Selling Our Health
Guest writer Arran Woodbury
Selling Our Health
When the first doctors, shamans or medicine men started practicing their craft, one of the underlying reasons for their undertakings, indeed their very existence, was to relieve the basic human condition of pain. Over the course of centuries, as science evolved and our knowledge of human anatomy and physiology blossomed, our ability to stop what was causing our pain grew exponentially. However, recently there has been a burgeoning medical industry aimed not at solving the root cause of pain, but simply managing the pain itself through synthetic medication. When did this shift in philosophy take place and what was the catalyst for it take such a prominent role in modern medicine despite its harmful side effects?
The relief of pain has played an important role in the advancement of medicine throughout our history. Whether salves or potions, it was a crucial aspect of a physician’s job to help an injured or sick individual to deal with the pain associated with their affliction. Derivative substances from opium poppies were used by ancient cultures for many centuries to relieve pain, but according to DrugFreeWorld.com it wasn’t until the early 19th century that morphine, in its pure form, was extracted and it was used heavily during the American Civil War. The first synthetic opioid, hydrocodone, was first produced in the early 1920’s and then introduced as Vicodin in the late 1970’s. However, it wasn’t approved by the FDA until 1983 (“Life without Vicodin”). “But the story of the painkiller epidemic can really be reduced to the story of one powerful, highly addictive drug and its small but ruthlessly enterprising manufacturer” (Mariani 2).
The real starting point on this sordid tale is December 12, 1995 (Meier and Petersen). It was then that the FDA approved OxyContin and it hit the streets (or in this case, the doctor’s offices) early the following year. It wasn’t as if this newly approved drug from Purdue Pharma was trying to do what pain medications hadn’t done in the past. On the contrary, OxyContin was a known opioid from its inception. Yet, the marketing point that fueled its growth was, ironically, its safety as it touted itself as a slow release tablet (Meier and Petersen). It was promoted that its potential for abuse would be highly unlikely as it didn’t produce the “rush” or “high” usually associated with opioids. One would think that in the United States, at the end of the 20th century, there would be mechanisms in place to ensure the company’s claims were accurate. It didn’t take long for the claims to not only be overblown, but to be shown to be completely untrue.
As mentioned earlier, alleviating pain had always been an unwritten part of a physician’s job description in trying to look out for their patient’s best interests. Before OxyContin was introduced, opioid pain medications were primarily aimed and used for chronic pain associated with cancer patients (Moghe). Because of the addictive nature and potential for abuse, opioids were not prescribed by doctors for anything other than patients in severe and constant pain. When OxyContin hit the market its producers decided that advising doctors to prescribe it to only their most severely suffering patients was limiting their potential for new “customers”.
Purdue Pharma “used an often criticized, but increasingly common marketing strategy: currying the favor of doctors in private practice with free trips and paid speaking engagements” at pain management seminars being held around the country (Meier and Petersen). In its first four years on the market, profits for the company increased well over 2000% (Mariani).
It seems the dark side of human nature emerged as newly formed organizations such as the American Pain Foundation, the American Board of Pain Medicine and the American Academy of Pain Medicine Foundation amongst others, looked to cash in on the suddenly lucrative field of pain medication. The American Pain Foundation “voluntarily” shut itself down in 2012 amid senate investigations after it was revealed that it received 90% of its funding during a fiscal year from the drug industry and that “its guides for patients, journalists and policymakers had played down the risks associated with opioid painkillers while exaggerating the benefits”(Ornstein and Weber). Sen. Max Baucus said in a statement during the investigation that “when it comes to these highly addictive painkillers, improper relationships between pharmaceutical companies and the organizations that promote their drugs can put lives at risk” (Ornstein and Weber). Another leading promoter of pain medicines, the UW Pain and Policies Studies Group was also in on the act. Also created in 1996, it was revealed in an investigative report by the Milwaukee Journal-Sentinel that the group had received millions of dollars in funding from pharmaceutical companies. The biggest of these contributors was Purdue Pharma who “in 2007 was accused by the US Dept. of Justice of fraudulently misleading doctors by claiming, with no proof, that the drug was less addictive, less likely to cause withdrawal and less subject to abuse than other pain medications”(Fauber). The company and three of its top executives pleaded guilty to this and paid fines and restitution payments in excess of $635 million (Fauber). To most people that sounds like an astronomical amount of money but according to Claire Bernish of The Free Thought Project.com, estimates of Purdue Pharma’s profits from OxyContin alone totaled over $30 billion from 1996 through 2015. It is under the guise of these “impartial” agencies advice that even doctors who weren’t prescribing these medications to get free trips or paid speaking engagements were fooled into believing they were helping their patients with little or no risk.
In a letter to physicians dated August 2016, the United States Surgeon General, Vivek H Murthy M.D., M.B.A. said “Nearly two decades ago, we were encouraged to be more aggressive about treating pain, often without enough training and support to do so safely. This coincided with heavy marketing of opioids to doctors. Many of us were even taught–incorrectly—that opioids are not addictive when prescribed for legitimate pain. The results have been devastating. Since 1999, opioid overdose deaths have quadrupled and opioid prescriptions have increased markedly—almost enough for every adult in America to have a bottle of pills. Yet the amount of pain reported by Americans has not changed.”
In 2014, the DEA finally started taking action against companies aggressively marketing the safe use of opioid analgesics for non-chronic pain. As per usual with government intervention, it is reactionary and comes after many of the people responsible have wiped their hands clean and the damage done. Unfortunately for many people, including myself, who have lost friends, family members and other loved ones to the swath of destruction caused by these drugs, it has come far too late and with the money still being generated by this :industry” it is here to stay. . As of August 30th 2016, the American Academy of Pain Medicine Foundation still has this chilling message on the front page of its website. “It is critical that each of us supports the AAPM Foundation’s research and educational mission. The Foundation has worked hard to foster a commitment to research and educational development helping to ensure the future of the profession of pain medicine.”
Fauber, John. “UW group ends drug firm funds.” Milwaukee Journal-Sentinel 20 June 2011
Mariani, Mike. “How the American opiate epidemic was started by one pharmaceutical
Company.” Pacific Standard 4 March 2015
Moghe, Sonia. Opioid history: “From ‘wonder drug’ to abuse epidemic.” CNN.com 12 May 2016
Meier, Barry and Petersen, Melody. “Sales of Painkiller Grew Rapidly, But Success Brought a
High Cost.” New York Times 5 March 2001
NY Magazine. “Life without Vicodin.” 2 July 2009
Ornstein, Charles and Weber, Tracy. “American Pain Foundation Shuts Down as Senators
Launch Investigation of Prescription Narcotics. ProPublica 8 May 2012