The health care system has been devastated by the opioid epidemic. Addictive opiate medications have not been shown to benefit patients with chronic pain, yet they are the most prescribed pills in the United States.
As a pain management physician, I have seen opiates, when in the wrong hands, destroy lives. As doctors and health care organizations scramble to treat more than 2 million Americans suffering from opioid addiction, drug companies look to expand their brand. Recently, Mundipharma, a global network of pharmaceutical corporations, began a worldwide marketing campaign for Oxycontin, the drug at the heart of America’s opioid crisis. If they are allowed to succeed, America’s opioid epidemic may quickly become our main export.
Opiates have a muddied history in American health care. For years, these drugs, such as morphine, were only used for acute and end-of-life pain but otherwise avoided due to powerfully addictive tendencies. People suffered from chronic pain but had no options. Thus, there has always been a need for a “non-addictive” pain medication.
In the early 1900s, heroin was introduced as that miracle drug. The nation watched in shock as prescription heroin unleashed a medication epidemic. In the 1990s, the mistake was repeated when Purdue Pharmaceuticals released Oxycontin. The results were much worse because Purdue unleashed a marketing campaign never before seen in healthcare.
Oxycontin was specifically advertised as the miracle “non-addictive” opiate medication. Purdue either leveraged physicians into leadership roles or silenced critics with threats of lawsuits. Purdue lobbied politicians and medical organizations to support regulations pressuring doctors to prescribe opiates for chronic pain. They even started marketing to patients; a concept never before used in healthcare. Purdue’s aggressive campaign, based on a lie, made Oxycontin the first billion-dollar drug.
The truth is, Purdue knew Oxycontin was powerfully addictive. In 2007, they were found guilty of misbranding and ordered to pay $600 million. By then, the damage was done. Over 500,000 Americans have died from opioid-related causes, and more than 75 people die every day. Chronic pain is the most common reason patients visit their primary care physicians, yet most doctors feel inadequately trained in safely managing this condition. I see patients every day with chronic pain; it is debilitating, and many are desperate for answers. Unfortunately, most patients are woefully uneducated about their condition and treatment options. The biggest challenges are correcting the misconceptions that chronic pain is completely curable and pills make people pain-free, especially when amplified by marketing campaigns. This mindset drives patients towards opiates and is the main obstacle in ending the opioid epidemic.
Despite Oxycontin’s devastating effects, Mundipharma, whose group includes Purdue Pharmaceuticals, is using the same strategies worldwide that resulted in Purdue’s lawsuit. Doctors in China and Brazil are urged to overcome “opiophobia” and patients are given discounts for opiates. Commercials in Spain show individuals struggling with and then overcoming chronic pain with the help of Mundipharma’s drugs. Mundipharma’s lobbyists are even urging foreign governments to aggressively reform their opiate prescribing policies.
This is the same formula that led to America’s opioid epidemic. International chronic pain patients are desperate for an answer. They are unaware of the 25 percent addiction rate for Americans on chronic opiates or that patients from Purdue’s “Swinging in the Right Direction with Oxycontin” commercial swung right into addiction. They simply want to feel better.
It is not just patients. Physicians worldwide are not prepared for opioid management. Opiates have never been part of their treatment plans, and now patients are coming to their clinics and asking for these pills. Many countries do not even have the screening tools to manage opioid therapy let alone the basic resources for substance use disorders.
Chronic pain is a tough condition, and I empathize with my patients. Most are hard-working people who just want to care for their loved ones. Some have become addicted to opiates, but many have not. Regardless, they are all victims of the opioid epidemic. Companies like Purdue took advantage of them.
Now, physicians like myself are left to pick up the shambles of opiate misuse and redefine our approach to chronic pain. Like locusts, Mundipharma has consumed our most valuable resource, our people, and are now finding new victims. As Americans, we have seen the destruction opioids can cause if not carefully regulated. Other countries are not prepared for what is headed their way. We are looking at the globalization of Oxycontin, one of the world’s most addictive prescription pills. We are already battling an opioid epidemic: We do not have the resources for a global pandemic.
Ankur Dave is a pain management specialist.
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