Pharmaceutical Industry: Saints or Sinners?

The opioid crisis is again in the news and on the rise with over 75,000 U.S. deaths in the past 12 months reported from overdosing. Up 35 percent from the year before. Two reasons for this tragic statistic:

1. The COVID-19 inspired lockdowns, job losses and business restrictions and closings, and general societal upheaval has exacerbated opioid deaths.
2. Lawsuits against pharmaceutical companies and opioid distributors are making their way through the courts to varying degrees of success.

When new incarnations of these drugs became front-page news back in the mid-1990s, I remember being confused: why were so many people becoming addicted to painkillers? I thought our society had it easier than previous generations; we didn’t work as much in the tough agricultural industry or do heavy labor in factories like our parents or grandparents’ generation had.

True enough that society has changed in many ways, and one way is that we’ve become far more comfortable with medical interventions of all sorts. Taking pills for a broad array of issues is common today. A recent survey found that 55 percent of Americans regularly take prescription medications – and they're taking more than ever.

Econ 101 suggests demand for pharmaceuticals is high. So of course, suppliers step up supply. This is true beyond opioids.

Also back in the 1990s, I had a particular experience that has stuck with me. We took our son to see our pediatrician who diagnosed him as suffering from an inner ear infection. She prescribed an antibiotic, but not knowing whether the infection was viral or bacterial, she didn’t want to overprescribe antibiotics which are useless against viruses. She suggested we not fill the prescription for 24 hours, and instead wait to see if the infection would dissipate on its own. We waited. It did.

The follow-up visit is what had particular resonance for me. After we thanked her for her caution, she shared how frustrating it can be dealing with parents who may have a more interventionist attitude. She said most people simply want the problem addressed, no matter what. Give me pain relief! Right now!

I can’t help but think that our desire for pain killers is also market-driven, meaning we want it. No matter what.

This doesn’t take companies off the hook, especially if they misled the public on the addictive severity of the drugs they were marketing. That’s what the courts are trying to establish, that there are clear communication trails where the manufacturers knew what they were selling wasn’t quite as benign as they had aggressively packaged.

Did they lie to us, get us hooked, just like a street illicit drug dealer does? Courts have come down on both sides of the issue, and many times the devil is in the details, even in terms of what statuettes are used to buttress the prosecution's position.

Some culprits have emerged. Purdue Pharma pled?guilty?to various felonies in 2007 and again last year, and Insys Therapeutics executives were?convicted?of bribing physicians to prescribe opioids and defraud insurers. Yet aside from these companies, proof of deliberate wrongdoing is scarce. Nevertheless, companies are eager to mitigate litigation risk by settling. Which in the public eye, might suggest a level of guilt.

Our liability laws work to protect us from unscrupulous business practices. Unfortunately, we don’t seem to be able to hold to account the federal agencies like the Food and Drug Administration (FDA), or the Drug Enforcement Administration (DEA), who approved all of the processes the companies engaged in. Worse, company representatives helped modify standards for the agencies. And because the government and the private sector can tango with the best of them, many at the FDA left their jobs to take on cushy roles at pharmaceuticals.

Shouldn’t the agencies share the blame in the culpability that is being leveled at big pharma?

There is a touch of irony too in our zeal to paint the pharmaceutical companies as devils who pushed drugs upon an unwary public. Because in fact, many are the same companies that we hailed as heroes and saviors of the world for the cutting-edge vaccines they came up with in record time. And the same agencies that allowed a nation to abuse opioids are the same agencies urging us to get vaccinated!

Makes you think…

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