewide View" column by Josh Bloom on March 3 regarding the opioid-addiction epidemic was profoundly misleading ("We're getting it all wrong with policies on opioid addiction").
But that came as no surprise. Bloom's employer, the Washington, D.C.,-based American Council on Science and Health, is a pro-industry organization known for defending corporations against concerns raised by scientists and consumers, according to Sourcewatch. Although it is not clear who funds this organization currently (it no longer has to disclose), in 2012 it was funded by large corporations, including pharmaceutical companies and private foundations like the Koch Foundation (a tool the Koch brothers use to promote their pro-industry, anti-regulation ideology).
I have worked in health care since 1986. Unfortunately, I have significant experience with the opioid epidemic and am well aware of the research that exists on the subject.
Contrary to Bloom's assertion, this epidemic began in the 1990s. It was, in part, a result of the financial influence of pharmaceutical companies. Through aggressive marketing and the funding of research, pharmaceutical companies, some of which had developed new preparations like Oxycontin, heavily influenced our approach to the treatment of pain. Undertreatment of pain was portrayed as a crisis. State medical societies began to mandate documentation and treatment of pain. Despite little scientific support, opioids became the treatment of choice for all pain — even pain that was formerly considered short-term and relatively mild.
The risks of addiction and abuse associated with this change in practice and the accompanying new opioid formulations were deliberately minimized by the pharmaceutical industry. The New Yorker had an excellent article chronicling this on Nov. 8, 2013, headlined, "Who Is Responsible for the Pain-Pill Epidemic?"
Heroin and fentanyl do account for more opioid-related deaths today, but that is a recent phenomenon. Years ago, health care experts recognized the epidemic of opioid dependence was a direct result of the overprescription of pain pills. A reevaluation of the available evidence on the treatment of pain and opioid addiction helped us develop tools and guidelines to protect patients from inappropriate prescribing. As the supply of these highly addictive prescription opioids decreased, illegal opioids like heroin, which largely had disappeared from much of the United States, reappeared.
Bloom was not just mistaken about this, his goal seemed to be to deceive readers. His supporters (pharmaceutical companies) seem to want you to believe the epidemic of opioid addiction is a direct result of the inappropriate regulation of the industry by an overzealous governmental agency imposing ill-conceived restrictions. That is not true.
The new rules substantially decreased the numbers of opioids prescribed and, thereby, the pills available. Whether they were prescribed, stolen from a medicine cabinet, or consumed at a party, these pills, for many, were the gateway to heroin. Bloom argued that if more pills were available, people who suffered from opioid addiction would not have had to switch to heroin and therefore fewer would be dying. What he failed to mention was that many were dying from prescription opioid overdose already. The return of heroin and the arrival of fentanyl, both cheaper and more potent, was inevitable.
I am confident our treatment of pain today is evidence-based. More importantly, it is safer and more appropriate than it was even five years ago.
Opioid addiction destroys health and kills too many in the prime of their lives. Communities like ours struggle to provide the care necessary for those who suffer from this disease. Instead of offering solutions, the pharmaceutical industry, through spokesmen like Bloom, obfuscates the issue in an apparent attempt to deflect blame and protect profits.
Imagine if the pharmaceutical industry financially supported established approaches to prevention and treatment instead of advocacy groups that protect its interests.
We should expect more from corporate America and the people who speak for it.
Dr. Nicholas Van Deelen is an emergency physician at St. Luke's. He has been working in Duluth since 1997 and is involved in community-based efforts and at St. Luke's to address the epidemic of opioid addiction.